A Digital Stackable Guide Protocol for FP1 Full‐Arch Esthetic Reconstruction With Monolithic Zirconia

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Institutions

Publication Details

Journal
Journal of Esthetic and Restorative Dentistry
Published
2026-08-26
DOI
https://doi.org/10.1111/jerd.70256
Primary Topic
Dental Implant Techniques and Outcomes
Type
article
Field-Weighted Citation Impact
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article

A Digital Stackable Guide Protocol for FP1 Full‐Arch Esthetic Reconstruction With Monolithic Zirconia

Pedro Barreiros, Lina Maiza
Journal of Esthetic and Restorative Dentistry
Dental Implant Techniques and Outcomes
article

A Digital Stackable Guide Protocol for FP1 Full‐Arch Esthetic Reconstruction With Monolithic Zirconia

Pedro Barreiros, Lina Maiza
article en

Abstract

OBJECTIVE: To describe a fully digital and stackable surgical guide workflow for full-arch rehabilitation in a patient with advanced periodontitis, aiming to restore esthetics, function, and biological stability with a monolithic zirconia prosthesis. CLINICAL CONSIDERATIONS: A 38-year-old female presented with excessive gingival display and tooth mobility associated with Stage III, Grade C periodontitis. After periodontal stabilization, a digital workflow integrating CBCT and intraoral scans was implemented using CoDiagnostiX software. A four-stage stackable guide system enabled precise anchor pin placement, bone reduction, and implant positioning for a six-implant ("All-on-Six") immediate-loading protocol. A prefabricated PMMA provisional prosthesis was delivered at surgery. At 5 months, a connective tissue graft refined soft tissue contours, and at 6 months, a definitive two-piece monolithic zirconia prosthesis was delivered, achieving excellent gingival integration, occlusal balance, and esthetic harmony. CONCLUSION: A digitally guided, stackable workflow allows accurate bone reduction, prosthetically driven implant positioning, and predictable esthetic outcomes in complex full-arch rehabilitations following periodontitis. CLINICAL SIGNIFICANCE: Integrating stackable guide technology with monolithic zirconia restorations enhances surgical precision, minimizes intraoperative variability, and ensures long-term esthetic and functional stability in full-arch implant rehabilitations.

Journal of Esthetic and Restorative Dentistry
University of Algiers Benyoucef Benkhedda (DZ), Cooperativa de Ensino Superior Politécnico e Universitário (PT), University of Algiers 3 (DZ), Instituto de Saúde (BR)
Openalex Percentile: Top 8%
Dental Implant Techniques and Outcomes
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