The Esthetic Challenge in Immediate Loading Full-Arch Rehabilitation. Full Digital Workflow with IPG Technology

The rehabilitation of fully edentulous patients represents still one of the most complex oral treatment procedures, requiring a comprehensive treatment plan and the execution of an accurate combined surgical and prosthetic protocol. At the time being, among the available treatment protocols, the Columbus Bridge Protocol (CBP) has been proposed and validated by the dental schools of the University of Genoa and Turin (IT) with 20-years follow-up scientific studies. This protocol encompasses the rehabilitation of the edentulous arch by means a fixed screw-retained prostheses supported by four or six implants, no regenerative techniques and the insertion of distal tilted implants to avoid distal cantilever. Since the beginning of 2000’s, the CBP research team set the goal of the rehabilitation trying to develop and implement the esthetic and biomechanical aspects of the all-on-four treatment concept, focusing the mayor efforts to be able to achieve the FP1 “natural” esthetic solutions, optimizing the soft tissue contouring of prosthetic rehabilitation.

One of the milestones of the procedure following the original prosthetic phase includes an immediate plaster impression for the realization of screw retained fix provisional prostheses with a very precise immediate metal framework.

In the last 6/7 years the research and clinical activity of the group has been mostly dedicated to the digitalization of the procedure, such as the implementation of the diagnostic phases with face scanners and the use of digital impression. 

One of the most epochal changes in this phase of the procedure has been represented by the introduction of the IPG technology in the registration of the position of the implants inserted, immediately after surgery. The author will describe how this instrument has radically changed the daily practice of the operators and permitted to develop the full digital CBP workflow, with the goal of the best esthetic full-arch rehabilitation in a short operative timing.