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All-Ceramic Surveyed Crowns For RPD Abutments
All-Ceramic Surveyed Crowns For RPD Abutments
All-Ceramic Surveyed Crowns For RPD Abutments
Sergio Kancyper, DDS, MS,a Marianella Sierraalta, DDS, MS,b and Michael E. Razzoog, DDS, MS, MPHc
University of Michigan, Ann Arbor, Mich.
All-ceramic restorations may have limitations when used in combinations with other treatment
modalities. Removable partial denture (RPD) abutment crowns are typically shaped to provide
guide planes, rest seats, and retentive areas. Porcelain-to-metal crowns are routinely fabricated with
retentive contours in the veneering porcelain, but until recently, the contours of the other portions
of the restoration were developed in metal. This article describes the fabrication of all-ceramic
crowns for RPDs with rest seats and guide planes in densely sintered aluminum oxide and retentive
areas in veneering porcelain. Within the limitations outlined, this procedure allows the practitioner
to use all-ceramic crowns in situations previously reserved for metal or metal-ceramic restorations.
(J Prosthet Dent 2000;84:400-2.)
PROCEDURE
1. Select the teeth that are going to serve as abutments for the RPD, and survey the cast to determine the path of insertion.
2. Design the RPD on the cast and resolve the anticipated positioning of the occlusal rest seats, clasps,
aGraduate,
Prosthodontics.
Assistant Professor, Department of Biological and Material
Sciences.
cProfessor, Department of Biological and Material Sciences.
bClinical
VOLUME 84 NUMBER 4
Fig. 5. Mirror photograph after fabrication of RPD framework casting and crowns are evaluated to determine intimate contact before addition of base and replacement teeth.
4. Make a full arch impression of the relevant anatomic landmarks, along with the tooth preparations.
401
6. Verify the occlusal contacts and marginal adaptation of the crown. Cement these all-ceramic
crowns using any accepted luting agent, then
make a new impression for an RPD using conventional methods to complete the fabrication of the
prostheses (Fig. 5).
DISCUSSION
Although traditional approaches have and will continue to function for the majority of dental patients
requiring RPDs, the proposed technique offers alternatives for both the dental patient and practitioner. The
outlined technique customizes aluminum oxide copings to provide a strong and smooth substructure that
incorporates guide planes, cingulum, and occlusal
rest seats while the retentive areas are developed with
veneering porcelain. By using this approach, practitioners who are familiar and comfortable with allceramic crowns may continue to use them in
conjunction with RPDs. Although not illustrated in
this article, dental laboratories are offering RPD clasps
with tooth-colored surfaces to mask out the metal
color, and the described technique for abutment
crown fabrication may be of benefit for that specific
patient situation. In addition, veneered aluminum
oxide partial denture abutment crowns may be of use
for patients who claim metal sensitivities and for whom
titanium RPD frameworks are prescribed. What is
missing from the published dental literature is longterm clinical studies of the soft tissue response to the
specific described type of restoration. The question
remains whether soft tissue response to polished aluminum oxide is the same or better than polished metal
or veneer porcelain.
The radius of 1.25 mm for the sapphire-tipped
probe constitutes the limits of the scanner to reproduce rest seats in the abutment. If the rest seat is smaller than 1.25 mm in any dimension, the probe tip will
not be able to record the surface topography, and the
resulting coping will not contain the area for the
occlusal rest seats. Therefore, it is important to follow
accepted formats for the development of rest seats.1
402
SUMMARY
Issues of esthetics, biocompatibility, and the
increasing cost of dental alloys have caused the practitioner to look for alternatives to the traditional cast
alloy or porcelain-fused-to-metal restorations. Until
recently, all-ceramic crowns could not be used for
RPD abutments because they lacked the strength to
withstand forces generated by the framework. The
procedure described in this article should be useful for
practitioners who wish to replace traditional materials
used for crowns supporting RPDs with all-ceramic
crowns. With the use of CADD/CAM technology, it
is possible to fabricate crowns for partial denture abutments with conventional support mechanisms for
proper guide plane, rest seat design, and rest seat
preparation.
REFERENCES
1. Rudd RW, Bange AA, Rudd KD, Montalvo R. Preparing teeth to receive
a removable partial denture. J Prosthet Dent 1998;82:536-49.
2. Andersson M, Oden A. A new all-ceramic crown. A dense-sintered,
high-purity alumina coping with porcelain. Acta Odontol Scand
1993;51:59-64.
3. Wagner WC, Chu TM. Biaxial flexural strength and indentation fracture
toughness of three new dental core ceramics. J Prosthet Dent
1996;76:140-4.
4. White SN, Caputo AA, Li ZC, Zhao XY. Modulus of rupture of the
Procera all-ceramic system. J Esthet Dent 1996;8:120-6.
5. Andersson M, Razzoog ME, Oden A, Hegenbarth EA, Lang BR. Procera:
a new way to achieve an all-ceramic crown. Quintessence Int
1998;29:285-96.
Reprint requests to:
DR MICHAEL E. RAZZOOG
DEPARTMENT OF BIOLOGICAL AND MATERIAL SCIENCES
DIVISION OF PROSTHODONTICS
THE UNIVERSITY OF MICHIGAN
SCHOOL OF DENTISTRY
1011 N UNIVERSITY AVE
ANN ARBOR, MI 48109-1078
FAX: (734)763-3453
E-MAIL: merim@umich.edu
Copyright 2000 by The Editorial Council of The Journal of Prosthetic
Dentistry.
0022-3913/2000/$12.00 + 0 10/1/110253
doi:10.1067/mpr.2000.110253
VOLUME 84 NUMBER 4