Short-Term Clinical Performance of Full-Arch Implant-Supported Full-Contour Monolithic Zirconia Prostheses Fabricated Through a Standardized Fully Digital Workflow: A Prospective Single-Arm Case Series.

Abstract

Purpose: This prospective single-arm case series evaluated short-term clinical outcomes of implant-supported full-arch full-contour monolithic zirconia (FCZ) prostheses fabricated with a standardized fully digital workflow.

Materials and methods: Fifty edentulous arches in 37 patients received screw-retained FCZ prostheses supported by 302 implants. The workflow comprised extraoral photogrammetry, complementary intraoral scanning, dataset merging, passive-fit verification with a milled aluminum bar, and PMMA prototype validation before definitive fabrication. The primary endpoint was prosthesis survival. Secondary outcomes included prosthetic success, implant survival, biological complications requiring intervention, and any unplanned intervention.

Results: All 50 prostheses completed at least 12 months of follow-up (mean 449.7 ± 99.6 days; range 366-731). Longer-term exposure was limited: 8 prostheses reached ≥18 months and 2 reached ≥24 months. Implant survival was 100% (302/302) and prosthesis survival was 100% (50/50). No Bravo, Charlie, or Delta complications and no biological complications requiring intervention were recorded. One non-ABCD maintenance event (access-channel unsealing) occurred at day 518 and was managed chairside, yielding conservative prosthetic success of 98.0% (49/50). The unplanned intervention rate was 1.62 events per 100 prosthesis-years (exact Poisson 95% CI: 0.04-9.05).

Conclusions: Within the observed minimum 12-month follow-up, FCZ prostheses fabricated through this standardized digital workflow showed favorable short-term implant and prosthesis survival. Because few prostheses contributed follow-up beyond 18 and 24 months, long-term durability and maintenance requirements remain uncertain.

Clinical relevance: In this prospective single-arm case series, a fully digital workflow combining extraoral photogrammetry, passive-fit verification with an aluminum bar, PMMA prototype validation, and definitive full-contour monolithic zirconia fabrication was associated with 100% implant and prosthesis survival over the mandatory minimum 12-month follow-up and a conservative prosthetic success rate of 98.0%. These data should be interpreted as short-term feasibility observations, because few prostheses contributed longer-term follow-up beyond 18 and 24 months.