-
The International Journal of Oral &... 2022The purpose of this systematic review and meta-analysis was to evaluate the effects of splinting impression copings on the accuracy of conventional impressions for... (Meta-Analysis)
Meta-Analysis
PURPOSE
The purpose of this systematic review and meta-analysis was to evaluate the effects of splinting impression copings on the accuracy of conventional impressions for two-unit nonparallel implant restorations.
MATERIALS AND METHODS
MEDLINE via PubMed, Embase, and Web of Science databases were searched with no publication year or language limits, and studies comparing the accuracy of conventional impressions for two-unit nonparallel implant restorations made using splinted impression copings and nonsplinted impression copings were identified. A meta-analysis was performed using Review Manager software. The mean difference (MD) with 95% confidence interval (95% CI) for the framework strain and marginal gap of the implant-framework connection between impressions using splinted and nonsplinted copings were statistically analyzed (α = .05).
RESULTS
Initially, 142 articles were identified after the removal of duplicates. Five in vitro studies were included in the systematic review, and four in vitro studies were included in the meta-analysis. All the included studies were focused on internal-connection implants and implant-level impressions. The implant angulation in the included studies ranged from 8 to 30 degrees. Impressions using splinted impression copings exhibited significantly smaller marginal gaps than those using nonsplinted impression copings (P = .02; mean difference [MD] = -13.34; 95% CI = -24.31 to -2.36). Moreover, with respect to the framework strain, no significant differences were found between impressions using splinted impression copings and nonsplinted impression copings (P = .47; MD = -12.64; 95% CI = -47.32 to 22.03).
CONCLUSIONS
Significantly larger marginal gaps were found in the impressions using splinted impression copings, but the clinical significance was low. Based on the limited number of studies included, splinting copings is unnecessary when making conventional impressions for two-unit nonparallel implant restorations.
Topics: Adaptation, Psychological; Dental Implants; Dental Impression Materials; Dental Impression Technique; Dental Prosthesis, Implant-Supported
PubMed: 35904821
DOI: 10.11607/jomi.9577 -
The International Journal of... 2023To compare the marginal gap and internal fit of fixed dental prostheses (FDPs) fabricated using intraoral vs extraoral scanning methods. (Meta-Analysis)
Meta-Analysis
PURPOSE
To compare the marginal gap and internal fit of fixed dental prostheses (FDPs) fabricated using intraoral vs extraoral scanning methods.
MATERIALS AND METHODS
MEDLINE/PubMed and the Cochrane database were searched. The focused PICO question was: For the fabrication of FDPs, does an intraoral scanning technique result in a different marginal gap than an extraoral scanning technique? The secondary outcome assessed was internal fit. Studies were selected based on the inclusion criteria, and a meta-analysis was performed.
RESULTS
A total of 14 studies (10 in vitro and 4 in vivo) were included in the meta-analysis. Marginal gap in single crowns was evaluated in 5 studies, copings for single crowns in 5 studies, three-unit FDPs in 3 studies, and both single-crown and three-unit FDPs in 1 study. Significantly lower marginal gap was found with intraoral scanning compared to impression scanning (P < .001) and cast scanning (P < .001), and for impression scanning compared to cast scanning (P = .037). Internal fit was superior with intraoral scanning compared to impression scanning, and this difference was significant (P < .001). No significant differences were found in internal fit with cast scanning compared to intraoral or impression scanning. The mean marginal gap/internal fit was 188.3 μm/146.2 μm with intraoral scanning, 116.29 μm/168.2 μm with impression scanning, and 195.1 μm/229.1 μm with cast scanning.
CONCLUSION
Marginal gap was lower with intraoral scanning than with impression scanning and cast scanning. Impression scanning showed less marginal gap than cast scanning. Internal fit with intraoral scanning was superior to impression scanning, but when compared to cast scanning, no difference was found.
Topics: Dental Prosthesis
PubMed: 36853226
DOI: 10.11607/ijp.7634 -
European Journal of Oral Implantology 2017The use of intraoral scanners (IOS) for making digital implant impressions is increasing. However, there is a lack of evidence on the accuracy of IOS compared with... (Review)
Review
AIM
The use of intraoral scanners (IOS) for making digital implant impressions is increasing. However, there is a lack of evidence on the accuracy of IOS compared with conventional techniques. Therefore, the aim of this systematic review was to collect evidence on the accuracy of digital implant impression techniques, as well as to identify the main factors influencing the accuracy outcomes.
MATERIALS AND METHODS
Two reviewers searched electronic databases in November, 2016. Controlled vocabulary, free-text terms, and defined inclusion and exclusion criteria were used. Publications in English language evaluating the accuracy outcomes of digital implant impressions were identified. Pooled data were analysed qualitatively and pertinent data extracted.
RESULTS
In total, 16 studies fulfilled the inclusion criteria: one in vivo and 15 in vitro studies. The clinical study concluded that angular and distance errors were too large to be acceptable clinically. Less accurate findings were reported by several in vitro studies as well. However, all in vitro studies investigating the accuracy of newer generation IOS indicated equal or even better results compared with the conventional techniques. Data related to the influence of distance and angulation between implants, depth of placement, type of scanner, scanning strategy, characteristics of scanbody and reference scanner, operator experience, etc were analysed and summarised. Linear deviations (means) of IOS used in in vitro studies ranged from 6 to 337 µm. Recent studies indicated small angle deviations (0.07-0.3°) with digital impressions. Some studies reported that digital implant impression accuracy was influenced by implant angulation, distance between the implants, implant placement depth and operator experience.
