OBJECTIVES:To systematically review the updated evidence for the clinical outcome of fixed implant prostheses treated with different combinations of implant placement and loading protocols in partially edentulous patients. MATERIALS AND METHODS:An electronic search was performed in Medline, Embase, and Central to identify studies of implants subjected to immediate placement + immediate restoration/loading (Type 1A), immediate placement + early loading (Type 1B), immediate placement + conventional loading (Type 1C), early placement + immediate restoration/loading (Type 2-3A), early placement + early loading (Type 2-3B), early placement + conventional loading (Type 2-3C), late placement + immediate restoration/loading (Type 4A), late placement + early loading (Type 4B), late placement + conventional loading (Type 4C) with implant-supported fixed dental prostheses (IFDPs) in partially edentulous patients. A cumulative survival rate for each type of the implant placement and loading protocols was weighted by the duration of follow-up and number of implants. RESULTS:From 11 427 records, 140 studies (42 RCTs; 98 CCTs/cohort studies) encompassing 10 456 implants met the criteria. Weighted cumulative survival rates for each protocol were: 98.0% (Type 1A), 91.6% (Type 1B), 95.0% (Type 1C), 97.8% (Type 2-3A), 100% (Type 2-3B), 94.0% (Type 2-3C), 97.2% (Type 4A), 97.9% (Type 4B), 97.5% (Type 4C). Protocols 1A, 1C, 2-3C, 4A, 4B, and 4C satisfy scientific and/or clinical validation thresholds, whereas 1B and 2-3B remain insufficiently documented despite high numeric survival. CONCLUSIONS:In immediate placement, Type 1C shows strong survival rates. It is considered scientifically and clinically validated, while Type 1A also meets the criteria for a scientifically and clinically validated protocol with high survival rates. Meanwhile, Type 1B continues to show lower and more variable survival rates-being clinically documented-underscoring the need for careful case selection. Regarding early placement, Type 2-3C is recognized as a scientifically and clinically validated protocol. Type 2-3A, which was previously underreported, now demonstrates similarly validated survival rates that expand the evidence for early implant placement with immediate loading. Although Type 2-3B is clinically documented, it still lacks sufficient evidence. All late implant placement protocols are considered scientifically and clinically validated: Type 4C offers high survival with long-term predictability, while Type 4A and Type 4B maintain stable survival rates backed by well-established evidence.

Accurate digital interocclusal registration is fundamental to achieving predictable occlusal relationships in prosthodontic rehabilitation. While digital workflows avoid many material-based limitations of conventional bite records, their accuracy depends on scanner behaviour, scan strategy, and the availability of stable occlusal landmarks. Evidence shows that fully dentate arches can achieve high trueness, whereas accuracy progressively decreases with increasing edentulous span. This article synthesizes current clinical and scientific evidence on digital interocclusal records for dentate and partially dentate patients. Bilateral buccal scans involving approximately four teeth per side consistently demonstrate the highest accuracy, whereas unilateral and anterior scans show greater susceptibility to lateral drift and alignment error. The article evaluates the role of software-based and AI-assisted alignment tools, emphasizing appropriate use of occlusal collision correction, recognition of algorithmic artefacts, and the need for careful management of soft tissue interference, reflective surfaces, and mandibular deviation during scanning. In partially dentate cases, accuracy declines significantly once more than three posterior or six anterior teeth are missing. To address geometric discontinuity, auxiliary strategies such as scanning bridges, modified or segmental PVS records, preoperative prosthesis integration, and reference-based alignment through external CAD software are outlined. Verification through occlusal heat maps, articulating paper, or printed prototypes remains essential before definitive prosthesis design. By combining evidence-based scanning protocols, judicious use of alignment tools, and structured verification, clinicians can achieve predictable and reproducible digital interocclusal relationships across a wide range of dentate and partially dentate clinical scenarios.

