All-on-X MD (Metal-Supported) refers to full-arch, implant-supported fixed restorations planned on 4, 6, or more implants, reinforced with a metal framework, for fully edentulous patients or those with advanced tooth loss. This system provides long-term biomechanical stability, especially in cases with high occlusal forces.

All-on-X MD restorations, produced at our dental laboratory in Istanbul, Floya, combine the reliability of traditional metal frameworks with digital design and manufacturing technologies, offering seamless clinical application and long-lasting, dependable results.

What is the All-on-X MD System?

In the “All-on-X” concept, “X” indicates the number of implants supporting the restoration (All-on-4, All-on-6, etc.), while “MD” (Metal-Supported) indicates that the framework is built on a titanium or cobalt-chromium metal skeleton.

The metal framework acts as a bridge between implants, ensuring even force distribution. The porcelain or ceramic layering applied over it not only fulfills functional requirements but is also shaped to achieve natural tooth contours and gingival aesthetics.

Clinical Advantages of All-on-X MD Restorations

• High Structural Strength: The metal framework minimizes flexing, cracking, and fracture risks in full-arch restorations. It provides a secure foundation for patients with bruxism or high occlusal forces.

• Passive Fit and Long-Term Implant Health: CAD/CAM-produced frameworks sit on implants with minimal stress, reducing the risk of screw loosening and bone loss.

• Aesthetic and Functional Control: The metal framework provides technicians with broad control during ceramic layering. Tooth lengths, gingival support, and smile lines can be optimized for each case.

• Cost and Durability Balance: Compared to zirconia or monolithic hybrid systems, All-on-X MD offers a more accessible cost while maintaining long-term stability when used in appropriate cases.

Production Process at Our Laboratory

Accuracy is critical in full-arch implant restorations. Our production process combines digital planning with controlled manual craftsmanship:

1. Digital Design (CAD): Implant positions, abutment relationships, and framework thicknesses are digitally planned based on measurements, scans, and bite records provided by the clinician.

2. Metal Framework Production: The designed frameworks are produced via laser sintering (SLM) or milling from blocks, a critical step to ensure passive fit.

3. Ceramic Layering: Porcelain is applied to the metal skeleton, shaped according to the patient’s age, facial type, and aesthetic needs to mimic natural tooth anatomy.

4. Occlusal and Functional Adjustments: Occlusal surfaces are carefully adjusted to transfer chewing forces vertically to the implants.

Which Cases Benefit Most from All-on-X MD?

All-on-X MD restorations are particularly advantageous in cases with angled implants in posterior regions, long-span edentulous areas, or limited bone support, as the metal framework provides strong bridging support.

These restorations work seamlessly with multi-unit abutment systems, offering clinicians ease of application and patients a natural-tooth-like comfort.