Design and Application of Implant Supported Compressive Resilient Restorative Appliances.

Objectives: Complete, quadrant, or single unit restorations supported by multiple or single implant placements commonly involve the use of occlusal components that are constructed of zirconium oxide materials. Despite durability advantages, such materials may be problematic in applications where decreased material resilience, significant weight and high hardness of prosthetic materials can result in excessive wearing of opposing dentition, unfavorable stress on supporting implants, and abutment component fractures. The present research describes the clinical application of a VEICRR (Virtual Esthetics Implant Compressive Resilient Restoration) prosthetic which includes a replaceable and easily modified polymethyl methacrylate (PMMA) occlusal portion, cemented using a dual-cure resin combined with custom mechanical retention into a zirconium tissue base which is screw retained onto supporting implant(s). This "hybrid" combination provides an alternative to issues that can accompany zirconium-type restorations.
Methods: From a one-year sample patient population (n=20+), completed cases utilizing zirconium-PMMA hybrid appliances are described including: full-arch prosthetics, multi-unit bridges, and single crowns, supported by single or multiple implants, and opposing restored or natural dentition.
Results: Descriptive clinical results demonstrate that within this timeframe, there are; 100% retention rates, 100% patient acceptance, and a 40% incidence of subsequent successful modifications (i.e. esthetics, implant failures, and regional changes in existing or prosthetic dentition).
Conclusions: In conclusion, the preliminary data supports further study of this flexible and esthetic restorative approach that reduces complexity when alterations on implant supported occlusion arises, and suggests reduced stress on supporting abutments. Expanded numerical analytic comparison modeling and expanded clinical studies are underway to further validate the VEICRR restorative option for addressing concerns of rigid implant supported restorative applications.