OBJECTIVES:The 1st Global Consensus for Clinical Guidelines (GCCG) in Implant Dentistry introduced an innovative, evidence-based approach to developing patient-centered and practical recommendations for the rehabilitation of the edentulous maxilla. Within this framework, Group 1 aimed to formulate clinical recommendations on the number of implants required, timing of implant placement, and timing of loading. MATERIALS AND METHODS:Group 1 followed the S2k-level guideline framework of the Association of the Scientific Medical Societies in Germany (AWMF), using a structured nominal group technique. The evidence base included three systematic reviews evaluating clinician-reported outcomes (ClinROs) and patient-reported outcomes (PROs), supplemented by structured single-round international surveys involving expert clinicians, patients, and cross-disciplinary experts. Survey content covered diagnostics, treatment planning, clinical procedures, and maintenance care. Draft recommendations were discussed during the in-person consensus meeting in Boston (June 16-18, 2025) and finalized through anonymous plenary voting. Consensus was defined as ≥ 75% and ≤ 95% agreement and strong consensus as > 95% agreement. RESULTS:Group 1 formulated 12 clinical recommendations across the workflow domains of diagnostic tools, treatment planning, and treatment procedure. During plenary voting, three of these recommendations reached strong consensus, and nine achieved consensus. The number of voters per recommendation ranged from 61 to 90, with an average of 83. CONCLUSIONS:This consensus report provides structured, evidence-based recommendations on implant number, placement timing, and loading protocols for rehabilitation of the edentulous maxilla. These guidelines are intended to support individualized, patient-centered care while also identifying priority areas for future research.

Digital strategies for interocclusal records in edentulous patients aim to record stable jaw relations by scanning the buccal surfaces of an interocclusal device that is subsequently aligned to the edentulous arches. Yet, predictability remains limited by the lack of stable jaw positions and rigid references for alignment. This narrative reviews current evidence and proposes various digital registration strategies, whereby virtual datasets are aligned within a single coordinate system and patient-relevant references, such as occlusal vertical dimension and centric relations, are incorporated. These strategies are organized by clinical scenarios: no pre-existing prosthesis, existing complete removable dentures, pre-surgical records, and existing fixed implant-supported restorations. Accuracy improves as the registration shifts from removable to fixed interocclusal devices, and stable references have a bigger impact than the choice of surface-registration algorithm. A concise option tree translates these principles into scenario-specific pathways. Evidence gaps remain, with few clinical studies that assess and compare digital interocclusal records with conventional workflows in edentulous patients. Due to the challenges in obtaining accurate occlusal registrations in both digital and conventional workflows, the most reliable pathway includes a physical interocclusal scanning device that supplies stable geometry for digital registration, followed by verification with a prototype try-in.

The innervation of the hard and soft tissues of the anterior maxilla depends on the nasopalatine nerve. Due to its anatomy and proximity to implants in the esthetic area, it is essential to fully com-prehend its traits and possible effects while performing implant placement procedures. This review and meta-analysis aimed to assess the prevalence of neurosensorial alteration and the survival and success rates of dental implants in a relationship with the nasopalatine canal. A comprehensive search of the literature was conducted in MEDLINE, Web of Science, and Scopus databases. The included articles had to be case series or studies conducted in patients undergoing implant pro-cedures in the incisive canal region or who had undergone dental procedures with incisive canal deflation or neurovascular lateralization. A quantitative synthesis was performed using a meta-anal-ysis software program. Fixed- or random-effects models were applied based on the heterogeneity among studies. Four studies were included, and neurosensorial alterations were present in three of them. The range of neurosensorial alteration prevalence varied from 0% to 60%. A weighted mean of 29% ± 13% of neurosensorial alterations was calculated from the meta-analysis, and mean sur-vival and success rates were both 100%. Implant placement in the nasopalatine area is associated with high survival and success rates, as it is a safe procedure, but clinicians should be aware that neurosensorial alterations may be present when placing implants in this area.

