Passive Fit of Full-arch Implant Prostheses
Conditions
Brief summary
compare the passive fit of three impression techniques: photogrammetry, intraoral digital scanning with splinted scan bodies, and the conventional open-tray impression technique, within the context of the All-on-X treatment concept. This comparison is expected to provide valuable clinical evidence to support clinicians in making informed decisions when considering the adoption of digital alternatives to conventional methods.
Detailed description
For edentulous patients undergoing full-arch rehabilitation, the All-on-X treatment approach has proven to be a very successful option, providing enhanced function, aesthetics, and patient satisfaction. Achieving passive fit, which reduces mechanical stress on implants and prosthetic components and reduces the possibility of problems such screw loosening, fracture, or marginal bone loss, is crucial to the long-term effectiveness of implant-supported prostheses. Passive fit has traditionally been evaluated after prostheses are fabricated using traditional open-tray impression techniques, which are regarded as the gold standard because of their great precision and dependability. These approaches, however, are challenging, technique-specific, and susceptible to human mistake or material deformation. Other methods include digital intraoral scanning with splinted scan bodies and photogrammetry have become more appreciated due to the quick development of digital dentistry. Potential advantages of these digital workflows include quicker digital data transfer to the lab, less chairside time, and improved patient comfort. In the context of the All-on-X procedure, there is still no clinical data comparing the accuracy especially passive fit and time efficiency of these more recent methods with traditional impressions, despite these benefits. Thus, the purpose of this study is to compare the time efficiency and passive fit of three impression techniques: traditional open-tray impressions, digital intraoral scanning with splinted scan bodies, and photogrammetry. The findings will provide clinicians with evidence-based insights into whether digital alternatives can match or surpass traditional techniques in terms of accuracy and workflow efficiency, ultimately supporting the transition toward more modern, streamlined protocols in implant prosthodontics.
Interventions
DEVICEPhotogrammetry-Based Full-Arch Impression
Use of a photogrammetry system to capture the positions of All-on-X implants digitally without physical impression materials. The technique aims to achieve precise passive fit and reduce chairside working time. Measurements of passive fit discrepancy and total procedure time will be recorded
Digital full-arch impression using splinted scan bodies connected with resin to enhance stability. An intraoral scanner captures the splinted assembly for framework fabrication. Passive fit and working time will be evaluated
Traditional full-arch open-tray impression using polyether or VPS material with splinted impression copings. This serves as the standard comparator for evaluating passive fit and procedure duration
Sponsors
October 6 University
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
45 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Adults aged 45-65 years. Fully edentulous or partially edentulous maxilla requiring full-arch rehabilitation. Sufficient maxillary bone volume to support at least four implants according to the All-on-X protocol. Systemically healthy patients with no contraindications to dental implant surgery (ASA I-II classification). Demonstrated ability to maintain adequate oral hygiene. Willingness to participate in the study and comply with follow-up visits and required maintenance protocols. Patients seeking a fixed, implant-supported prosthesis for the maxilla due to missing teeth and inability to use removable prostheses effectively. Acceptable radiographic findings with no signs of pathology, infection, or significant anatomical limitations.
Exclusion criteria
Uncontrolled systemic diseases (e.g., uncontrolled diabetes, osteoporosis, immunosuppressive disorders) History of radiation therapy to the head and neck region Active periodontal disease or untreated caries Maxillary cysts, tumors, or pathologies Poor oral hygiene or inability to maintain postoperative care Insufficient bone volume for All-on-X without extensive grafting Maxillary sinus pathology or oroantral fistula Psychiatric illness or cognitive impairment affecting compliance Bruxism or parafunctional habits Pregnant or lactating women History of implant failure or titanium allergy Use of bisphosphonates or antiresorptive medications Heavy smoking (\>10 cigarettes/day) Inability or unwillingness to attend follow-up visits Diagnosed or symptomatic temporomandibular joint disorders (pain, clicking, locking, limited opening)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Passive fit measured using 3D inspection software (Geomagic Control X) | Immediately after framework verification |
Secondary
| Measure | Time frame |
|---|---|
| Time efficiency, assessed using stop watch and measured by seconds. | During impression procedure |
Contacts
Primary ContactMohammed Fathy Ghobashy, Bachelor of Dental Surgery
Outcome results
None listed