Full-arch zirconia restorations on implants have gained popularity due to zirconia’s strength and aesthetics, yet they are still associated with challenges like structural fractures, peri-implant complications, and design misfits. Advances in CAD/CAM and digital workflows offer potential improvements, but a technique that consistently addresses these issues in fixed, full-arch, implant-supported prostheses is needed. This novel technique integrates a facially and prosthetically driven treatment approach, which is divided into three phases: data acquisition, restoration design, and manufacturing/delivery. Digital tools, including intraoral scanning and photogrammetry, facilitate accurate implant positioning, while 3D design software enables functional and aesthetic validation before final milling. A dual software approach is used to reverse engineer a titanium bar from the final restoration design, ensuring a superior outcome to other protocols. The restoration incorporates a zirconia–titanium hybrid structure, optimizing strength, flexibility, and weight. The proposed workflow enhances restoration precision and predictability through a prosthetically driven treatment plan, by ensuring passivity and aligning with biological and mechanical principles to promote long-term stability. By starting with the proposed restoration design and reverse engineering the bar, while also allowing for flexibility in material and component choices, this technique accommodates both patient needs and financial considerations. This approach demonstrates potential for improving patient outcomes in full-arch implant restorations by minimizing complications associated with traditional methods. Further research is recommended to validate the technique’s efficacy and broaden its clinical applications.

Background: In recent years, advancements in digital dentistry have provided new opportunities for more predictable and efficient treatment options, particularly in patients with failing dentition. This study aimed to evaluate the effectiveness and accuracy of a fully digital workflow using stackable surgical templates for complete dental arch rehabilitation with implant-supported fixed restorations. Methods: Four patients, comprising two males and two females with a mean age of 66 years, were included in this case series. Each patient underwent meticulous digital planning, including CBCT and intraoral scanning, to create a virtual patient for preoperative assessment and virtual treatment planning. The assessment of the trueness of implant positioning was conducted in Geomagic Control X software (version 2017.0.3) by referencing anatomical landmarks from both the preoperative and one-year postoperative CBCT scans. Results: A total of 25 dental implants were placed in the maxilla, followed by the installation of long-term provisional restorations. The results showed minimal deviation between the planned and actual implant positions, with mean 3D coronal, apical, and angular discrepancies of 0.87 mm, 2.04 mm, and 2.67°, respectively. All implants achieved successful osseointegration, and no failures were recorded, resulting in a 100% survival rate at the one-year follow-up. Patients reported high satisfaction with both the esthetic and functional outcomes based on their subjective feedback. Conclusions: The findings suggest that the use of a fully digital workflow with stackable surgical templates is a reliable and effective approach for immediate implant placement and prosthetic rehabilitation, enhancing treatment precision and patient comfort.

Static guided surgery for dental implant insertion is a well-documented procedure requiring the manufacturing of a custom-made surgical guide, either teeth-supported, mucosal-supported, bone-supported, or mixed (teeth-mucosal-supported), depending on the clinical situation. The guidance of the surgical drills during implant bed preparation could be undertaken using a sequence of different diameters of metal drill sleeves or, with the sleeves incorporated in the surgical guide, shank-modified drills, both clinically accepted and used with good results. Despite the great number of advantages associated with the use of guided surgery, one of the major risks is guide fracture during drilling for implant bed preparation. Therefore, the aim of the present study was to evaluate the surgical guides without metal sleeves and to simulate, with the aid of Finite Element Analysis (FEA), the use of such dentally supported guides for implant insertion. The FEA is performed in CATIA v5 software after defining the surgical guide mesh material and bone properties. A maximum stress of 6.92 MPa appeared on the guide at the special built-in window meant to allow cooling during drilling, and the maximum value of the guide displacement during drilling simulation was 0.002 mm. Taking into consideration the limits of the current research, the designed tooth-supported surgical guide can withstand the forces occurring during the surgery, even in denser bone, without the risk of fracture.

