OPTIMIZ: A Constraint-Driven Tool for Decision-Making in Full- Arch Rehabilitation

To present OPTIMIZ, a clinical tool developed to simplify restorative decision-making in full-arch implant rehabilitation of the edentulous maxilla.

Decision-making remains one of the most challenging aspects of full-arch implant rehabilitation. Implant-supported fixed complete prostheses (iFCPs) may provide highly favorable biologic, functional, and esthetic outcomes. However, their success depends on appropriate case selection and careful evaluation of esthetic, prosthetic, functional, soft tissue and bone-related factors. Inappropriate treatment selection may result in compromised esthetics, avoidable bone reduction, or overtreatment through extensive augmentation procedures. OPTIMIZ was developed as a structured clinical assessment tool to facilitate early decision-making during full-arch rehabilitation. It does not prescribe a specific treatment plan or sequence of clinical steps. Rather, it evaluates the constraints that determine whether FP1 rehabilitation is anatomically and prosthetically feasible, leaving final treatment selection to individualized clinical judgment. The tool is based on seven diagnostic criteria: lip position at rest and incisal display, tissue excess and smile line, tissue visibility during smiling, interarch relationship and occlusion, midline discrepancy, intrusion of the tooth forms, and Z-axis positioning. Collectively, these parameters allow systematic assessment of the relationship between the proposed restorative design and the existing biological envelope.

OPTIMIZ is a practical tool developed to simplify decision-making and improve treatment predictability in full-arch rehabilitation while minimizing avoidable surgical intervention. The tool should be used in conjunction with comprehensive patient evaluation, individualized treatment planning, and professional clinical judgment.