OBJECTIVE:To evaluate the precision of complete-arch digital implant scans using intraoral scanning (IOS) and photogrammetry (PG). METHODS:Nineteen completely edentulous arches were included. Each arches contained at least four implants. Abutment-level digital scans were taken using IOS (3Shape Trios 3) and PG (Imetric ICam 4D, 1st gen). Each arch was scanned five times with each device. Implant cartesian coordinates were extracted, and the Spatial Fit, Cross-Arch Distance, and Virtual Sheffield tests were conducted. A generalized estimating equation (GEE) analysis was conducted to compare the precision of IOS and PG for the three tests. A GEE was used to assess further the association between jaw type (maxilla vs. mandible) and the precision for each device in all three tests. The significance level was set at α=0.05. RESULTS:PG demonstrated greater precision in all three tests (p < 0.0001). Precision was not significantly associated with jaw type in the PG group (p > 0.05). For IOS, the mandibular arch demonstrated inferior levels of precision compared to the maxilla for the Spatial Fit (p = 0.040), Cross-Arch Distance (p = 0.026), and Virtual Sheffield (p = 0.019) tests. CONCLUSION:PG represented a more precise scanner for complete-arch digital implant scans. Maxillary arch scans were associated with superior precision compared to scans of the mandible, yet statistical significance was only found in the IOS group. CLINICAL SIGNIFICANCE:IOS scanning for fixed implant rehabilitation of the edentulous jaw with conventional scan bodies should be approached with caution due to the poor precision, particularly in the mandible. PG represented a more precise scanner for complete-arch digital implant scans.

Digital implant planning -utilizing the convergence of digital surface scanners, CBCT scans, and advanced planning software -has transformed dental implantology. The merging of these datasets through triangulation of landmarks provides a detailed digital model of the dental arches, facilitating precise implant positioning in edentulous areas. A critical step in this digital workflow is the accurate merging of DICOM files with .STL/.PLY/.OBJ files, which underpins the design and fabrication of surgical templates for accurate implant placement. Errors in this phase can lead to implant mispositioning or damage to adjacent structures. Particularly in partial edentulism, the merging is based on the occlusal topography of the remaining teeth, but scattering in the CBCT data -caused by interactions of radiation with radiodense materials -can complicate this process or even render it impossible. The present article presents a technique utilizing radiopaque markers to overcome scattering effects, ensuring accurate dataset superimposition in the mandible. Intl Periodontics Restorative Dent 2025;45:539-546. doi: 10.11607/prd.7183

Computer-assisted implant planning allows for a comprehensive treatment plan by combining radiographic data provided by CBCT with surface optical scan data that includes the patient's intraoral situation and the intended restorative planning. Integrating a tailored restorative de-sign with the patient's anatomical conditions through virtual implant planning allows for an ideal biorestorative treatment planning that maximizes biologic, functional, and esthetic outcomes. This article discusses dataset registration techniques that combine radiographic CBCT data with re-storative information as the main path to create a virtual patient. The described techniques include the use of removable radiographic templates with radiopaque markers, the dual scan technique, and direct digital file registration of intraoral scans using anatomical references. Depending on the individual clinical situation, different factors must be considered to appropriately select methods that achieve an optimal registration of diverse datasets. An inherent challenge lies in the presence of scattering artifacts in CBCT scans. Two approaches are proposed for these situations: the use of chairside-fabricated composite resin markers or adhesive spot-markers fabricated for use with computed tomography scans. Both techniques exhibit limitations that must be considered. Further approaches should be developed for situations involving scattering in CBCT scans.

This narrative review examines the application of photogrammetry (PG) in complete-arch implant fixed prosthodontics, as it offers an alternative to conventional and intraoral scanning (IOS) impression techniques. Evidence from in vitro and in vivo studies suggests that PG provides high trueness and precision. The technique supports both immediate and delayed loading workflows, potentially reducing prosthetic misfit and chairside adjustments. Limitations include the need for separate IOS scans to capture soft tissues and occlusion, the cost of the device, and the restricted scanning scope. Future improvements in integration and accessibility may broaden its role in implant dentistry.

