Optimizing Complete-Arch Implant Rehabilitations: Comprehensive Review of Restorative Protocols

Digital workflows for the restoration of implant supported complete arch prostheses have presented a range of distinct advantages over conventional impression techniques including decreased risk of distortion, enhanced patient experience, and streamlined operational efficiency. However, determination of proper techniques for, and concerns over the accuracy of these rapidly emerging and evolving digital technologies remains to be a hurdle for adopting these digital workflows to replace the gold standard conventional technique. This narrative review aims to analyze various digital workflows employed in the impression-taking process for implant supported complete arch prostheses. A comprehensive manual search of databases thoroughly assessed digital impression methodologies and associated workflows, including intraoral scanning utilizing scan bodies, modified scan bodies/gauges, photogrammetry, and reverse scan bodies. Edentulous intraoral scanning with scan bodies presents challenges stemming from inadequate quantities or quality of reference points between scans, resulting in improper stitching. Modifications to scan bodies and creation of scan gauges have been introduced to address these shortcomings. Photogrammetry has further introduced superior accuracy in capturing precise implant positioning. Finally, the reverse scan body technique simulates the traditional back-pouring technique within the digital workflow. A summary diagram demonstrates key findings across different studies, providing an overview of current digital impression technologies. Current literature reveals limitations with variations in study designs, absence of standardized guidelines, and difficulty in comparing accuracy. When implemented effectively, digital impression techniques demonstrate equivalent or superior clinical accuracy compared to conventional impression techniques for implant supported complete arch prostheses.