The Choice of Preserving vs Reducing Bone in Full Arch Implant Therapy
Intentionally removing bone for an All-on-X prosthesis is irreversible. This webinar weighs bone preservation (FP1) against bone reduction (FP3), covering implant number, restorative space, smile line, materials, clinical cases, practical solutions to potential problems and a decision framework.
Full-arch and full-mouth implant rehabilitation has become one of the fastest-growing areas of modern dentistry. Many clinics now focus almost entirely on “All-on-X” treatment, and the patients seeking it are increasingly younger, often in their early 40s. Many standardized full-arch protocols rely on substantial alveolar bone reduction to create restorative space and hide the prosthesis–tissue junction. That reduction is irreversible. For a patient who may live with implants for 30 to 40 years, the amount of bone removed on the day of surgery matters long after the first prosthesis is delivered.
This webinar examines a central question in full-arch therapy: should we preserve the patient’s bone and restore with an FP1 prosthesis, or reduce the bone and restore with an FP3 prosthesis?
An FP1 prosthesis replaces only the clinical crowns, so the result resembles natural teeth emerging from the soft tissue. An FP3 prosthesis replaces both the teeth and part of the lost soft and hard tissue with pink restorative material.
FP3 restorations have a strong track record of predictability and long-term durability. They tolerate small variations in implant position, provide enough restorative space for strong prosthetic materials, and follow a well-standardized workflow. The cost is a more aggressive alveoloplasty, the permanent loss of bone and soft tissue, and fewer options if the patient later needs retreatment.
FP1 restorations preserve bone and offer a more natural, tooth-like result. They demand precise three-dimensional implant positioning, careful soft-tissue management and meticulous prosthetic design. Because restorative space is limited, the prosthetic material is thinner and more prone to fracture.
The lecture will cover the main factors that drive this decision:
a)the number and distribution of implants needed to restore a full arch
b)how much bone reduction is actually necessary in each approach, and why
c)how smile line and restorative space shape the plan
material selection and prosthetic design for each option
d)practical strategies to overcome the limitations of both FP1 and FP3
Clinical cases will illustrate each scenario, along with complications and how they were managed.
By the end of the webinar, participants will understand the “All-on-X dilemma” and have a structured, patient-centered framework for choosing between bone preservation and bone reduction.
Learning Objectives
By the end of this webinar, participants will be able to:
1)Define the FP1, FP2 and FP3 fixed prosthesis categories and identify the clinical features of each.
2)Assess the factors that guide the choice between FP1 and FP3: smile line, available bone, restorative space.
3)Determine the appropriate number and distribution of implants for full-arch rehabilitation in different clinical situations.
4)Estimate the amount of bone reduction each prosthetic design requires, and recognize the long-term biological cost of reducing bone, particularly in younger patients.
5)Compare the advantages, disadvantages and complication profiles of FP1 and FP3 restorations, including mechanical risks such as material thickness and fracture, and biological risks.
6)Apply strategies to manage the challenges of each approach, including implant positioning, soft-tissue handling, material selection.
7)Develop a structured, patient-specific decision-making process for full-arch treatment planning that balances predictability, aesthetics and long-term preservation of tissue.
Tribune Group GmbH is an ADA CERP Recognized Provider.