Complete Dual-Arch All-on-4® Rehabilitation Using a Fully Digital Workflow: A Case Report

This article presents a case report describing a fully digital workflow for a dual-arch All-on-4® rehabilitation, highlighting the integration of intraoral and facial scanning, mandibular motion tracking, prosthetically driven implant planning, guided surgery, and computer-aided design/computer aided manufacturing (CAD/CAM)-fabricated fixed prostheses. The patient's diagnostic pathway included intraoral optical impressions, 3-dimensional (3D) facial scanning, and dynamic jaw-motion recording to verify a new vertical dimension of occlusion. A digital smile design established a fixed prosthesis 2 (FP2)-type prosthetic concept. Guided surgery was performed with 3D-printed templates; immediate loading was achieved using prefabricated polymethyl methacrylate provisionals. After a 3-month healing period, definitive digital impressions and passive-fit verification jigs were obtained. CAD/CAM titanium frameworks and zirconia superstructures were fabricated, characterized, and delivered as screw-retained prostheses. The workflow enabled precise implant placement, accurate passive fit, stable occlusion validated by functional motion capture, and highly esthetic outcomes, all within a minimally invasive treatment concept. This case demonstrates the effectiveness of a fully digital All-on-4 approach to optimize accuracy, efficiency, and patient satisfaction in a complex full-arch rehabilitation.