Optimizing passive fit and esthetic results of screw-retained zirconia implant-supported fixed complete dentures designed and produced digitally

Objective: We aimed to present a novel protocol for the complete digital design and production of screw-retained zirconia implant-supported fixed complete dentures (IFCDs) to achieve predictable esthetic results and an optimal passive fit. Methods: The novel protocol consisted of the following: 1) three-dimensional acquisition of intraoral and facial scans; 2) construction of the virtual patient; 3) conception of the new smile using computer-assisted design (CAD) software for the provisional prosthesis following standardized esthetic criteria; 4) finishing of the interim polymethyl methacrylate prosthesis after surgery; 5) CAD design of the final prosthesis following the same standardized esthetic criteria used for the provisional one; 6) computer-aided manufacturing of the final monolithic zirconia prosthesis; and 7) bonding of the titanium abutments into the zirconia framework using a physical cast derived from a zirconia jig. Results: This novel protocol is time-efficient, delegable, and effective in achieving predictable esthetic results and optimal passivity, which may reduce the fracture rate of the zirconia framework. Conclusions: Monolithic zirconia IFCDs may be a reliable alternative, and a fully digital workflow can reduce operative time and improve standardization and deferability. This protocol enabled the achievement of optimal passive fit, thereby reducing the probability of framework fractures. Statement of clinical relevance: This novel protocol offers a time-efficient workflow that improves esthetic outcomes and passive fit, potentially reducing the incidence of zirconia framework fractures. It enhances the reliability and standardization of implant-supported prostheses, contributing meaningfully to advancements in restorative dental practices.