All-on-6 upper jaw implants placed with stackable guided surgery and immediate loading

All-on-X (Full-arch Implant-supported Rehabilitation) Stackable Surgical Guides for Maxillary Terminal Dentition: a 2-year Retrospective Analysis

This study will test whether a fully digital stackable guided surgery workflow with immediate loading works well for adults needing full-arch upper jaw (All-on-6) implants.

Quick facts

• Study type: Observational
• Enrollment: 40 (estimated)
• Ages: 40 Years to 70 Years
• Sex: All
• Sponsor: Menoufia University (other)
• Locations: 1 site (Shibīn al Kawm, Menoufia)
• Trial ID: NCT07353619 on ClinicalTrials.gov

What this trial studies

This is a retrospective analysis of a prospectively maintained clinical database of adults with terminal maxillary dentition treated with a prosthetically driven All-on-6 protocol. Planning used three-dimensional imaging and dedicated software to design stackable surgical guides that allow guided bone reduction and fully guided implant placement, followed by immediate loading when insertion torque reached at least 35 Ncm. Patients received screw-retained provisional fixed prostheses on multi-unit abutments with minimized occlusal contacts and were followed clinically and radiographically for a minimum of two years. Primary outcome is implant survival at six months, with secondary peri-implant clinical parameters and regression analysis to explore the influence of surgical and prosthetic variables including basal seating guide design.

Who should consider this trial

Good fit: Adults with terminal maxillary dentition treated with a prosthetically driven All‑on‑6 protocol using a fully digital stackable guided surgery workflow, immediate loading, and complete clinical and radiographic records are ideal candidates.

Not a fit: Patients with uncontrolled systemic disease, prior head and neck radiotherapy, untreated periodontal or peri‑implant infection, severe maxillary atrophy, need for simultaneous bone grafting, FP‑3 prosthetic design, or cases done without guided surgery or immediate loading are unlikely to benefit or be included.

Why it matters

Potential benefit: If successful, this technique could speed up upper‑jaw rehabilitation and produce predictable implant survival and peri‑implant health for patients needing full‑arch implants.

How similar studies have performed: Previous reports of All‑on‑X protocols with guided surgery and immediate loading have generally shown high implant survival rates, though the specific use of stackable guides for guided bone reduction is less extensively reported.

Eligibility criteria

Inclusion Criteria:

Adult patients presenting with terminal dentition of the maxillary arch

Rehabilitation with a maxillary All-on-6 implant-supported complete fixed dental prosthesis

Treatment performed using a fully digital stackable guided surgery workflow

Immediate loading with a provisional fixed prosthesis

Availability of complete clinical and radiographic records

Minimum follow-up period of 2 years

Prosthetic design classified as (Fixed prosthesis) FP-1 or FP-2 according to Misch classification

Exclusion Criteria:

Uncontrolled systemic conditions contraindicating implant surgery

History of head and neck radiotherapy

Presence of untreated periodontal or peri-implant infection at the time of surgery

Incomplete or missing clinical or radiographic records

Cases requiring simultaneous bone grafting procedures

Severe maxillary atrophy (Cawood and Howell Class III-V)

Cases requiring FP-3 prosthetic design

Rehabilitation performed without guided surgery or without immediate loading

Where this trial is running

Shibīn al Kawm, Menoufia

• Faculty of Dentistry — Shibīn al Kawm, Menoufia, Egypt (RECRUITING)

Study contacts

• Principal investigator: Mohammed El-Sawy, PhD — Menoufia University
• Study coordinator: Mohammed El-Sawy, PhD

Conditions: Bone Loss