Full arch monolithic zirconia prosthesis in a patient with bilateral cleft palate: A clinical report

Adult patients with bilateral cleft lip and palate present unique challenges for prosthodontic treatment because of mobility of the premaxillary segment, oral-nasal communication, multiple missing and malpositioned anterior teeth, unfavorable soft tissues, and scar tissue underneath the maxillary lip. This clinical report describes the prosthodontic treatment of an adult patient with a terminal maxillary dentition and bilateral cleft palate, by using 5 dental implants and a 1-piece complete-arch fixed implant-supported prosthesis made of monolithic zirconia. The zirconia prosthesis aided in rigidly splinting not only the implants but also in orthopedically splinting the mobile premaxillary segment to the maxilla. Additional surgical and prosthodontic considerations in splinting the mobile premaxilla as well as biomechanical principles involved in management of such patients are also presented in this article.