{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:23:53Z","timestamp":1787739833064,"version":"build-2784847793"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe a fully digital and stackable surgical guide workflow for full\u2010arch rehabilitation in a patient with advanced periodontitis, aiming to restore esthetics, function, and biological stability with a monolithic zirconia prosthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Considerations<\/jats:title>\n                    <jats:p>A 38\u2010year\u2010old female presented with excessive gingival display and tooth mobility associated with Stage III, Grade C periodontitis. After periodontal stabilization, a digital workflow integrating CBCT and intraoral scans was implemented using CoDiagnostiX software. A four\u2010stage stackable guide system enabled precise anchor pin placement, bone reduction, and implant positioning for a six\u2010implant (\u201cAll\u2010on\u2010Six\u201d) immediate\u2010loading protocol. A prefabricated PMMA provisional prosthesis was delivered at surgery. At 5\u2009months, a connective tissue graft refined soft tissue contours, and at 6\u2009months, a definitive two\u2010piece monolithic zirconia prosthesis was delivered, achieving excellent gingival integration, occlusal balance, and esthetic harmony.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A digitally guided, stackable workflow allows accurate bone reduction, prosthetically driven implant positioning, and predictable esthetic outcomes in complex full\u2010arch rehabilitations following periodontitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance<\/jats:title>\n                    <jats:p>Integrating stackable guide technology with monolithic zirconia restorations enhances surgical precision, minimizes intraoperative variability, and ensures long\u2010term esthetic and functional stability in full\u2010arch implant rehabilitations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jerd.70256","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:56:47Z","timestamp":1787738207000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Digital Stackable Guide Protocol for\n                    <scp>FP1<\/scp>\n                    Full\u2010Arch Esthetic Reconstruction With Monolithic Zirconia"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9571-258X","authenticated-orcid":false,"given":"Lina","family":"Maiza","sequence":"first","affiliation":[{"name":"Department of Periodontology, Faculty of Medicine University of Algiers (Ziania)  Algiers Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0951-3227","authenticated-orcid":false,"given":"Pedro","family":"Barreiros","sequence":"additional","affiliation":[{"name":"Department of Oral Rehabilitation Instituto Universit\u00e1rio de Ci\u00eancias da Sa\u00fade  Gandra Portugal"},{"name":"UNIPRO\u2013Oral Pathology and Rehabilitation Research Unit University Institute of Health Sciences (IUCS\u2010CESPU)  Gandra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.11607\/jomi.5556"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022\u20103913(12)60186\u20103"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.13346"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12175"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100501.2012.02552.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.18\u20100006"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.17\u20100721"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0030\u20104220(51)90080\u20101"},{"issue":"2","key":"e_1_2_9_10_1","first-page":"23","article-title":"Density of Bone: Effect on Treatment Plans, Surgical Approach, Healing, and Progressive Bone Loading","volume":"6","author":"Misch C. E.","year":"1990","journal-title":"International Journal of Oral Implantology"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jopr.13375"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40729\u2010024\u201000547\u2010w"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10051107"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/dj12110347"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.16\u20100350"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12407"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2026.02.006"},{"issue":"1","key":"e_1_2_9_18_1","first-page":"35","article-title":"Clinical Outcomes of Full Arch Fixed Implant\u2010Supported Zirconia Prostheses: A Systematic Review","volume":"10","author":"Bidra A. S.","year":"2017","journal-title":"European Journal of Oral Implantology"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034517737483"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u2010051X.2005.00642.x"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prosdent.2015.08.025"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708\u20108208.2003.tb00010.x"},{"issue":"3","key":"e_1_2_9_23_1","first-page":"227","article-title":"The Rehabilitation of Completely Edentulous Maxillae With Different Degrees of Resorption With Four or More Immediately Loaded Implants: A 5\u2010Year Retrospective Study and a New Classification","volume":"4","author":"Mal\u00f3 P.","year":"2011","journal-title":"European Journal of Oral Implantology"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1708\u20108208.2005.tb00080.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.4103\/jips.jips_523_22"},{"issue":"4","key":"e_1_2_9_26_1","first-page":"712","article-title":"The Influence of Soft Tissue Thickness on Crestal Bone Changes Around Implants: A 1\u2010Year Prospective Controlled Clinical Trial","volume":"24","author":"Linkevicius T.","year":"2009","journal-title":"International Journal of Oral & Maxillofacial Implants"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.12684"}],"container-title":["Journal of Esthetic and Restorative Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jerd.70256","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jerd.70256","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jerd.70256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:56:48Z","timestamp":1787738208000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jerd.70256"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":26,"alternative-id":["10.1111\/jerd.70256"],"URL":"https:\/\/doi.org\/10.1111\/jerd.70256","archive":["Portico"],"relation":{},"ISSN":["1496-4155","1708-8240"],"issn-type":[{"value":"1496-4155","type":"print"},{"value":"1708-8240","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]},"assertion":[{"value":"2025-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jerd.70256"}}