{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T10:24:22Z","timestamp":1787048662014,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sociedad Espa\u00f1ola de Pr\u00f3tesis Estomatol\u00f3gica"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Whether arch-specific anatomical configuration affects early peri-implant bone behavior in monolithic zirconia full-arch prostheses is unclear. This prospective cohort study evaluated 40 edentulous patients with 49 monolithic zirconia full-arch prostheses (25 maxillary, 24 mandibular; 308 implants). MBR and patient-reported outcomes were recorded at baseline and 12 months; mandibular morphology (U- vs. V-shaped) was classified on CBCT, and inter-implant distance and cantilever length were measured on CAD designs. Because 9 of 40 patients contributed both arches, the primary MBR comparison used a linear mixed-effects model; morphology and geometry associations were exploratory (ANOVA; Pearson correlation). Implant and prosthetic survival were 99.4% and 97.9%. Mean MBR was higher in the mandibular (0.86 \u00b1 0.06 mm) than the maxillary arches (0.73 \u00b1 0.02 mm); the mixed-effects model estimated this difference as \u03b2 = 0.13 mm (95% CI: 0.10\u20130.16; p &lt; 0.001). V-shaped mandibles (0.91 \u00b1 0.04 mm) showed higher MBR than U-shaped mandibles (0.81 \u00b1 0.04 mm; mean difference 0.10 mm; p &lt; 0.001), and inter-implant distance correlated negatively with MBR in the mandible (r = \u22120.70, p &lt; 0.001) but not in the maxilla (r = 0.01, p = 0.97). Patient-reported outcomes improved markedly in both arches; two minor chipping events occurred, both in V-shaped mandibles. Monolithic zirconia full-arch prostheses showed favorable short-term outcomes in both arches. Arch- and mandibular-morphology-related differences in early MBR were statistically robust and highly consistent in standardized effect size, although the absolute differences were numerically modest; these findings suggest an association between anatomical configuration and early bone remodeling under rigid, full-arch monolithic zirconia frameworks that warrants further confirmation.<\/jats:p>","DOI":"10.3390\/bioengineering13080933","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T09:06:41Z","timestamp":1787044001000},"page":"933","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Arch- and Morphology-Related Variation in Early Marginal Bone Remodeling of Monolithic Zirconia Full-Arch Prostheses: An Exploratory Prospective Cohort Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9962-0338","authenticated-orcid":false,"given":"Luis Carlos","family":"Garza","sequence":"first","affiliation":[{"name":"Department of Restorative Dentistry, Universitat Internacional de Catalunya, 08195 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Crooke","sequence":"additional","affiliation":[{"name":"Private Practice, 29016 M\u00e1laga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1420-8788","authenticated-orcid":false,"given":"Marta","family":"Vall\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Universitat Internacional de Catalunya, 08195 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Soliva","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Universitat Internacional de Catalunya, 08195 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8978-8230","authenticated-orcid":false,"given":"Xavier","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, Universitat Internacional de Catalunya, 08195 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4872-4118","authenticated-orcid":false,"given":"Miguel","family":"Roig","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Universitat Internacional de Catalunya, 08195 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Chen, C., Lai, H., Zhu, H., and Gu, X. (2022). Digitally prefabricated versus conventionally fabricated implant-supported full-arch provisional prosthesis: A retrospective cohort study. BMC Oral Health, 22.","DOI":"10.1186\/s12903-022-02376-y"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1111\/jopr.13510","article-title":"Digital workflow in implant treatment planning for terminal dentition patients","volume":"31","author":"Papaspyridakos","year":"2022","journal-title":"J. Prosthodont."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s40729-025-00641-7","article-title":"German S3 guideline on implant-supported all-ceramic restorations","volume":"11","author":"Waltenberger","year":"2025","journal-title":"Int. J. Implant Dent."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1177\/00220345940730010801","article-title":"Deformation of the human mandible during simulated tooth clenching","volume":"73","author":"Korioth","year":"1994","journal-title":"J. Dent. Res."},{"key":"ref_5","first-page":"178","article-title":"Mandibular forces during simulated tooth clenching","volume":"8","author":"Korioth","year":"1994","journal-title":"J. Orofac. Pain"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Pera, F., Pesce, P., Bagnasco, F., Pancini, N., Carossa, M., Baldelli, L., Annunziata, M., Migliorati, M., Baldi, D., and Menini, M. (2023). Comparison of milled full-arch implant-supported frameworks realised with a full digital workflow or from conventional impression: A clinical study. Materials, 16.","DOI":"10.3390\/ma16020833"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e946624","DOI":"10.12659\/MSM.946624","article-title":"Accuracy of 3 intraoral scanners in recording impressions for full arch dental implant-supported prosthesis: An in vitro study","volume":"30","author":"Jain","year":"2024","journal-title":"Med. Sci. Monit."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e2423840","DOI":"10.1080\/17452759.2024.2423840","article-title":"Ionic substitution through bredigite doping for microstructure and performance adjustment in DLP 3D-printed TPMS porous HA bone scaffolds","volume":"19","author":"Guo","year":"2024","journal-title":"Virtual Phys. Prototyp."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"111412","DOI":"10.1016\/j.compscitech.2025.111412","article-title":"Functionalized degradable soybean oil-based biomimetic porous scaffolds for complex bone defects","volume":"273","author":"Guo","year":"2026","journal-title":"Compos. Sci. Technol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/jerd.13143","article-title":"A guide for selecting the intraoral scan extension when fabricating tooth- and implant-supported fixed dental prostheses","volume":"36","author":"Kois","year":"2024","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"321","DOI":"10.2186\/jpr.JPR_D_22_00107","article-title":"Facial scanning technologies in the era of digital workflow: A systematic review and network meta-analysis","volume":"67","author":"Antonacci","year":"2023","journal-title":"J. Prosthodont. