Truness of Full Arch Impressions in All on x Cases

This study aims to compare the trueness and precision of three impression methodologies photogrammetry, digital intraoral scanning with splinted scan bodies, and conventional open tray impressions in the context of the All-on-X treatment concept. This will provide valuable evidence for clinicians considering digital workflows for implant-supported prostheses. Does the use of photogrammetry and digital impression techniques with splinted scan bodies result in improved accuracy in implant position transfer in the All-on-X concept compared to conventional open tray impressions?

Inclusion Criteria: * Adults aged 45-65 years. * Fully edentulous or partially edentulous maxilla requiring full-arch rehabilitation. * Sufficient maxillary bone volume to support at least four implants according to the All-on-X protocol. * Systemically healthy patients with no contraindications to dental implant surgery (ASA I-II classification). * Demonstrated ability to maintain adequate oral hygiene * Willingness to participate in the study and comply with follow-up visits and required maintenance protocols. * Patients seeking a fixed, implant-supported prosthesis for the maxilla due to missing teeth and inability to use removable prostheses effectively. * Acceptable radiographic findings with no signs of pathology, infection, or significant anatomical limitations. Exclusion Criteria: * Uncontrolled systemic diseases (e.g., uncontrolled diabetes, osteoporosis, immunosuppressive disorders) * History of radiation therapy to the head and neck region * Active periodontal disease or untreated caries * Maxillary cysts, tumors, or pathologies * Poor oral hygiene or inability to maintain postoperative care * Insufficient bone volume for All-on-X without extensive grafting * Maxillary sinus pathology or oroantral fistula * Psychiatric illness or cognitive impairment affecting compliance * Bruxism or parafunctional habits * Pregnant or lactating women * History of implant failure or titanium allergy * Use of bisphosphonates or antiresorptive medications * Heavy smoking (\>10 cigarettes/day) * Inability or unwillingness to attend follow-up visits * Diagnosed or symptomatic temporomandibular joint disorders (pain, clicking, locking, limited opening)