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Conventional and Digital Impression Techniques Led to Similar Clinical Outcomes in Tooth- and Implant-Supported Fixed Prostheses
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- This systematic review and meta-analysis analyzed the clinical outcomes of tooth-supported and implant-supported fixed prostheses fabricated using conventional and digital impression techniques. Based on the included eight randomized clinical trials (four studies on tooth-supported fixed prostheses and four studies on implant-supported fixed prostheses), the authors reported no significant differences in clinical outcomes between implant-supported fixed prostheses fabricated using a conventional impression and those fabricated using a digital impression. For a tooth-supported fixed prosthesis, the marginal fit of the prosthesis fabricated using the digital impression was significantly better, except for the occlusal region, where a conventional impression led to a favorable outcome.
- No significant differences in clinical outcomes were observed between implant-supported fixed prostheses fabricated using conventional and digital impression techniques. Despite discrepancies in the occlusal region, a favorable marginal fit was obtained in tooth-supported fixed prostheses fabricated using digital impressions.
abstract
This abstract is available on the publisher's site.
Access this abstract nowOBJECTIVE
To analyze the clinical outcomes of implant-supported prostheses and tooth-supported fixed prostheses, fabricated from digital and conventional impression.
MATERIALS AND METHODS
The literature search was carried out on two electronic databases (PubMed and Cochrane Library). Randomized controlled trials (RCT) published from January 2011 to September 2022 were included. The bias risk was evaluated using Cochrane Risk of Bias Tool 2.0. Further screening was done for meta-analysis according to modified Newcastle-Ottawa scoring criteria. Forest plot was generated using a statistical method of inverse variance of random effect with 95% confidence interval.
RESULTS
A total of 8 randomized controlled trials were included for systematic review out of which four studies were based on tooth-supported fixed prosthesis and remaining four were based on implant-supported prosthesis. Further screening was conducted and three studies were eligible for meta-analysis. Tooth-supported fixed prosthesis fabricated from digital impression showed no significant difference in the marginal fit in any region measured, except for occlusal region where conventional impression showed more favorable marginal fit. Implant-supported prosthesis fabricated from digital impression showed survival rates ranging from 97.3 to 100% and there was no statistically significant difference in marginal bone loss (p = 0.14).
CONCLUSION
Implant-supported prostheses fabricated from digital and conventional impressions show no significant differences in their clinical outcomes. Tooth-supported fixed prostheses fabricated from digital impression have shown favorable findings in terms of marginal fit. Despite that, there is still lack of clinical trials with larger sample size and longer follow-up periods. Future studies that fulfill these two criteria are deemed necessary.
Additional Info
Disclosure statements are available on the authors' profiles:
Clinical outcomes of implant-supported and tooth-supported fixed prostheses fabricated from digital versus analogue impression: a systematic review and meta-analysis
Evid Based Dent 2023 Jun 27;[EPub Ahead of Print], NS Mahat, NY Shetty, S Kohli, NB Jamayet, P PatilFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Recent years have increasingly brought digital technologies to the fore in clinical dentistry. Digital workflow has increasingly challenged traditional dental techniques in attaining indirect restorative outcomes, both with implant-supported and tooth-borne restorations. As digital technologies have matured, the question of whether there is an advantage and better outcomes in comparison with traditional analogue techniques has continued to ramp up. This systematic review and meta-analysis set out to address this comparison for both implant-supported and tooth-borne indirect restorations.
The authors applied an updated methodology (PRISMA 2020) in selecting the systematic review and meta-analysis strategy for choosing the inclusion criteria for the data used to address the stated PICO question for comparing digital versus analogue impression techniques and their effect on clinical outcomes. The bottom-line results suggested no difference between the former and the latter in clinical outcomes. Weaknesses in this clinical-outcome analysis included a short follow-up period (≤1 year), a low number of included studies, and heterogeneity in defined clinical outcomes (eg, success vs survival rates). Other outcome factors, such as the marginal gap, occlusal fit, marginal leakage, and plaque index, have significantly varied clinical effects when comparing implant-supported and tooth-borne restorations. Although these terms may have aided in the literature search strategy, they pose weaknesses in outcome comparisons between implant-supported and tooth-borne restorations. Future efforts for the authors to address digital versus analogue techniques for implant-supported and tooth-borne restorations may include longer (≥5 years) and better-defined outcomes such as success that includes quality of life (patient-centric) versus survival (provider-centric).