BACKGROUND:Misfit at the implant-prosthesis interface arises from small errors that occur during impression-taking, cast fabrication and milling. Implant verification jigs (IVJs) have been described as a quality-control device in fixed implant prosthodontics, yet protocols and indications are inconsistently described This narrative review aims to compare materials and fabrication methods, map their functional roles and provide clinical recommendations for both analogue and digital workflows. METHODS:Peer-reviewed English-language publications from 1 January 1980 to 30 October 2025 were searched on PubMed and Scopus using MeSH and free-text terms for dental implants and IVJs. Eligible studies include technique reports, in vitro studies, clinical studies and narrative reviews that reported materials, fabrication or functional roles of IVJs in fixed implant prosthodontics. Titles, abstracts and full texts were screened against predefined criteria. Data were synthesised narratively by workflow and verification approach. RESULTS:Fifty-two publications met the criteria (29 technique descriptions, 12 in vitro, 8 in vivo, 1 case report, 2 reviews). The materials reported for IVJs included PMMA, UDMA, photopolymerising composite resins and Type III/IV dental stone jigs. In analogue workflows, intra-oral and extra-oral verification procedures have been reported. In digital workflows, digitising IVJs or implant verification casts as well as CAD-CAM IVJs have been described. CONCLUSIONS:Within the limits of this narrative review, IVJs can be used as adjuncts for conventional impressions and intra-oral scans with vertical scanbodies. Photogrammetry and systems that pair horizontal scanbodies and AI-based recognition provide datasets with greater accuracy, negating the need for conventional IVJs. Future studies should standardise verification strategies and evaluate long-term clinical outcomes. CLINICAL RELEVANCE:This narrative review clarifies the indications for IVJs, outlines workable analogue and digital strategies, and provides clinical recommendations. Selective use of IVJs prior to the fabrication of the definitive prosthesis can reduce the likelihood of misfit.

In biorestoratively driven implant treatment planning, the initial prosthetic design is determined before implant placement. However, in patients with a terminal dentition, the loss of vertical dimension after tooth extraction and the absence of reference teeth complicate the alignment of the prosthetic design with the postextraction clinical situation, as well as precise occlusal registration and optimal tooth positioning. This article introduces a novel workflow that employs an additional cone beam computed tomography (CBCT) scan after implant placement to enhance data alignment, prosthetic rehabilitation, and occlusal registration for complete arch immediate loading of dental implants. By integrating preoperative and postoperative CBCT scans and utilizing stable bony landmarks as reference structures, this method effectively transfers preoperative planning into the postoperative intraoral environment. Unlike removable appliances or fiduciary markers, which are prone to misalignment, this technique ensures accurate prosthesis insertion with minimal adjustments, is adaptable to various workflows, including freehand implant placement, and provides a reliable and versatile solution to optimizing the outcomes of implant-supported prostheses.

The interforaminal region is considered more favorable for implant placement than the posterior mandible in edentulous patients, mainly because the inferior alveolar nerve can interfere with implant placement in the severely resorbed posterior mandible. However, complications in the interforaminal region may occur due to the presence of the mandibular incisive nerve. This scoping review aims to describe the mandibular incisive nerve anatomy related to the potential interference in implant therapy. A comprehensive literature search was conducted in the following databases: MEDLINE (via PubMed), Web of Science, and Scopus. This scoping review was structured according to the Joanna Briggs Institute method. Thirteen studies were included in the review. All of the studies were observational cohort anatomical studies, carried out mainly by CBCT and on cadavers. A total of 1,471 patients/cadavers were studied. The mandibular incisive nerve was present in 87% to 100% of cases, with an average length of 9.97 mm and an average diameter of 1.97 mm. The mandibular incisive nerve may be damaged during drilling and implant placement, especially when using implant lengths > 12 mm. Damage to the mandibular incisive nerve due to implant placement could be present, but it is necessary to conduct more studies focusing on assessing mandibular incisive nerve damage to understand the clinical relevance of this nerve and its associated morbidities, such as neurosensorial alterations. Due to the different anatomical characteristics of this nerve, CBCT analysis is recommended for implant therapy in the anterior mandible to prevent the described complications.

