We are in the era where the face of dentistry demands unequivocal skills to fulfill its upgraded standards.
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These prostheses simulate a typical ceramo-metal bridge made for natural teeth in the sense that a substructure is fabricated to provide both the attachment to underlying implants as well as an ideal porcelain thickness for long term durability. A full-contour wax-up of the framework is done. It is then cut back to create the ideal veneering ceramic thickness and then it is scanned. The scanned image is employed in a CAM process to create a metal framework from a ceramic compatible alloy. In some situations, the wax up may be cast in a ceramo-metal alloy but full-arch precision of fit is more difficult to obtain than with a CAM substructure.
A metal-ceramic prosthesis shows very good esthetics, as ceramic is more life-like than acrylic resin. One disadvantage of a metal-ceramic prosthesis is that ceramic chipping or fracture may occur and may be difficult to repair. The opposing occlusion should be invariably and scrupulously considered, especially if a parafunctional habit is suspected. If indicated, consider prescribing an occlusal guard for adjunctive protection of the applied dental materials.
We are in the era where the face of dentistry demands unequivocal skills to fulfill its upgraded standards.