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Volume 14
Issue 23
10.3390/jcm14238353
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Digital Workflow for Interim Prosthetic Rehabilitation Through the All-on-4 Concept Using 3D Printing Additive Process

by
Miguel de Araújo Nobre
1,*,
Ricardo Almeida
2,
Carlos Moura Guedes
2,
Gonçalo Alvarez
3,
Carolina Antunes
1,
Ana Ferro
4,
Mariana Nunes
4,
Armando Lopes
4,
João Rangel
2,
João Pedro Martins
2,
Diogo Santos
4 and
Miguel Gouveia
4
1
Research, Development and Education, MALO CLINIC, Avenida dos Combatentes, 43, 1600-042 Lisbon, Portugal
2
Prosthodontics, MALO CLINIC, Avenida dos Combatentes, 43, 1600-042 Lisbon, Portugal
3
CERAMICS, CAD-CAM, MALO CLINIC, Avenida dos Combatentes, 43, 1600-042 Lisbon, Portugal
4
Oral Surgery, MALO CLINIC, Avenida dos Combatentes, 43, 1600-042 Lisbon, Portugal
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(23), 8353; https://doi.org/10.3390/jcm14238353
Submission received: 29 October 2025 / Revised: 17 November 2025 / Accepted: 20 November 2025 / Published: 24 November 2025
(This article belongs to the Special Issue Current Trends and Future Directions in Prosthetic and Implant Dentistry in the Digital Era, 3rd Edition)
Review Reports Versions Notes

Abstract

Background/Objectives: Fully digital workflows used in implant dentistry have been evolving to improve rehabilitation times and patient satisfaction. More studies are necessary for full scientific validation. The aim of this study was to evaluate the 6-month outcome of implant-supported fixed prostheses for full edentulism rehabilitation using OnX Tough 2 resin (SprintRay) and the Pro 2 (SprintRay) 3D printer following the All-on-4 concept. Methods: This study included 16 patients (10 female, 6 male) with 20 implant-supported fixed full-arch prostheses following the All-on-4 concept (10 rehabilitations for each stackable guide and photogrammetry protocols). Primary The primary outcome measure was implant and prosthetic survival. The secondary outcome measures included manufacturing issues, prosthetic passive fit, marginal bone loss (MBL), mechanical and biological complications, modified plaque and bleeding indexes, pocket depths, patient subjective evaluation, and the Oral Health Impact Profile. Results: No patients were lost to follow-up. Two prostheses failed and 2 two implants were lost, resulting in a cumulative survival rate of 90% and 97.5% at 6 months for prostheses and implants, respectively. The mean MBL was 0.31 mm ± 0.52 mm at 4 months. The mechanical complications rate was 50% at patient level. One patient (6.3%) experienced one biological complication. The grades regarding “comfort of prostheses in the mouth” and “overall chewing feeling” were 9.35 ± 1.29 and 8.79 ± 1.67 out of 10, respectively. The mean total sum of the OHIP-14 was 1.61 out of 56. Conclusions: Implant-supported full-arch rehabilitations with fixed prostheses following the All-on-4 concept, through a fully digital workflow protocol, are a viable option in the short term.
Keywords: All-on-4; implant-supported prosthesis; immediate loading; 3D printing; photogrammetry; prosthesis failure All-on-4; implant-supported prosthesis; immediate loading; 3D printing; photogrammetry; prosthesis failure

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MDPI and ACS Style

de Araújo Nobre, M.; Almeida, R.; Moura Guedes, C.; Alvarez, G.; Antunes, C.; Ferro, A.; Nunes, M.; Lopes, A.; Rangel, J.; Martins, J.P.; et al. Digital Workflow for Interim Prosthetic Rehabilitation Through the All-on-4 Concept Using 3D Printing Additive Process. J. Clin. Med. 2025, 14, 8353. https://doi.org/10.3390/jcm14238353

AMA Style

de Araújo Nobre M, Almeida R, Moura Guedes C, Alvarez G, Antunes C, Ferro A, Nunes M, Lopes A, Rangel J, Martins JP, et al. Digital Workflow for Interim Prosthetic Rehabilitation Through the All-on-4 Concept Using 3D Printing Additive Process. Journal of Clinical Medicine. 2025; 14(23):8353. https://doi.org/10.3390/jcm14238353

Chicago/Turabian Style

de Araújo Nobre, Miguel, Ricardo Almeida, Carlos Moura Guedes, Gonçalo Alvarez, Carolina Antunes, Ana Ferro, Mariana Nunes, Armando Lopes, João Rangel, João Pedro Martins, and et al. 2025. "Digital Workflow for Interim Prosthetic Rehabilitation Through the All-on-4 Concept Using 3D Printing Additive Process" Journal of Clinical Medicine 14, no. 23: 8353. https://doi.org/10.3390/jcm14238353

APA Style

de Araújo Nobre, M., Almeida, R., Moura Guedes, C., Alvarez, G., Antunes, C., Ferro, A., Nunes, M., Lopes, A., Rangel, J., Martins, J. P., Santos, D., & Gouveia, M. (2025). Digital Workflow for Interim Prosthetic Rehabilitation Through the All-on-4 Concept Using 3D Printing Additive Process. Journal of Clinical Medicine, 14(23), 8353. https://doi.org/10.3390/jcm14238353

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