Non-Immediacy for Non-Destructive Equilibrium: Surgical, Osteogenic, and Prosthetic Innovations in Full-Arch Implant Rehabilitation with Terminal Dentitions – A Three-Year Case Report

Full-arch implant rehabilitation - necessitating a holistic, transdisciplinary approach - has been one of the most rapidly advancing disciplines in implant dentistry, driven by rising standards and modern technological advancements. Despite indicated cases and genuine efforts to improve efficiency, the current trend of immediacy or “teeth-in-a-day” protocol may have unintentionally veiled a more conservative, predictable, and practical potential in wound healing process, esthetics, and occlusion. Through a more phased approach utilizing terminal dentitions as strategic abutments, this case report of three years follow-up emphasizes the leverage of natural biological phenomena in tissue maturation, remodeling, and condensation, along with prosthetic sophistications focusing on its meticulousness in execution and long-range trajectory success. This workflow actualizes a high-quality level of craftsmanship with surgical and prosthetic innovations, introduced as a “re-tightening bilateral sling periosteal mattress suture” (RBSPMS) concept for intermittent tensocompressive mechanotransduction-induced guided bone regeneration and “LegOvate” protocol for seamless loading of prosthetic conversions, emphasizing the intricate reciprocity between physiology and biomechanics for a primary goal of non-destructive equilibrium.