Repair of fractured metal-ceramic restoration using CAD/CAM technologies. Case report

Fractures in esthetic ceramic veneering are one of the potential failure modes during prosthetic treatment. Depending on the type of chipping fracture, there are three possible outcomes: replacement, restoration repair, or polishing of the fractured area. Computer-aided design and manufacturing (CAD/CAM) technologies provide new methods to the maintenance and repair of fixed metal-ceramic restorations. Here, we report the case of a 68-year-old patient who came to the dentist with comcerns about his appearance due to spontaneous gingival bleeding and a fracture in the ceramic veneering of a metal-ceramic restoration. The patient reported occurrences of bruxism. The proposed treatment plan included consultation with a cardiologist, periodontal treatment, polishing of the chipped areas, repair of the fractured zone with an exposed metal core, and fabrication of a mouth guard. Once the ceramic veneering on the palatal and buccal sides of the retainers had been completely removed, a digital impression was obtained and sent to the dental lab so that milled zirconium veneer could be manufactured. The veneering was cemented the next day using the standard prosthetic field preparation process and resin-modified glass ionomer cement. In conclusion, fixed metal-ceramic restorations that have fractured can be successfully repaired using CAD/CAM methods and materials.