OBJECTIVE:This in-vitro study assessed the influence of two intraoral scanning (IOS) protocols on the accuracy (trueness and precision) of digital scans performed in edentulous arches. METHODS:Twenty-two abutment-level master casts of edentulous arches with at least four implants were scanned repeatedly five times, each with two different scanning protocols. Protocol A (IOS-A) consisted of scanning the edentulous arch before inserting the implant scan bodies, followed by their insertion and its subsequent digital acquisition. Protocol B (IOS-B) consisted of scanning the edentulous arch with the scan bodies inserted from the outset. A reference scan from each edentulous cast was obtained using a laboratory scanner. Trueness and precision were calculated using the spatial fit analysis, cross-arch distance, and virtual Sheffield test. Statistical analysis was performed using generalized estimating equations (GEEs). Statistical significance was set at α = .05. RESULTS:In the spatial fit test, the precision of average 3D distances was 45 μm (±23 μm) with protocol IOS-A and 25 μm (±10 μm) for IOS-B (p < .001), and the trueness of average 3D distances was 44 μm (±24 μm) with protocol IOS-A and 24 μm (±7 μm) for IOS-B (p < .001). Cross-arch distance precision was 59 μm (±53 μm) for IOS-A and 41 μm (±43 μm) for IOS-B (p = .0035), and trueness was 64 μm (±47 μm) for IOS-A and 50 μm (±40 μm) for IOS-B (p = .0021). Virtual Sheffield precision was 286 μm (±198 μm) for IOS-A and 146 μm (±92 μm) for IOS-B (p < .001), and trueness was 228 μm (±171 μm) for IOS-A and 139 μm (±92 μm) for IOS-B (p < .001). CONCLUSIONS:The IOS-B protocol demonstrated significantly superior accuracy. Placement of scan bodies before scanning the edentulous arch is recommended to improve the accuracy of complete-arch intraoral scanning.

OBJECTIVE:To provide technical and clinical recommendations for implementing a digital workflow in Static Computer-Aided Implant Surgery in the anterior maxilla. CLINICAL CONSIDERATIONS:An optimal 3D implant position is crucial for achieving satisfying results in implant rehabilitation in the esthetic area. Due to its complexity, implant placement in the esthetic zone should be executed with precision and predictability. Static Computer-Aided Implant Surgery requires thorough planning and detailed attention to every step of the digital workflow protocol. CONCLUSIONS:Implant positioning in the esthetic zone using Static Computer-Aided Implant Surgery is a technique-sensitive procedure that requires precise execution of each step. This approach ensures accurate prosthetically driven 3D implant placement and prevents potential errors that could lead to inaccurate positioning. CLINICAL SIGNIFICANCE:The proper implementation of Static Computer-Aided Implant Surgery may increase the level of agreement between the planned and definitive implant 3D positions in the esthetic zone, thus enhancing the esthetic outcomes of implant rehabilitation.

OBJECTIVE:This study aims to present the bio-restorative approach in implant dentistry, which combines biological and restorative concepts through digital planning. This concept combines periodontal, surgical, and prosthetic variables, aiming to reduce patient morbidity while achieving satisfactory esthetic and functional outcomes in implant-supported restorations in the long term. OVERVIEW:Implant dentistry evolved from a primarily surgical to a recent prosthetically driven approach. This evolution was partly due to advancements in bone reconstructive techniques and an increased demand for esthetic outcomes. Recently, digital planning has introduced a new paradigm that allows for the full integration of both approaches. The bio-restorative concept considers functional, esthetic, and biological variables in a virtual planning environment. This is achieved through the simultaneous digital assessment of (A) anatomical site characteristics and (B) implant restorative variables. These variables include digital tooth arrangement, soft-hard tissue conditions, implant variables, supra-platform components, and a surgical plan that respects or modifies peri-implant phenotype. CONCLUSIONS:The bio-restorative concept is intended to improve contemporary implant dentistry by integrating updated biological and prosthetic notions through digital planning. Adopting this paradigm has the potential to redefine the standards in implant dentistry, fostering a holistic and patient-centered approach. CLINICAL CONSIDERATIONS:It enhances patient and clinician satisfaction through more efficient and less invasive procedures. Significantly, it improves predictability, leading to successful implant-supported restorations in the long term.

