Evaluation of polymethyl methacrylate as a provisional material in a fully digital workflow for immediate-load complete-arch implant-supported prostheses over three months

Abstract

While complete-arch digital-implant-scanning protocols have been described, their clinical outcomes when using polymethyl methacrylate (PMMA) as a provisional material remain insufficiently substantiated. This clinical study aims to integrate digital solutions into implant dentistry and establish PMMA as a reliable material for immediate-loaded protocols. Fifty-six patients received 432 implants and 72 immediate fixed interim complete-arch prostheses, all fabricated using a fully digital workflow. Patients were followed up at 3 months to evaluate implant survival, prosthesis survival, and implant mean marginal bone loss using an interim PMMA prosthesis. Patients completed the Oral Health Impact Profile (OHIP) questionnaire to determine the implants’ impact on quality of life. Statistical analyses included analysis of variance, Fisher’s least significant difference (LSD) test, and the Wilcoxon signed-rank test. Of the 432 implants placed, only two failures were observed. Marginal bone loss (MBL) was significantly greater in male patients (p = 0.002) and older smokers (p = 0.016). Patient-reported outcomes, as measured by the OHIP questionnaire, demonstrated significant improvements in quality of life. PMMA is a reliable material for immediate-loading protocols in fixed interim complete-arch implant prostheses. Its combination of mechanical strength, biocompatibility, and esthetic properties, along with the accuracy of fully digital workflows, ensures predictable clinical outcomes.