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4047\/jap.2023.15.1.22","article-title":"Analysis of the trueness and precision of complete denture bases manufactured using digital and analog technologies","volume":"15","author":"Ciocca","year":"2023","journal-title":"J. Adv. Prosthodont."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1111\/jerd.13451","article-title":"Rehabilitation of a terminal dentition patient using an immediate loading protocol with a virtual patient-assisted workflow: A case report","volume":"37","author":"Ntovas","year":"2025","journal-title":"J. Esthet. Restor. Dent."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1111\/clr.14258","article-title":"A randomized clinical trial on zirconia versus titanium implants in maxillary single tooth replacement","volume":"35","author":"Cune","year":"2024","journal-title":"Clin. Oral Implants Res."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Froimovici, F.O., Butn\u0103ra\u015fu, C.C., Montanari, M., and S\u0103ndulescu, M. (2024). Fixed full-arch implant-supported restorations: Techniques review and proposal for improvement. Dent. J., 12.","DOI":"10.3390\/dj12120408"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Todaro, C., Cerri, M., Rodriguez y Baena, R., and Lupi, S.M. (2024). Lower jaw full-arch restoration: A completely digital approach to immediate load. Healthcare, 12.","DOI":"10.3390\/healthcare12030332"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"27","DOI":"10.11607\/ijp.5804","article-title":"Immediate versus delayed loading of dental implants supporting fixed full-arch maxillary prostheses: A 10-year follow-up report","volume":"32","author":"Pera","year":"2019","journal-title":"Int. J. Prosthodont."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.prosdent.2021.09.011","article-title":"A fully digital protocol to provide a fixed interim complete denture for immediate loading for a completely edentulous patient: A dental technique","volume":"130","author":"Espona","year":"2023","journal-title":"J. Prosthet. Dent."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Garza, L.C., Crooke, E., Vall\u00e9s, M., Soliva, J., Rodr\u00edguez, X., Rodeja, M., and Roig, M. (2025). Evaluation of polymethyl methacrylate as a provisional material in a fully digital workflow for immediate-load complete-arch implant-supported prostheses over three months. Materials, 18.","DOI":"10.3390\/ma18030562"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"67","DOI":"10.2535\/ofaj.82.67","article-title":"Morphological classification of mandibular dental arch forms by correlation and principal component analyses","volume":"82","author":"Kumabe","year":"2005","journal-title":"Okajimas Folia Anat. Jpn."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"5","DOI":"10.2535\/ofaj.81.5","article-title":"A morphological study on the classification of maxillary dental arches","volume":"81","author":"Nakatsuka","year":"2004","journal-title":"Okajimas Folia Anat. Jpn."},{"key":"ref_22","first-page":"11","article-title":"The long-term efficacy of currently used dental implants: A review and proposed criteria of success","volume":"1","author":"Albrektsson","year":"1986","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"349","DOI":"10.11607\/ijp.8479","article-title":"Fixed dental prostheses on six zirconia implants for an anterior maxillary rehabilitation: Case report with 10-year follow-up","volume":"37","author":"Flores","year":"2024","journal-title":"Int. J. Prosthodont."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"381","DOI":"10.11607\/jomi.10022","article-title":"Retrospective cohort evaluation of full-arch zirconia implant-supported fixed prostheses","volume":"38","author":"Thalji","year":"2023","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_25","first-page":"844","article-title":"Implant-supported full-arch rehabilitation with immediate loading using two different digital impression techniques: A case report with 2-year follow-up","volume":"54","year":"2023","journal-title":"Quintessence Int."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gao, J., Jiang, L., and Zhao, B. (2023). Median mandibular flexure: The unique physiological phenomenon of the mandible and its clinical significance in implant restoration. Front. Bioeng. Biotechnol., 11.","DOI":"10.3389\/fbioe.2023.1238181"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s40729-021-00312-3","article-title":"Clinical performance of narrow-diameter titanium-zirconium implants in immediately loaded fixed full-arch prostheses: A 2-year clinical study","volume":"7","author":"Coskunses","year":"2021","journal-title":"Int. J. Implant Dent."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1186\/s40729-020-00271-1","article-title":"A fixed reconstruction of fully edentulous patients with immediate function using an apically tapered implant design: A retrospective clinical study","volume":"6","author":"Eskan","year":"2020","journal-title":"Int. J. Implant Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4103\/ccd.ccd_185_18","article-title":"Association between marginal bone loss and bone quality at dental implant sites based on evidence from cone beam computed tomography and periapical radiographs","volume":"10","author":"Yousefi","year":"2019","journal-title":"Contemp. Clin. Dent."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"159","DOI":"10.5125\/jkaoms.2022.48.3.159","article-title":"Marginal bone loss around crestal or subcrestal dental implants: Prospective clinical study","volume":"48","author":"Sargolzaie","year":"2022","journal-title":"J. Korean Assoc. Oral Maxillofac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Garza, L.C., Crooke, E., Vall\u00e9s, M., Soliva, J., Rodr\u00edguez, X., and Roig, M. (2026). Hierarchical Variance in Early Marginal Bone Change in Monolithic Zirconia Full-Arch Implant Prostheses: A Multilevel Prospective Analysis. 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