A DIGITAL PALATIN LANDMARK: AN INNOVATIVE TOOL IN FULL-ARCH DIGITAL IMPLANTS SURGICAL PLANNING AND PROSTHETIC REHABILITATION

¹ Private practitioner in Alba, Cuneo, Italy
² Head and Neck Department, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy
³ Private practitioner in Boves, Cuneo, Italy
⁴ Private practitioner in Rosà, Vicenza, Italy
⁵ Social and Healthcare Unit 9 Specialist, Verona, Italy
⁶ Head and Neck Department, Department of Surgery, Dentistry, Pediatrics and Gynecology, University of Verona, Verona, Italy; Private practitioner in Caldiero, Verona, Italy

Correspondence to:

European Journal of Musculoskeletal Diseases 2026 September- December 15(3): Ahead of Print
https://doi.org/10.82093/ejmd/2026v15iss3_1

Received: 29 July 2026 Accepted: 1 September 2026

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Abstract

The main aim of this paper, which focuses on a clinical case report, is to evaluate and discuss the effectiveness of using a palatal landmark as a tool to improve the overall digital workflow in immediate-loading primary prosthetics for full-arch structures. The palatine landmark allows the vertical dimension to be maintained from the pre-extraction phase to the delivery phase of the temporary restoration. The patient is treated with 4 implants in the premaxilla and 2 in the pterygoid area (these 2 posterior fixtures are extremely important to dramatically reduce the posterior cantilever). In this case report, no particular issues were encountered in matching the pre-/intra-/post-surgery digital full arch impression using a photogrammetry device (Shining Elite Plus). The temporary Toronto was applied within the expected timeframe (less than 24 hours) and the patient was highly satisfied. The palatine landmark allows an excellent matching of the digital files, the pre-extraction optical impression, with the one generated with the shining elite photogrammetry. This photogrammetry can be applied to both the four post-extraction anterior implants and the posterior implants to generate a file for the primary/temporary prosthetic structure and also for the permanent one. This new photogrammetry device allows for more predictable, precise impression-taking, even with an open flap. To read soft tissue (such as the fornix in the lower arch, which is often mobile), “caps” are used, which are placed directly above the MUA immediately after the fixture is inserted. Despite the extremely limited number of patients, at the moment in our opinion, there are no other better techniques or devices that allow full-arch completion of complex cases in such a short time, and with such satisfactory results reported by patients themselves. We hope this first article will serve as a starting point for sharing and further exploring this new technique, also in NZP® rehabilitation in atrophic patients.

Keywords: analogical and digital reference in full arch impression, digital matching, full arch rehabilitation, intra oral photogrammetry, NZP®, precision and stability in fully digital planning