Full Digital Model-Free Maxillary Prosthetic Rehabilitation by Means of One-Piece Implants: A Proof of Concept Clinical Report with Three-Years Follow Up

ABSTRACT

Over the past decades, osseointegrated dental implants have become a reliable and established method for supporting fixed restorations, with high long-term survival rates. Recently, there has been growing attention on the aesthetic outcomes and the stability of peri-implant tissues over time. Key factors influencing the aesthetic quality of implant-supported restorations include the 3D position of the implant, the quantity and quality of hard and soft tissues, and the design of the prosthetic emergence profile.

A concern with traditional implant systems is the micro-gap between the implant and abutment, which can lead to micromovements under load, potentially compromising the stability of surrounding tissues. One-piece implants, which lack this connection, can overcome this issue. They offer several advantages, such as fewer surgical steps, reduced inflammation and pain, improved soft tissue healing, and the ability to use smaller diameters while maintaining mechanical strength. However, they also present limitations, particularly regarding transmucosal healing when primary stability is not achieved.

Despite existing knowledge, there is limited data on the use of one-piece implants in guided surgery for full-arch rehabilitations. Therefore, the present study aimed to clinically and radiographically evaluate peri-implant tissue outcomes following a fully digital, model-free full-arch rehabilitation using one-piece implants Fixo.