Current Considerations for Full-Arch Fixed Rehabilitations: A Narrative Review.

Purpose: To review and critically discuss current and controversial topics in full-arch rehabilitation, particularly the combination of immediate implant placement and immediate loading.

Materials and methods: A literature review was conducted using a PubMed search of recent relevant publications regarding immediate placement and immediate loading for full-arch rehabilitation. Subtopics identified for review included the following: (1) defining a hopeless dentition and implications for full-mouth extraction; (2) the role of bone removal; and (3) the number of implants required for a full-arch fixed prosthesis.

Results: The number of implants required to support a full-arch fixed restoration is supported by strong scientific evidence. The definition of hopeless dentition and the role of bone removal are still areas of clinical debate with no established consensus.

Conclusions: The classification of hopeless dentition, prosthetic design, bone reduction, and implant number require individualized treatment planning and adherence to evidence-based practices. Evidence-based clinical guidelines remain limited, leaving clinicians without clear protocols for planning and executing complex implant-supported full-arch rehabilitations. Integrating clinical expertise with ethical decision-making is essential to ensure optimal outcomes and long-term success.