Predictable Full Digital Workflow Using Stackable Surgical Templates for Complete Dental Arch Rehabilitation with Implant-Supported Fixed Restorations—Case Series and Proof of Concept

Abstract

Background: In recent years, advancements in digital dentistry have provided new opportunities for more predictable and efficient treatment options, particularly in patients with failing dentition. This study aimed to evaluate the effectiveness and accuracy of a fully digital workflow using stackable surgical templates for complete dental arch rehabilitation with implant-supported fixed restorations. Methods: Four patients, comprising two males and two females with a mean age of 66 years, were included in this case series. Each patient underwent meticulous digital planning, including CBCT and intraoral scanning, to create a virtual patient for preoperative assessment and virtual treatment planning. The assessment of the trueness of implant positioning was conducted in Geomagic Control X software (version 2017.0.3) by referencing anatomical landmarks from both the preoperative and one-year postoperative CBCT scans. Results: A total of 25 dental implants were placed in the maxilla, followed by the installation of long-term provisional restorations. The results showed minimal deviation between the planned and actual implant positions, with mean 3D coronal, apical, and angular discrepancies of 0.87 mm, 2.04 mm, and 2.67°, respectively. All implants achieved successful osseointegration, and no failures were recorded, resulting in a 100% survival rate at the one-year follow-up. Patients reported high satisfaction with both the esthetic and functional outcomes based on their subjective feedback. Conclusions: The findings suggest that the use of a fully digital workflow with stackable surgical templates is a reliable and effective approach for immediate implant placement and prosthetic rehabilitation, enhancing treatment precision and patient comfort.