Background and Objectives: With the increased trend towards digitalization in dentistry, intraoral scanning has, to a certain extent, replaced conventional impressions in particular clinical settings. Trueness and precision are essential traits for optical impressions but have so far been incompletely explored. Materials and Methods: We performed a study to evaluate the differences in the three-dimensional spatial orientations of implant analogs on a stone cast when using an intraoral scanner compared to a dental laboratory scanner. We assessed the deviation of the intraoral scans compared to the laboratory scan for three standardized implant measurement plans and compared these results with control scans of the neighboring natural teeth. Results: We found no statistically significant correlation between the measurements at the scan body level and the landmarks chosen as controls on the neighboring natural teeth (p = 0.198). The values for the implant scans presented wider variation compared to the control scans. The difference between the implant and the control planes ranged from −0.018 mm to +0.267 mm, with a median of −0.011 mm (IQR: −0.001–0.031 mm). While most values fell within a clinically acceptable margin of error of 0.05 mm, 12.5% of the measurements fell outside of this acceptable range and could potentially affect the quality of the resulting prosthetic work. Conclusions: For single-unit implant-supported restorations, intraoral scanning might have enough accuracy. However, the differences that result when scanning with an intraoral scanner may affect the quality of prosthetic work on multiple implants, especially if they are screw-retained. Based on our results, we propose different adaptations of the prosthetic protocol to minimize the potential effect of errors that may occur during the digital workflow.

Background/Objectives: Immediate provisionalization in the esthetic zone is a well-documented but technique-sensitive procedure, and the choice of provisional connection geometry, with or without an antirotational index, remains debated. The aim of this retrospective single-arm cohort clinical study was to evaluate the clinical performance of a digitally planned, guide-delivered provisionalization protocol using prefabricated provisional crowns connected to 5-degree Morse taper implants without an antirotational index, with emphasis on emergence profile shaping and peri-implant tissue stability at one year; Methods: Twenty consecutive single-implant cases treated according to the standardized protocol from January 2024 onward and completing at least one year of follow-up after definitive crown delivery by the February 2026 data-lock date were included (19 female, 1 male; mean age 38.1 ± 12.7 years; 18 anterior and 2 premolar sites). All implants were placed with primary insertion torque ≥ 30 N·cm (mean 34.75 ± 2.55 N·cm) and immediately restored with a digitally designed, non-antirotational provisional crown. Primary outcome was provisional retention without major intervention; secondary outcomes included biologic complications, papilla score, marginal bone change at T0–T3 and T3–T4, and buccal contour change (T0 vs. T2 intraoral scan superimposition). Wilson 95% confidence intervals, Fisher’s exact test, and Mann–Whitney U test were used (α = 0.05); Results: Provisional retention without major intervention was 75.0% (15/20; 95% CI 53.1–88.8). Biologic complications were uncommon (bleeding on probing, suppuration, midfacial recession, and chairside adjustment, each 5.0%). Mean total marginal bone loss at one year was 0.37 ± 0.20 mm; mean buccal contour gain was 1.41 ± 0.48 mm. A complete papilla was preserved in 70.0% of cases. Conclusions: Digitally planned, guide-delivered provisionalization on a non-antirotational 5-degree Morse taper interface appears clinically feasible for emergence profile shaping in the esthetic zone, with favorable peri-implant tissue outcomes at one year.

Background/Objectives: Immediate provisionalization in the esthetic zone is a well-documented but technique-sensitive procedure, and the choice of provisional connection geometry (indexed vs. non-indexed) remains debated. The aim of this ret-rospective single-arm cohort clinical study was to evaluate the clinical performance of a digitally planned, guide-delivered provisionalization protocol using prefabricated provisional crowns connected to 5-degree Morse taper implants without an antirota-tional index, with emphasis on emergence profile shaping and peri-implant tissue sta-bility at one year; Methods: Twenty consecutive single-implant cases (19 female, 1 male; mean age 38.1 ± 12.7 years; 18 anterior and 2 premolar sites) were treated between January 2024 and February 2026. All implants were placed with primary inser-tion torque ≥ 30 N·cm (mean 34.75 ± 2.55 N·cm) and immediately restored with a digitally designed, non-antirotational provisional crown. Primary outcome was provision-al retention without major intervention; secondary outcomes included biologic com-plications, papilla score, marginal bone change at T0–T3 and T3–T4, and buccal con-tour change (T0 vs T2 intraoral scan superimposition). Wilson 95% confidence inter-vals, Fisher’s exact test, and Mann–Whitney U test were used (α = 0.05); Results: Pro-visional retention without major intervention was 75.0% (15/20; 95% CI 53.1–88.8). Biologic complications were uncommon (bleeding on probing, suppuration, midfacial recession, and chairside adjustment, each 5.0%). Mean total marginal bone loss at one year was 0.37 ± 0.20 mm; mean buccal contour gain was 1.41 ± 0.48 mm. A complete papilla was preserved in 70.0% of cases; Conclusions: Digitally planned, guide-delivered provisionalization on a non-antirotational 5-degree Morse taper interface appears clinically feasible for emergence profile shaping in the esthetic zone, with stable peri-implant tissues at one year.