Immediate loading of full arch implant restorations demands that the prosthesis be ready before the first incision. This requires a fully digital pre-planning workflow that integrates implant planning, prosthetic design, and prototype fabrication.
Pre-Operative Phase
1. CBCT and IOS data are merged to create a virtual patient model.
2. Implant positions are planned virtually, accounting for bone volume, A-P spread, and restorative space.
3. The PMMA prototype is designed pre-operatively on the planned implant positions.
4. The prototype is milled before surgery day and is ready for immediate pick-up at the surgical appointment.
Key Success Factors
- Accurate CBCT/IOS merge (within 0.5mm tolerance)
- Precise implant placement matching the virtual plan
- Adequate primary stability (minimum 35Ncm insertion torque)
- Well-designed prototype with passive fit on multi-unit abutments
The PMMA prototype serves dual purpose: immediate restoration and diagnostic tool for the final prosthesis design.