Frequently Asked Questions

Passive fit means the restoration seats on all implants without introducing stress or tension. When a full arch restoration does not fit passively, it can cause screw loosening, framework fracture, or even implant failure. We verify passive fit using photogrammetry (ICam4D,Shining3D,PIC) for every AOX case, achieving accuracy within 5-30 microns.

For monolithic zirconia full arch restorations, we recommend a minimum of 12mm restorative space from the implant platform to the occlusal plane. This allows for adequate connector dimensions (minimum 12-16mm cross-section) and proper material thickness. For titanium-acrylic hybrid restorations, 15mm or more is ideal. If your restorative space is limited, we can advise on alternative design strategies.

Full arch zirconia fractures typically result from one or more of: (1) inadequate connector dimensions, (2) excessive cantilever length relative to A-P spread, (3) uneven occlusal loading, or (4) internal fit issues creating stress concentration. Our design protocol specifically addresses each of these risk factors before finalizing any case.

Yes. We have library access to all major implant systems including Nobel Biocare, Straumann, Dentsply Sirona (Astra, Ankylos), Zimmer Biomet, BioHorizons, MegaGen, Osstem, Hiossen, and many others. If you are using a specific implant system, let us know and we will confirm compatibility.

We accept intraoral scans in STL format, CBCT in DICOM format, and photos in JPG/PNG. We deliver design files in STL format, ready for printing or milling. If your milling center requires a specific file format, we can accommodate most requests.

Photogrammetry uses multiple cameras to capture the 3D positions of implant scan bodies and triangulates their exact positions. This method eliminates cumulative errors from traditional splinted impression techniques. Studies show photogrammetry achieves accuracy within 5-30 microns for full arch cases, compared to 50-150 microns for conventional impressions.

A standard AOX full arch design takes 2-3 working days from receipt of complete data. Complex cases involving both a titanium bar and a zirconia superstructure may take 3-4 working days. Rush service (24 hours) is available for urgent cases.

For a full arch implant case, we need: (1) intraoral scan or impression scan with scan bodies, (2) opposing arch scan, (3) bite registration, (4) implant details (system, platform, abutment type/height), (5) your prescription (material, design preferences), and (6) clinical photos. For surgical guides, we also need CBCT data.

Every case follows a standardized design protocol. Each design is reviewed by a senior designer before delivery. Our checklists cover fit verification, connector dimensions, cantilever management, emergence profile, and occlusal scheme. We track remake rates as continuous improvement metrics.

Currently, you can send your case data via WeTransfer using the Send Your Case button on our website. We are developing a dedicated client portal for direct uploads. You can also contact us at info@mdcmasterdesign.com for a custom upload arrangement.

AOX is a full arch fixed restoration supported by 4-6 implants, designed for patients who have lost all or most teeth in an arch. Unlike conventional implant bridges that replace a few teeth, AOX replaces an entire arch. The key difference is that AOX uses tilted distal implants to maximize A-P spread and often avoids bone grafting. Conventional implant bridges require more implants placed axially and may need bone grafting if volume is insufficient.

A diagnostic wax-up serves as the 3D blueprint for treatment. It establishes tooth proportions, occlusal scheme, and esthetic outcome before any tooth is prepared. For single posterior crowns, a wax-up is optional. For any case involving anterior teeth, multiple units, or full arch rehabilitation, a wax-up is essential. Without it, the clinician and technician are guessing at the final result.

Stackable guides provide progressive precision through layered sequential guidance. Each surgical step (pilot drill, intermediate drills, final osteotomy) has a dedicated guide layer with correctly sized sleeves. This eliminates sleeve wear from undersized drills in oversized sleeves, reduces angular deviation, and provides better irrigation access. For full arch cases with tilted implants, stackable guides consistently achieve placement accuracy within 1mm and 3 degrees of the virtual plan.

The choice depends on your restorative workflow. Titanium bars are indicated when you need a rigid framework connecting all implants — common for hybrid restorations with acrylic or composite superstructures. Individual abutments are used when placing separate crowns or bridges on each implant. For full arch cases with 4-6 implants, a titanium bar with a separate superstructure provides the best combination of passive fit, retrievability, and repairability.

