Zirconia and Digital Planning Transform Full-Arch Implant Prostheses
Advances in prosthetic materials and digital technology are redefining full-arch implant rehabilitation, improving both strength and esthetics. Zirconia, hybrid designs, and digital workflows provide patients with durable, lifelike results while streamlining treatment for clinicians.
Prosthetic materials for full-arch fixed implant prostheses have evolved significantly from acrylic and metal-acrylic options to include reinforced composites, polyether ether ketone, monolithic zirconia, and titanium bars with zirconia overlays. These advanced materials offer enhanced durability and esthetics. Zirconia particularly stands out for its superior strength, wear, and fracture resistance, and lifelike translucency when porcelain is added. Its highly polishable surface improves patient maintenance capabilities compared to acrylic alternatives. Both monolithic zirconia and titanium-zirconia hybrid designs reduce the required prosthetic space compared to traditional metal-acrylic prostheses.
Digital technology has revolutionized prosthetic and surgical planning for full-arch rehabilitation. Cone-beam computed tomography (CBCT) scans merged with intraoral scans create highly accurate three-dimensional models that allow clinicians to identify anatomical features to avoid, plan optimal implant placement based on prosthetic requirements, and anticipate potential grafting needs. These merged scans enable guided surgery planning using computer-aided design and manufacturing technology, helping predict and avoid surgical and prosthetic complications.
Various technologies and techniques are available for full-arch rehabilitation, including trough guides from ideal denture set-ups (Figure 1), stackable guides with prefabricated conversion prostheses (Figure 2), photogrammetry, and scan gauges.1 Historical challenges in transitioning from the implant healing phase to final prosthesis have been addressed by newer digital methods that allow efficient progression in just a few appointments. These advanced approaches include photogrammetry, scan bodies with reverse scan techniques, and scan gauges, though they require intraoral scanners and specific digital systems. While initial costs and learning curves present barriers to adoption, these techniques become highly predictable once mastered.
Reference
- Cappare P, Sannino G, Minoli M, Montemezzi P, Ferrini F. Conventional versus digital impressions for full arch screw-retained maxillary rehabilitations: a randomized clinical trial. Int J Environ Res Public Health. 2019;16:829.
This originally appeared in Chang B. The evolution of full-arch implant rehabilitation. Decisions in Dentistry. 2025;11(3):10-15.
