Guided Surgery Case for Same-Day Placement
A fully digital All-on-X case by Dr Chris Navarro, Beeston Dental Practice & Implant Clinic, in collaboration with GoDigital Dental, Nottingham
Case Summary
Case: Upper and lower full-arch rehabilitation
Workflow: Fully digital, guided surgery
Loading: Immediate load
Provisional: High-strength PMMA
Digital capture: IOS + CBCT + ArchTracer
Clinician: Dr Chris Navarro
Laboratory: GoDigital Dental, Nottingham
Delivery: Same-day provisional
A New Standard in Same-Day Full-Arch Rehabilitation
Delivering same-day immediate load treatment across a full arch is one of the most demanding procedures in modern implant dentistry. It requires absolute precision, seamless digital communication, and a workflow that maintains restorative accuracy from the first scan to final torque.
In this featured case, Dr Chris Navarro of Beeston Dental Practice, Nottingham, partnered with GoDigital Dental Laboratory, Nottingham, to deliver a fully digital, prosthetically driven guided-surgery protocol with same-day high-strength PMMA conversion for primary restorations, which are to be finalised in a later article once all healing has taken place.
Both the upper and lower arches were completed on separate days, two weeks apart, ensuring patient comfort while maintaining clinical efficiency.
This article follows the complete journey through implant planning, surgery, laboratory conversion, and immediate load.
Primary Upper and Lower IOS Scans
The workflow began with a high-resolution intraoral scan capturing soft-tissue architecture, occlusion, and arch form.
This digital record became the foundation for all subsequent planning.
UPPER SCAN
LOWER SCAN
Diagnostic Wax-Up
An upper diagnostic digital wax-up was created from the patient’s original denture and pre-op scan. GoDigital Dental created a diagnostic wax-up to establish ideal tooth position, vertical dimension, and aesthetic goals, which became the restorative blueprint that drove implant positioning.
Original denture and opaque markers
Diagnostic digital wax up palatal view
Digital wax-up anterior view
CBCT Scan (Cone Beam Computed Tomography)
A CBCT scan was acquired to assess bone volume, anatomical limitations, and implant feasibility. This dataset was essential for merging prosthetic and surgical planning.
Data Integration & Implant Planning with Pre-Operative Scan and Markers
Upper and lower merged scan files included IOS and CBCT for diagnostic wax-up and implant positioning stent.
UPPER
LOWER
Imported wax-up overlay to implant positions
The IOS and wax-up were imported into the CBCT software, where Dr Navarro and GoDigital Dental collaborated to:
- Align datasets with precision
- Plan implant positions prosthetically
- Determine angulation, depth, and spacing
- Ensure the final prosthesis is fully supported by the implant distribution
This collaborative planning approach was designed to support predictable implant placement and long-term restorative success.
UPPER
LOWER
Surgical Guide Design & Manufacture
A stent sequence with upper and lower original IOS, restorative designs and stent design for guided surgery was required.
GoDigital Dental designed a fully guided surgical stent, incorporating anchor pin positions where required, and palatal strap and lower extensions for stability of position at placement.
The guide was then 3D printed in the dental laboratory in a highly accurate, biocompatible resin ready for surgery.
UPPER
LOWER
On screen image of upper stent ready for printing
CBCT image of placed implants
Following implant placement, CBCT imaging confirmed the position and angulation of the implants in relation to the digitally planned positions.
ArchTracer™ Technology: ARCHTRACER™ Fiducial Marker
For this case, ARCHTRACER™ markers provided by Quoris 3D were used to align the scans, the markers are placed and scanned pre op. The geometric shape along with the implant scan bodies ensure accuracy.
These markers needed to remain in place for the final conversion stage. The IOS was then sent to GoDigital Dental.
GoDigital Dental recommends dentists use ARCHTRACER™ to enhance precision in All-on-X workflows.
By capturing verified 3D implant positions without the distortion associated with traditional verification jigs, ArchTracer™ provides a highly accurate digital foundation for both surgical and restorative phases. We use the markers to align all scans together.
