Periodontal and prosthetic perspective of implant-supported full-arch prostheses with monolithic zirconia and porcelain fused metal restorative materials: A three-year retrospective case series

Abstract

Full-mouth implant-supported prosthetic rehabilitation for failing dentition is a complex, multifactorial process influenced by prosthetic materials and peri-implant periodontal health. Traditionally, porcelain-fused-to-metal (PFM) frameworks have ensured functional stability and acceptable esthetics; however, the advent of monolithic zirconia layered with porcelain has introduced enhanced mechanical strength and esthetic appeal. This retrospective case series evaluated the 3-year clinical outcomes of full-arch implant-supported prostheses fabricated using either monolithic zirconia or PFM in edentulous patients, focusing on peri-implant soft-tissue health, marginal bone loss, and prosthetic complications. Ten edentulous patients rehabilitated with full-arch implant-supported prostheses were included and assessed clinically and radiographically for peri-implant tissue health, plaque accumulation, probing depth, bleeding on probing, marginal bone levels, and technical complications over a 3-year follow-up. Both prosthetic materials demonstrated stable peri-implant tissue health and 100% implant survival at the 3-year mark. Monolithic zirconia restorations exhibited reduced plaque accumulation, stable bone levels, and absence of prosthetic complications, whereas the PFM group showed minor technical issues such as porcelain chipping and screw loosening. Within the limitations of this study, both materials proved clinically viable for full-arch implant rehabilitation; however, monolithic zirconia showed a trend toward superior biological and mechanical outcomes. Larger, prospective studies are warranted to validate these preliminary findings. © 2025 Indian Society of Periodontology.