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Digital Workflow for Duplication of Gold Onlay Anatomy to Monolithic Zirconia Onlay

Now online in the Journal of Prosthodontics, a new technique report co-authored by ACP members Mohammed A. Alfaifi, BDS, MS. FRCDC, FACP, Majed S. Altoman, BDS, MS. FRCDC, FACP, Hatem Alqarni, BDS, MS. FRCDC, FACP, and Mathew T. Kattadiyil, BDS, MDS, MS, FACP.

Digital replication of an existing cast gold onlay (CGO) anatomy to a more esthetic material for a new complete denture is challenging. This report describes a technique that uses digital technology to fabricate a new maxillary complete denture with monolithic zirconia onlays (MZOs) that duplicate the anatomy of an existing complete denture with CGOs.

Several methods have been utilized effectively to reduce the rate of wear on resin denture teeth (RDT) using amalgam fillings on occlusal surfaces of RDT, gold, or base metal onlays. However, because of the higher cost of gold and reduced patient acceptance of esthetics due to color, alternative techniques and materials have been considered for improved wear resistance and esthetics.

In this report, high translucency monolithic zirconia was used to fabricate the monolithic zirconia onlay (MZO) due to its excellent esthetic and mechanical properties. When incorporated on occlusal surfaces of RDT is an esthetic, biocompatible alternative to cast gold onlay.

This technique duplicates the anatomy of an existing CGO which minimizes the need for occlusal adjustments and adaptation period, and reduces the laboratory costs and eliminates the need for casting gold restorations.

The digital fabrication of complete dentures with RDT and MZO is a complex protocol due to the limitations of available options of CAD software. Additionally, shade matching between RDT and MZO can be challenging.

The presented technique maintains the occlusion and the teeth form of the existing prostheses and reduces patient appointments.

Alfaifi, MA, Altoman, MS, Alqarni, H, Gadah, TS, Kattadiyil, MT. Digital workflow for duplication of gold onlay anatomy to monolithic zirconia onlay for a complete denture: A technique paper. J Prosthodont. 2023; 1– 4. https://doi.org/10.1111/jopr.13734

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