A Titanium Framework Full Arch Rehabilitation for Ireneusz: 24 Units Over Nucleoss Implants

A titanium framework full arch rehabilitation separates the job into two materials. Ireneusz was treated at International Plus as a Polish speaking patient and his record lists 24 zirconia units carried on titanium across the upper and lower jaw over Nucleoss implants in shade Om2. The metal does the structural work. The ceramic does the visible work. This case study follows that division.

Key Takeaways

• The challenge: A two arch rehabilitation recorded with a metal substructure beneath the ceramic rather than ceramic alone.
• The solution: A titanium framework carrying 24 zirconia units across both jaws over Nucleoss implants.
• The technique: Shade Om2 with the clinic’s Plus 3 smile design style, recorded before the units were produced.
• The outcome: 24 units delivered on a titanium substructure in the upper and lower jaw.

What a Titanium Framework Does in a Full Arch

A framework is the substructure that spans between implants and carries the visible restoration above it. Titanium is used for that layer because it combines high strength with low weight while resisting the corrosion a mouth presents.

A comparative study of framework materials examined marginal fit and fracture resistance across polyetheretherketone, zirconia and titanium after thermomechanical ageing (Atsu S, et al., 2024). Material choice at the substructure level answers a different question from material choice at the surface.

Ireneusz’s record lists titanium across both arches. The two layers are planned separately because the forces that break a long span are not the forces that chip a crown. Restorations of this type are covered under dental crowns and readers wanting the general picture will find it in our guide to what a dental crown is.

Ireneusz’s Record and the Nucleoss Implants

The file lists the implant system by name. Nucleoss is a Turkish manufactured dental implant system and recording the brand matters because a clinician servicing the work years later has to identify the components before ordering anything.

Twenty four zirconia units are listed across the upper and lower jaw on a titanium substructure. The shade reads Om2 and the smile design style reads Plus 3.

Our clinic writes the system, the substructure and the ceramic as three separate fields rather than as one description. For example, our implant supported zirconia bridge case documents the same Nucleoss system beneath a different prosthetic design so the two records can be compared directly.

| Record | Detail |

|—|—|

| Zirconia units | 24 across the upper and lower jaw |

| Substructure | Titanium framework |

| Implant system | Nucleoss |

| Shade | Om2 |

| Smile design style | Plus 3 |

| Language | Patient treated in Polish |

Why the Substructure Material Is Chosen Separately

Long span work fails differently from single unit work. A single crown answers to the tooth beneath it. A framework spanning several implants answers to the load the whole arch generates every time the patient closes.

Clinical evidence on prosthetic design and peri-implant bone loss has been gathered in a systematic review and meta-analysis (Lin GH, et al., 2025). Design decisions at this level carry consequences at the bone, not only at the surface.

Titanium adds a manufacturing stage and a cost that a monolithic design avoids but the metal is accepted on long spans because it distributes load in a way ceramic alone does not. For example, our clinic records the substructure material in the patient file alongside the ceramic so both layers are identifiable later. Implant treatment at the clinic is covered under dental implant.

The 24 Zirconia Units Above the Metal

Twenty four units covers both arches in a design of this kind. A superstructure is the visible ceramic layer seated over the framework, carrying shade and shape while the metal beneath carries the load.

Survival and complication rates for implant supported ceramic restorations have been reviewed across veneered and monolithic designs (Pjetursson BE, et al., 2021). Separate work has reviewed the clinical performance of monolithic zirconia specifically (Leitão CIMB, et al., 2022).

Shade Om2 and the Plus 3 style were both recorded before production began, a stage offered as digital smile design. Production ran in the clinic’s own digital laboratory so the metal stage and the ceramic stage stayed on one site. Comparable two arch work is documented in our bar supported rehabilitation case and our screw retained rehabilitation case.

What the Record Shows

Ireneusz’s file documents 24 zirconia units on a titanium framework over Nucleoss implants in shade Om2, designed in the Plus 3 style. Each of those five items is written down rather than described in general terms.

That matters for anyone servicing the work later. A clinician who knows the implant system, the substructure material and the ceramic can plan a repair. A clinician who knows only that the patient has a full arch cannot. Our clinic issues a written record of all of them.

This is one patient’s recorded outcome and individual results may vary. International Plus has treated more than 200,000 patients from 140+ countries since 2014 and holds a rating of 4.8 out of 5 across 5,504 reviews. No clinic can promise an identical design because the substructure that suits one arch does not automatically suit another.

Book a consultation with International Plus if you want to know which substructure would suit your own arch.

Frequently Asked Questions

What is a titanium framework in a dental rehabilitation?

A framework is the substructure that spans between implants and carries the visible restoration above it. Titanium is used at that level for strength and corrosion resistance. The ceramic bonded or screwed over it handles shade and shape so the two layers answer different requirements within one restoration.

Why use titanium rather than making the whole thing from zirconia?

The two materials fail differently. A metal substructure distributes load across a long span while ceramic delivers the optical result at the surface. Comparative studies have measured marginal fit and fracture resistance across framework materials and the choice is made per arch rather than applied universally.

What are Nucleoss implants?

Nucleoss is a Turkish manufactured dental implant system. Recording the brand in the patient file matters because components differ between manufacturers. A dentist servicing the restoration years later needs to identify which system was placed before ordering any replacement part for it.

How many units does a two arch titanium framework case carry?

This record lists 24 zirconia units across the upper and lower jaw. Unit counts vary with how many positions are restored and how the arch is divided. The number is decided from the anatomy and the implant positions rather than applied as a standard figure.

Does the shade apply to the metal or the ceramic?

Shade applies to the ceramic layer only, recorded here as Om2. Titanium beneath is not visible once the restoration is seated. The smile design style, listed as Plus 3 in this file, governs tooth shape and proportion rather than colour so the two settings are recorded separately.

Reviewed by Dr. Mehmet Yavuz

References

1. Atsu S, et al. J Prosthet Dent. 2024. PMID: 37620182
2. Lin GH, et al. J Periodontol. 2025. PMC12273757
3. Pjetursson BE, et al. Clin Oral Implants Res. 2021. PMC9293296
4. Leitão CIMB, et al. J Prosthodont Res. 2022. PMID: 34615842

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