A PMMA (polymethyl methacrylate) prototype is a milled temporary full arch restoration used for immediate loading or as a diagnostic try-in. It serves three purposes: (1) validates passive fit on the multi-unit abutments before the final framework is fabricated, (2) allows the patient to experience the new vertical dimension and esthetics, and (3) serves as a reference for the ceramist when fabricating the final zirconia superstructure.

Our design protocol targets marginal gaps of 30 microns or less. This is achieved through precise margin detection on the intraoral scan, proper cement space design, and careful emergence profile contouring. We verify each case against reference scans and flag any preparations with unclear margins before proceeding.

Digital dentures offer five key advantages: (1) permanent digital archiving — lost or damaged dentures can be reproduced exactly from the stored file, (2) fewer appointments — typically 2-3 vs 4-5 for conventional, (3) consistent base fit — no polymerization shrinkage distortion, (4) try-in preview via 3D printing, and (5) reduced laboratory turnaround time.

Custom GBR meshes are fabricated from medical-grade titanium (Grade 5, Ti-6Al-4V ELI). This material is fully biocompatible, has a long clinical track record in implant dentistry, and is routinely used for craniofacial reconstruction. The mesh is 3D-printed or milled, then cleaned and sterilized. It can remain in place for 6-9 months during graft maturation and is removed at the time of implant placement.

Minimum thickness depends on the material. Lithium disilicate (E.max) veneers can be as thin as 0.3mm when pressed, or 0.5mm when milled. Zirconia veneers require minimum 0.5mm thickness. However, these are absolute minimums — we recommend designing to 0.5-0.7mm for lithium disilicate and 0.7-1.0mm for zirconia to ensure adequate strength for clinical function.

Yes. Our clear aligner setups include attachment design based on the type of tooth movement required. Rectangular attachments for rotation control, beveled attachments for extrusion, horizontal attachments for intrusion, and optimized attachments for root torque. Each attachment is positioned to maximize force application efficiency while being as small and comfortable as possible for the patient.

We design all major splint types: (1) stabilization splints (Michigan type) for TMD and bruxism with even centric contacts and anterior guidance, (2) anterior repositioning splints for disc displacement with recapture, (3) anterior bite planes for posterior disclusion, and (4) soft splints for mild bruxism and sports mouthguards. Each is designed with proper occlusal scheme based on your prescription.

Scans must capture the complete arch including all teeth and soft tissue within 5mm of the gingival margin. Preparation margins must be clearly visible without blood or saliva contamination. Scans with unclear margins or significant artifacts will be flagged and the case will not proceed until the scan is retaken. We recommend using the scan body scanning protocol from your implant system manufacturer.

If a design does not meet the clinical requirements specified in your prescription, we will revise it at no additional charge. Remakes due to our design error are free. Remakes due to changes in the clinical situation (different implant placed, scan protocol change, revised prescription) are charged at a reduced rate. We track remake rates across all designers and use them as continuous improvement metrics.

We take patient data security seriously. All case data is stored on encrypted cloud storage. We do not share patient-identifying information with third parties. Images shared on our website or social media are de-identified and used only with the clinician permission. Our data handling complies with international standards for protected health information.

Yes. We export in standard STL format, which is universally compatible with all major milling machines (Roland, Ivoclar, Amann Girrbach, vhf, imes-icore) and 3D printers (Formlabs, Asiga, Stratasys, SprintRay, NextDent). If you have specific export requirements (file format conversion, nesting orientation, support structure preferences), please include these in your prescription.

Our team communicates in English for all case-related correspondence, design prescriptions, and technical documentation. We are experienced in working with dental professionals from North America, Europe, Australia, and Asia. All case notes, design feedback, and technical questions are handled in English.

Milled frameworks are recommended for all implant cases because they offer superior passive fit (10-20 microns vs 80-120 microns for cast frameworks). The digital milling process eliminates casting shrinkage and porosity. Cast frameworks remain an option for conventional removable partial dentures where implant-level precision is not required. For full arch implant bars, we exclusively recommend milled frameworks.

Welcome! Start by contacting us through the Contact page or email at info@mdcmasterdesign.com. Tell us about your case — the restoration type, implant system, and timeline. We will confirm the design workflow, pricing, and expected turnaround time. Then send your case data via WeTransfer using the Send Your Case button on our website. We offer a trial case at a reduced rate for new clients to experience our quality.