Success and survival of full-arch implant-supported monolithic zirconia fixed dental prostheses fabricated using a digital workflow: A 2-year prospective cohort study.

OBJECTIVES

To assess the 2-year success and survival rates of full-arch implant-supported monolithic zirconia fixed dental prostheses (FDPs) and identify factors influencing peri‑implant bone loss.

METHODS

20 edentulous arches were restored with full-arch screw-retained monolithic zirconia FDPs supported by four implants using a fully digital workflow. Prosthesis and implant success and survival rates were recorded. Additionally, marginal bone level (MBL) changes were assessed using periapical radiographs at provisional and definitive FDP delivery, and at 6, 12, and 24 months. Linear mixed models were applied to identify factors affecting MBL.

RESULTS

Prosthesis success and survival rates were 100 %. Implant success rates were 100 % during the first year, decreasing slightly to 90 % at 12 months and 88.75 % at 24 months, while survival rates remained 100 %. Significantly greater MBL (p < 0.05) was observed in bone types 2-4 (Misch, 1988) compared with type 1, and in sites without guided bone regeneration (GBR). Lower MBL was associated with removable antagonists, wider and longer implants, and anterior implant positions. No significant differences in MBL were found between the early and later follow-up periods.

CONCLUSIONS

Full-arch screw-retained monolithic zirconia FDPs demonstrated high success during the 2-year follow-up period. MBL showed no statistically significant longitudinal changes, although subgroup analysis suggested associations with bone density, GBR, removable antagonists, and implant size.

CLINICAL SIGNIFICANCE: Digitally fabricated full-arch monolithic zirconia FDPs may represent a promising rehabilitation option for edentulous patients, although the results highlight the need for careful case selection and further long-term follow-up.