Full Arch8 min read
Prosthetic-first full arch: why the bar comes before the surgery plan
A practical sequence for full-arch cases that keeps screw access, emergence and cantilever within safe limits from the first appointment.
Full-arch cases go wrong at planning, not at delivery. When implant positions are fixed before the prosthesis is designed, you inherit screw access through incisal edges and cantilevers nobody wanted.
The sequence we hold to
- Define the final tooth position and lip support first, from the diagnostic record.
- Place implants to serve that prosthesis, with access channels placed palatally or occlusally by design.
- Validate emergence and cleansability at the bar before any framework is finalised.
- Confirm cantilever length against the A-P spread, and document the limit for the surgeon.
Documentation is part of the design
Each full-arch case is delivered with the reasoning attached — access rationale, cantilever numbers and material assumptions — so a second clinician can pick it up without re-deriving the plan.
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