An interim solution for a fractured complete-arch fixed implant-supported prosthesis using an Essix retainer.

Figure 1. Fractured maxillary metal-resin fixed complete-arch implantsupported prosthesis. Patient had been treated by another provider and did not have interim or conversion prosthesis. Complete-arch fixed implant-supported prostheses are known to be an excellent solution for edentulism. Although new, stronger materials have evolved, the metal-resin prosthesis using a combination of cast or milled bar supporting acrylic resin and denture teeth continues to be popular because of its lower cost and simplicity. However, these prostheses have a high rate of mechanical complications, primarily related to the fracture of the acrylic resin and denture teeth. A prospective cohort study of 24 fixed metal-resin complete-arch implant-supported prostheses found that each prosthesis required resin maintenance 5 to 6 times over a 10-year period. This represents a significant inconvenience and investment to both the practitioner and the patient. Additionally, some patients with limited prosthetic space or parafunctional habits may have even higher fracture rates. Because of the frequency of fracture of the acrylic resin and denture teeth, clinicians may encounter various scenarios and may not always be able to provide immediate repair. One quick solution would be to replace the definitive prosthesis with the patient’s screw-retained interim prosthesis or conversion prosthesis while the definitive prosthesis was repaired in the dental laboratory. However, the interim prosthesis may not be available and an immediate solution is required to satisfy esthetic and social needs. An Essix retainer is a removable, clear vacuumformed matrix that was first described by Sheridan et al to maintain tooth positions during and/or after orthodontic treatment. These retainers are used in prosthodontics to replace missing anterior teeth during various treatments by simply filling the pontic space of