When delivering a full arch layered zirconia implant-supported prosthesis, a relatively common complication is chipping or fracture of the layered porcelain. Nowadays, we are moving away from prostheses that need 360-degree layered ceramics to a minimal layering design or fully monolithic to minimize the risk of chipping.

This visual essay walks through the basic steps of solving a fracture problem on a full arch layered zirconia implant-supported prosthesis.

Frontal view on the day of insertion of a full arch layered zirconia implant-supported prosthesis on the maxilla and a hybrid implant-supported prosthesis on the mandible.
Five years after insertion, the patient fractured the buccal porcelain on #7, #8 and #9.
Close-up view of the fractured porcelain with a black contrastor.
The prosthesis was removed and analyzed in the master cast. No damage was observed in the zirconia framework or any other area of the prosthesis.
A PVS impression was made and both the impression and prosthesis were sent to the laboratory for veneer fabrication.
Porcelain veneers were fabricated while the patient utilized the prosthesis that was saved in the patient's box as a
Intaglio surface of the veneers before etching.
Frontal view of veneer try-in in the prosthesis.
Occlusal view of veneer try-in in the prosthesis.
Hydrofluoric acid etching of the intaglio surface of the veneers.
Hydrofluoric acid etching of the surface of the prosthesis.
Etched and silanized surface.
Bonding agent application to the receiving surface.
Bonding agent application to the intaglio surface of the veneer.
Veneer resin cement is applied and the veneers are seated in place extraorally in the master cast.
Excess cement is removed carefully and polished.
Frontal view of the repaired prosthesis on the master cast.
Frontal view of the repaired prosthesis seated in the patient's mouth.
Frontal view of the prosthesis after the occlusion was adjusted and polished.
Frontal view of the 3-year follow-up.

A step-by-step technique to solve the porcelain chipping/fracture of a full arch layered zirconia implant-supported prosthesis is a very simple way to fix this problem without remaking the entire prosthesis.

Ricardo Mitrani, D.D.S., M.S.D., is a member of Spear Resident Faculty.


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