INTRODUCTION:Using mini implants as transitional implants (TIs) for complete arch implant-supported rehabilitations may overcome limitations associated with mucosa-supported surgical guides and facilitate immediate fixed provisionalization. This study aimed to assess the success of TIs in supporting surgical guides for implant placement and fixed provisional prostheses. METHODS:Patients who received TIs between 2012 and 2023 for a complete arch implant-supported prosthesis were evaluated retrospectively. Patient demographic data, TI functionality in supporting a surgical guide and supporting a complete arch provisional prosthesis, and dates of TI placement and regular implant placement were collected. Descriptive statistics were used to determine the survival rate and success rate for TIs. RESULTS:Twenty-six patients, 35 jaws, 136 TIs, and 216 regular implants were included. The survival rate of TIs was 74.26%; however, the use of TIs yielded success in 97% of jaws for supporting a surgical guide and a fixed complete-arch provisional prosthesis throughout the complete provisional phase. An average of 4 TIs per maxilla and 3 TIs per mandible supported surgical guides. Thirty-five provisional prostheses were placed on an average of 4 TIs in the maxilla and 3 TIs in the mandible. Thirty-four provisional prostheses were successfully supported by TIs and regular implants until final restoration delivery. The survival of regular implants placed in conjunction with the use of TIs was 98%. CONCLUSIONS:Using TIs to support a surgical guide and provisional prosthesis may be a predictable approach with a high success rate. All surgical guides planned to be supported on TIs were successful. Despite premature loss or replacement of TIs, this approach was able to support most provisional prostheses until the regular implants could be loaded.

BackgroundFor over three decades, digital technologies have been used in Implant Dentistry, beginning with the introduction of planning software for Static Computer-Assisted Implant Surgery (S-CAIS). During this time, this field has witnessed the emergence of diverse methodologies and a proliferation of technological advancements. Today, S-CAIS is a widely adopted procedure for the placement of dental implants in both partially and fully edentulous patients, with Dynamic Computer-Assisted Surgery (D-CAIS) and Robotic-Assisted Implant Surgery (RAIS) rapidly gaining attention among dental professionals. The continuous advancements in this arena are not merely indicative of technological progress; they represent a steadfast dedication to refining precision, enhancing efficiency, and fostering innovation with the goal of optimizing patient outcomes in dental implantology.AimsThe purpose of the following review is to meticulously examine the spectrum of digital technologies available and to describe their protocols, advantages, and shortcomings as well as to evaluate their accuracy in implant surgery in patients with complete edentulism.Materials and MethodsA scoping review was performed following the Joanna Briggs Institute (JBI) protocols, leveraging the population, concept, and context (PCC) framework to construct the research question and determine the inclusion and exclusion criteria.ResultsTwo hundred and sixty-seven records were identified for screening. After applying all the screening criteria, 41 articles were included for review and qualitative data analysis.DiscussionS-CAIS, D-CAIS, and RAIS were identified as the main technologies for computer assisted implant surgery. Their applications, characteristics, protocols and levels of accuracy were compared and described.ConclusionTaking into consideration the limitations of this study, S-CAIS appears to be the most applied and validated technology in implant surgery for fully edentulous patients followed by D-CAIS and RAIS being these last two promising initiatives in the field. Despite having similar levels of accuracy, the overall comparison showed a slightly higher values in RAIS followed by D-CAIS and S-CAIS.

Over the past decade, emerging evidence indicates a strong relationship between prosthetic design and peri-implant tissue health. The objective of this narrative review was to evaluate the evidence for the corresponding implant prosthodontic design factors on the risk to peri-implant tissue health. One of the most important factors to achieve an acceptable implant restorative design is the ideal implant position. Malpositioned implants often result in a restorative emergence profile at the implant-abutment junction that can restrict the access for patients to perform adequate oral hygiene. Inadequate cleansability and poor oral hygiene has been reported as a precipitating factors to induce the peri-implant mucositis and peri-implantitis and are influenced by restorative contours. The implant-abutment connection, restorative material selection and restoration design are also reported in the literature as having the potential to influence peri-implant sort tissue health.

This case report describes a new digital workflow for computer-assisted implant surgery in an edentulous patient using transitional implants to support a fixed surgical template and interim prosthesis. The accuracy of the final implant position using the described protocol was evaluated and compared to the outcomes obtained using other types of surgical templates. This novel digital approach appears to enhance the accuracy of implant positioning for edentulous patients and seems to be comparable to a tooth-supported surgical template.