All-on-X Stackable Guides for Maxillary Terminal Dentition

January 18, 2026 updated by: Mohammed El-Sawy, Menoufia University

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

This retrospective study will evaluate the clinical performance of maxillary All-on-X(full-arch implant-supported rehabilitation) implant rehabilitation using stackable guided surgery and immediate loading. Implant survival and peri-implant outcomes will be assessed over a 2-year follow-up, with regression analysis will be used to investigate the influence of surgical and prosthetic variables, including basal seating guide design.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This study is a retrospective analysis of data derived from a prospectively maintained clinical database evaluating the clinical performance of maxillary All-on-X implant rehabilitation using a fully digital stackable guided surgery protocol with immediate loading.

Consecutive patients presenting with terminal maxillary dentition were treated with a maxillary All-on-6 implant-supported complete fixed dental prosthesis (ISCFDP) using a prosthetically driven digital workflow. Implant planning was performed using three-dimensional imaging and dedicated implant planning software, allowing for virtual determination of implant number, position, angulation, and depth in relation to the planned prosthesis. Stackable surgical guides were designed and fabricated to allow guided bone reduction when indicated, followed by fully guided implant placement.

All implants were placed under local anesthesia using a standardized surgical protocol. Implants achieving a minimum insertion torque of 35 Ncm were immediately loaded with a screw-retained provisional fixed prosthesis on multi-unit abutments. Occlusal contacts were minimized during the healing phase to reduce functional loading. Patients were followed according to a predefined clinical and radiographic follow-up schedule for a minimum period of two years.

The primary outcome of the study will be implant survival at 6 months after placement. Secondary outcomes will include peri-implant clinical parameters (plaque index, bleeding on probing, and probing depth), marginal bone level changes which will be assessed on standardized periapical radiographs at prosthesis delivery, 1-year, and 2-year follow-up visits, and implant success according to established criteria.

Study Type

Observational

Enrollment (Estimated)

40

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Egypt
    • Menoufia
      • Shibīn al Kawm, Menoufia, Egypt
        • Recruiting
        • Faculty of Dentistry
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

N/A

Sampling Method

Non-Probability Sample

Study Population

The study population consists of adult patients with terminal maxillary dentition who underwent rehabilitation with a maxillary All-on-6 implant-supported complete fixed dental prosthesis using a fully digital stackable guided surgery workflow and immediate loading protocol. Patients included had complete clinical and radiographic records available and were followed for a minimum of 2 years. Prosthetic designs were limited to FP-1 or FP-2 according to Misch classification. Patients with uncontrolled systemic conditions, previous head and neck radiotherapy, untreated infections, or requiring simultaneous bone grafting were excluded.

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Implant Survival Rate
Time Frame: 6 months after implant placement
Implant survival was defined as the presence of the implant in situ without removal for any reason, including biological or mechanical failure. Survival was assessed clinically and radiographically following implant placement and immediate loading.
6 months after implant placement

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Menoufia University

Collaborators

Mansoura University

Investigators

  • Principal Investigator: Mohammed El-Sawy, PhD, Menoufia University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2024

Primary Completion (Estimated)

March 1, 2026

Study Completion (Estimated)

May 1, 2026

Study Registration Dates

First Submitted

January 8, 2026

First Submitted That Met QC Criteria

January 18, 2026

First Posted (Actual)

January 20, 2026

Study Record Updates

Last Update Posted (Actual)

January 20, 2026

Last Update Submitted That Met QC Criteria

January 18, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ADMNF-002026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Up on request from the corresponding author

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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