What is the Solution when High "VOD" meets Limited Zirconia?

Author: Lemei                      Date: January 8, 2026

At our lab, we thrive on challenges. Every complex case is an opportunity to demonstrate our commitment to precision, collaboration, and finding solutions where others see obstacles. Today, we’re sharing a remarkable All-on-X case that perfectly embodies this spirit.

This was a classic full-mouth edentulous case. The treatment plan called for robust, long-lasting, screw-retained prostheses: Ti-Bar Integrated Zirconia Bridges for both the maxillary and mandible. The design promised excellent strength, passive fit and aesthetic versatility.

However, a significant surgical decision created a unique prosthetic challenge.

The Challenge: Exceeding the Material Limits

During surgery, the clinician expertly leveled the maxillary alveolar ridge to create an ideal foundation. This surgical step, while beneficial for long-term stability and hygiene, resulted in a significantly increased Vertical Dimension of Occlusion (VDO).

When our design team received the scan data and plan, we faced a hard material limit: the final restorative space exceeded the maximum thickness of a standard monolithic zirconia disc (typically 20-25mm, with some blocks up to 30mm). A one-piece, full-contour zirconia bridge of the required height was physically impossible to mill from a single block.

The Problem: How do we deliver the prescribed, high-strength Ti-Bar Zirconia design when the anatomy exceeds the manufacturing constraints of the material?

Our Laboratory Solution: The Strategic "Step" Design

Our technical team devised an elegant and biomechanically sound solution. Instead of compromising the design or material, we re-engineered the approach to the hybrid structure itself.

1. Foundation First: We meticulously designed and milled the titanium bar framework to perfectly fit the implants and follow the arch contour. This bar was crafted to be the primary structural backbone. 

2. Strategic Balance between Ti Bar and Zirconia Bridge: We then designed the zirconia superstructure to be fabricated at the maximum possible millable thickness. For the excess height required in certain we planned a precise reduction. When designing this case, we extended the height of Ti bar and reduce the zirconia bridge height.

3. Creating the "Step": The key was in the connection. We designed a clean, precise "step" or shelf on the titanium bar itself. The zirconia portion would seat against this titanium step. This meant that in the final prosthesis, a segment of the polished titanium bar would be visible... but only sub-gingivally and in areas completely concealed by the lip and cheek.

The Result: Strength, Aesthetics and Function  achieved

Why This Case Matters for Your Practice?

This case is a powerful testament to the value of a true clinician-laboratory partnership. It highlights critical lessons for planning complex full-arch cases:

Prosthetic-Driven Planning is Non-Negotiable: Even the best surgical plans must be evaluated in the context of prosthetic possibilities and material science. Advanced 3D planning with the lab involved from the outset can anticipate such challenges.

Material Knowledge is Key: A deep understanding of the physical properties and limits of materials like zirconia and titanium allows for proactive problem-solving.

"Hybrid" Means Adaptable: The Ti-Bar Integrated design isn't just a product; it's a versatile concept. In the hands of an experienced technical team, it can be adapted ingeniously to meet anatomical realities without sacrificing the core principles of strength, retrievability, and aesthetics.

Are You Facing a Complex, Seemingly "Impossible" Full-Arch Case?

Don't let material limits or complex anatomy be a roadblock. Let them be the starting point for a collaborative solution. Our laboratory specializes in turning prosthetic challenges into clinical successes. We don't just follow orders; we provide expert consultation, creative technical solutions, and impeccable craftsmanship for the most demanding All-on-X and full-mouth rehabilitation cases.

Whatsapp Lemeib via +86 19928009909 or e-mail us at cad@lemeidentallab.com for a case consultation or to send us your 1st All on X case.

(Hereby we would like to extend our sincere gratitude and deep respect to Dr. Mark, who contributed this outstanding clinical case. As an exceptional expert in the field, Dr. Mark never compromises when it comes to patient care, always striving for excellence with the utmost sense of responsibility. We deeply admire his professionalism and dedication. His attitude and spirit continue to inspire our team to move forward and pursue even higher standards. Thank you Dr. Mark!)