For full-arch cases, where even minor discrepancies can lead to misfit or mechanical complications and failure, ArchTracer™ enables:
- Passively fitting provisional and definitive prosthetics
- Reduced chairside adjustment
- Improved immediate-load outcomes
- Long-term prosthetic stability
Integrated into a fully digital workflow, ArchTracer™ streamlines communication between clinician and laboratory, supporting efficient, repeatable same-day/next-day All-on-X treatment with consistently predictable results.
Guided Implant Placement
Guided surgery was then undertaken using the printed stent. Following the guide, Dr Navarro placed the implants exactly as planned to ensure the restorative design and surgical execution remained perfectly aligned.
Post-placement IOS image received from dentist of scan bodies and ArchTracer markers in situ
A second IOS was taken after implant placement, capturing:
- Scan bodies
- Keeping all ArchTracer markers in situ
This scan became the definitive reference for converting the diagnostic wax-up to the implant positions.
Scan bodies and ArchTracer markers
UPPER
LOWER
Wax-Up Conversion by GoDigital Dental Laboratory
At GoDigital Dental laboratory, the original diagnostic wax-up was aligned with the new implant IOS to make sure the immediate same-day provisional matched the planned aesthetics, occlusion, and soft-tissue support, as well as the designated implant positions
Digital alignment of wax-up to implant scan of upper and lower.
UPPER
LOWER
PMMA Provisional Manufacture
A high-strength PMMA provisional was printed and bonded to temporary cylinders or titanium bases depending on the implant system.
The provisional was then finished, polished, and prepared for same-day delivery.
Bridge and duplicate backup were printed and ready for wash cure.
High-strength PMMA provisional on printed model attached by Ti (titanium) bases
Fitting the PMMA Bridge
As Dr Navarro is local to GoDigital Dental in Nottingham, we were able to deliver the restoration on the same day.
Having already designed the bulk of the work during the pre-planning stages, the lab accepted the new IOS from Dr Navarro and made any adjustments required and printed the restoration. This was then hand-delivered to our client whilst he completed the surgery on the patient.
For cases where we are unable to deliver on the same day, we are able to send by courier for next-day delivery, ensuring a smooth transition for the patient into their new prosthetic.
On the same day, the PMMA provisional was fitted by Dr Navarro, ensuring:
- Passive seating is verified
- Occlusion is refined (if required)
- Soft-tissue support is confirmed
Immediate load prosthesis in situ; the patient left with a stable, aesthetic, functional full-arch restoration while the implants integrate.
A Predictable Outcome from Digital Planning to Immediate Restoration
This case demonstrates the strength of a fully digital, collaborative workflow between Dr Chris Navarro and GoDigital Dental Nottingham.
From prosthetically driven planning to guided surgery and same-day PMMA conversion, every stage was engineered for:
- Accuracy
- Predictability
- Exceptional patient outcomes
The precision of the digital workflow also provided a reliable foundation for the final stages of the patient’s rehabilitation, ensuring a smooth transition from provisional to definitive restoration.
The next stage will be final prosthetics for upper and lower, this will be documented separately.
Case Study Before
Case Study Design
Case Study After
“Working with GoDigital Dental on this case of ‘teeth in a day’ which was completed in two stages (upper and lower arches two weeks apart for patient comfort) was exceptionally straightforward. From uploading the intraoral scans and CBCT to receiving the surgical guide and PMMA tempory/primarybridges. The digital workflow was seamless and well coordinated. Chair-side adjustments were minimal, the fit and occlusion were accurate on delivery, and having direct access to the lab team by phone/WhatsApp made planning and any last-minute tweaks efficient for both me and the patient. Overall, GoDigital’s service quality made a complex full-arch rehabilitation feel routine.’
Dr Chris Navarro
BDS MFGDP, MSc (Implantology)
Principal Dentist, Beeston Dental Nottingham
GDC 82120
Credits to:
Surgical work by
Dr Chris Navarro BDS MFGDP MSc (Implantology)
All design work for upper and lower cases
Mrs Nicole Moon RDT, CADCAM Team Leader
Finishing of all work for both arches
Ms Jenna Ellis RDT, Ceramic Team Leader
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