Photogrammetry-assisted digital workflow for full-arch monolithic zirconia restorations: A clinical report

Introduction: Achieving cross-arch accuracy and passive fit remains a major challenge in conventional impression techniques for full-arch implant restorations. In contrast, photogrammetry-assisted digital workflows offer enhanced precision, efficiency, and predictability. This clinical report describes the rehabilitation of a 56-year-old fully edentulous female patient using a fully digital protocol and monolithic zirconia prostheses for both jaws. Case Description: Twelve endosseous implants (Ø3.7 mm, length 10–12 mm; ETK, France) were placed in anterior and posterior regions of the maxilla and mandible. After successful osseointegration, multi-unit abutments were connected. Final impressions were obtained using a hybrid protocol that combined photogrammetry (Imetric-Icam, Switzerland) with intraoral scanning (iTero Lumina, USA). With reference bars in place, interocclusal records and vertical dimension were registered using C-type vinyl siloxane ether (Zetaplus, Zhermack, Italy). Facial photographs and marker data were recorded in natural head position and transferred to the laboratory. Digital alignment and virtual articulation (Artex, Germany) were performed. A CAD-CAM resin mock-up (Armaresin, Turkey) was fabricated and evaluated intraorally for esthetics and occlusion. Final restorations were designed as full-arch, screw-retained prostheses using monolithic zirconia (Ceramill Zolid FX, Amann Girrbach, Austria) and torqued to 15 Ncm. Discussion: The photogrammetry-based workflow demonstrated superior cross-arch accuracy and passive fit compared to conventional techniques. The try-in allowed for verification of occlusal harmony, vertical dimension, and esthetics in a single appointment. Follow-up at 1-, 3-, 6-month, and 1-year intervals revealed no peri-implant complications. The patient reported high satisfaction in function and esthetics. This case highlights the clinical advantages of photogrammetry and monolithic zirconia in streamlining full-arch implant rehabilitation.