Full-Arch Restoration of the Maxilla Using a Digital Protocol and Ultra-Compact XGATE Dental V-Type Multi-Units

Dec 11, 2025 | Cases


 

Dr. Alexander Sikharulidze
This case was presented by Dr. Alexander Sikharulidze, a prosthodontist from Tbilisi, Georgia.

“My professional work primarily focuses on implant prosthetics. I actively strive to integrate the use of intraoral scanners into everyday clinical practice and fully embrace modern trends in digital dentistry.”


This clinical case is of interest due to the combination of a digital protocol and the use of ultra-low profile multi-unit abutments. This combination allows for the most secure fit of the restoration to the alveolar ridge and, in some situations, eliminates the need for angled abutments—provided that the inter-implant divergence angle does not exceed 40°.

Before moving on to a detailed description of the case, it is advisable to briefly outline the key features of the XGATE Dental MUA V-Type compared to most market alternatives, as these components made the implementation of this clinical protocol possible.

Firstly, they feature a large contact area for the support sleeve—specifically 10 mm², as opposed to 6 mm² in the previous generation of MUAs. This makes the screw connection more stable and durable.
XGATE Dental MUA V-Type multi-unit abutments components for full-arch implant restorations
XGATE MUA V-Type contact area comparison showing 10mm² versus 6mm² support sleeve contact for improved screw connection stability
Secondly, they offer the opportunity to create a durable restoration in conditions of insufficient space between the implant platform and the antagonist tooth.
Diagram showing insufficient space between implant platform and antagonist tooth, demonstrating need for ultra-low profile MUA

Besides, these abutments are available with ultra-low sleeves measuring just 0.5 mm in height. In clinically challenging situations, they can be used as support elements without forming a screw shaft, avoiding structural weakness in the prosthesis. This approach is also justified in cases where the intended screw channel exit point is located on the buccal surface, potentially compromising the aesthetics of the restoration.

Ultra-low profile 0.5mm sleeve for MUA support without screw shaft formation in challenging clinical situations

Let’s return to our case.

Patient Summary

Patient: Female, 44 years old
Complaints: Aesthetic and functional discomfort, as well as a desire to replace the previously installed metal-ceramic restoration.

Initial clinical situation showing existing metal-ceramic restoration in maxilla before treatment, patient presenting with aesthetic and functional complaints
General health: Generally healthy.

Periodontal status: Significant periodontal pathology was noted: deep periodontal pockets, along with supra- and subgingival calculus and plaque. Grade II tooth mobility was diagnosed in the maxilla; localized deep periodontal and bony defects were observed in specific segments of the mandible. Functional overload caused by a prognathic bite was also detected.

Treatment Plan and Implementation

Based on 3D computed tomography data and a clinical examination, comprehensive oral rehabilitation was planned.

Maxilla: The plan included removing the old prosthesis and teeth, placing dental implants, and fabricating a new prosthesis using a one-stage implantation protocol with immediate loading. Six implants were planned.

Mandible: Despite Grade I-II tooth mobility, taking the patient’s wishes into account, it was decided to preserve her natural teeth as much as possible. Only tooth 3.1 was indicated for extraction. Prosthetic restoration of the lower jaw was performed using prepared teeth with preserved vital roots.

3D computed tomography scan showing maxillary implant treatment planning with six implant positions marked

Six standard-diameter Neobiotech dental implants were placed in the maxilla; no narrow-diameter implants were used.

Six Neobiotech standard-diameter dental implants placed in maxilla for full-arch restoration with immediate loading protocol

Using an intraoral scanner, a digital impression was obtained. Based on this, a temporary fixed bridge made of PMMA plastic was milled from premilled blanks. The use of premilled blanks ensures high precision and an optimal passive fit of the structure due to the standardized implant/abutment interface.

The patient wore the implant-supported provisional prosthesis for six months.

After the completion of the osseointegration period, straight XGATE V-Type multi-units were selected to manufacture the permanent restoration.

Implant Placement Diagram

Tooth Position (FDI) Implant System MUA Type & Gingival Height
#11 Neobiotech (Standard Ø) XGATE V-Type MUA — 1 mm
#13 Neobiotech (Standard Ø) XGATE V-Type MUA — 3 mm
#17 Neobiotech (Standard Ø) XGATE V-Type MUA — 3 mm
#21 Neobiotech (Standard Ø) XGATE V-Type MUA — 1 mm
#24 Neobiotech (Standard Ø) XGATE V-Type MUA — 1 mm
#26 Neobiotech (Standard Ø) XGATE V-Type MUA — 1 mm
Total: 6 Implants 6× Neobiotech 6× XGATE V-Type MUA (Straight)
XGATE MUA V-Type multi-unit abutments with color-coded markings indicating different gingival heights installed on implants
Please note: The color marking of the MUA V-type determines the gingival height.
XGATE MUA V-Type color marking reference chart showing correlation between colors and gingival cuff heights (1mm, 2mm, 3mm)

Based on the thickness of the soft tissues, the patient received:

  • MUA V-type – 1 mm – in positions 21, 24, 26 and 11
  • MUA V-type – 3 mm – in positions 13 and 17

Next, using CAD/CAM technologies, a fixed, full-contour zirconia bridge was manufactured, designed for screw retention on titanium sleeves.

CAD/CAM design of full-contour zirconia bridge for maxillary full-arch restoration, occlusal view showing screw access holes
CAD/CAM design of full-arch zirconia bridge showing frontal view with anatomical tooth contours and emergence profile

The final impression was performed using XGATE digital scan bodies, which made it possible to maintain a fully digital workflow at all stages of treatment.

XGATE digital scan bodies installed for intraoral scanning, enabling fully digital workflow for implant impression taking

At implant sites 16 and 23, an angled screw channel technique using Torx-type screws was employed to optimize the positioning of the screw access hole.

The following images show the final treatment result. The patient expressed complete satisfaction with both the functional outcome and the aesthetic aspects of the restoration.

Final full-arch zirconia restoration on maxilla, occlusal view showing screw-retained prosthesis with sealed access holes
Final treatment result showing patient smile with full-arch maxillary zirconia restoration demonstrating excellent aesthetics
Frontal close-up view of completed full-arch maxillary restoration showing natural tooth morphology and gingival harmony

XGATE Products: Maxillary Rehabilitation Case

The products selected for this digital workflow include V-Type abutments for a low profile and angled screw channel solutions.

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We hope you found this clinical case interesting. If you have any questions about the characteristics and delivery of XGATE Dental products, please contact us in any convenient way.

XGATE Dental Group GmbH
Falkensteiner Straße 77, 60322
Frankfurt am Main
Germany

E-mail: [email protected]
350 W Passaic
St Rochelle Park, NJ 07662
United States

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Disclaimer: Any medical or scientific information provided in connection with the content presented here makes no claim to completeness and the topicality, accuracy and balance of such information provided is not guaranteed. The information provided by XGATE Dental Group GmbH does not constitute medical advice or recommendation and is in no way a substitute for professional advice from a physician, dentist or other healthcare professional and must not be used as a basis for diagnosis or for selecting, starting, changing or stopping medical treatment.

Physicians, dentists and other healthcare professionals are solely responsible for the individual medical assessment of each case and for their medical decisions, selection and application of diagnostic methods, medical protocols, treatments and products.

XGATE Dental Group GmbH does not accept any liability for any inconvenience or damage resulting from the use of the content and information presented here. Products or treatments shown may not be available in all countries and different information may apply in different countries. For country-specific information please refer to our customer service or a distributor or partner of XGATE Dental Group GmbH in your region.

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