CONCLUSIONS
According to the results of this systematic review and based on mainly in vitro studies, digital implant impressions offer a valid alternative to conventional impressions for single- and multi-unit implant-supported restorations. Further in vivo studies are needed to substantiate the use of currently available IOS, identify factors potentially affecting accuracy and define clinical indications for specific type of IOS. Data on Data on accuracy OF digital records, as well as accuracy of printed or milled models for implant-supported restorations, are of high relevance and are still lacking. Conflict-of-interest and funding statement: The authors state there is no conflict of interest.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Technique; Humans; Image Processing, Computer-Assisted
PubMed: 28944372
DOI: No ID Found -
The Journal of Evidence-based Dental... Dec 2023The present study aimed to systematically review the current randomized clinical trials (RCTs) with respect to computer-aided design/computer-aided manufactured... (Meta-Analysis)
Meta-Analysis
COMPARISONS BETWEEN DIGITAL-GUIDED AND NONDIGITAL PROTOCOL IN IMPLANT PLANNING, PLACEMENT, AND RESTORATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS.
OBJECTIVES
The present study aimed to systematically review the current randomized clinical trials (RCTs) with respect to computer-aided design/computer-aided manufactured (CAD/CAM) techniques in the process of implant planning, placement, and rehabilitation.
MATERIALS AND METHODS
Four independent reviewers conducted an electronic and manual literature search using several databases, including the National Library of Medicine (MEDLINE-PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE. Articles were included if they were RCTs involving the interventions regarding the computer-guided impression, placement, and manufacturing process. The outcomes of interest include clinical and patient-reported outcomes and time efficiency. A meta-analysis was conducted to evaluate the time efficiency, pain severity, accuracy of implant placement, and postsurgery marginal bone level.
RESULTS
A total of 39 and 25 articles were included in the qualitative and quantitative analysis, respectively. The results of the meta-analysis showed that significantly less time was spent performing the digital impression procedure than the conventional impression (P = .002). In addition, the average adjustment time of the final prosthesis was significantly less than the nondigital fabricated prosthesis (P = .0005). Computer-guided groups reported significantly lower painkiller consumption compared to control groups (P = .03).
CONCLUSIONS
Digital impressions and CAD/CAM procedures are time-saving and provide stable and predictable outcomes. Moreover, computer-guided surgery can effectuate an accurate implant placement and less postsurgery discomfort.
Topics: Humans; Dental Implants; Randomized Controlled Trials as Topic; United States
PubMed: 38035896
DOI: 10.1016/j.jebdp.2023.101919 -
Biomimetics (Basel, Switzerland) Mar 2024The popular immediate dentin sealing (IDS) technique is used to improve the bond strength of indirect restorations. This systematic review assessed whether bond strength... (Review)
Review
The popular immediate dentin sealing (IDS) technique is used to improve the bond strength of indirect restorations. This systematic review assessed whether bond strength is affected by the type of aging conditions, bonding agents, flowable resin composites, impression materials, temporary materials, and/or resin cement used within the IDS procedure. A comprehensive database search of PubMed, Embase, Scopus, Ovid Medline, Web of Sciences, Cochrane Library, Dentistry & Oral Sciences Source, and ProQuest was carried out up to 30 January 2024 without publication year or language limitations. Only in vitro full-texts regarding the effect of IDS on bond strength were included, and the quality of their methods was assessed via a Risk of Bias (RoB) test. In total, 1023 pertinent studies were initially found, and 60 articles were selected for review after screening for the title, abstract, and full texts. IDS application improves the bond strength of indirect restorations to dentin and reduces the negative effects of temporary materials on the bond durability of final indirect restorations. Filled dentin bonding agents or combinations with flowable resin composite are preferred to protect the IDS layer from conditioning procedures.
PubMed: 38534867
DOI: 10.3390/biomimetics9030182 -
The Journal of Prosthetic Dentistry Apr 2021Intraoral scanners have been increasingly used in recent years. However, the accuracy of digital scans as it affects marginal adaptation is unclear. (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Intraoral scanners have been increasingly used in recent years. However, the accuracy of digital scans as it affects marginal adaptation is unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the marginal adaptation of single-unit zirconia crowns fabricated with digital scans or with conventional impressions.
MATERIAL AND METHODS
The electronic databases PubMed (MEDLINE), Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (ISI), Scopus, and EMBASE were searched and complemented by a manual search. Risks of bias were assessed by using a modified methodological index for nonrandomized studies (MINORS). Mean ±standard deviation (SD) values of marginal accuracy of studies were extracted for both methods. Mean marginal difference and 95% confidence interval (CI) were calculated to evaluate the marginal accuracy of each method. Pooled data were statistically analyzed by using a random-effect model.
RESULTS
Seventeen studies were used to perform the meta-analysis. Subgroup analysis was performed based on intraoral scanners. Standardized mean marginal difference and 95% CI of each subgroup were as follows: Lava: -0.85 μm (95% CI: -1.67, -0.03) (P=.043); CEREC: -1.32 μm (95% CI: -2.06, -0.59) (P<.001); iTero: -0.44 μm (95% CI: -1.35, 0.47) (P=.338); TRIOS: -1.26 μm (95% CI: -2.02, -0.51) (P=.001); unknown scanner: -0.21 μm (95% CI: -1.14, 0.72); all studies: -0.89 μm (95% CI: -1.24, -0.54) (P<.001).
CONCLUSIONS
Digital scanning of prepared teeth for single-unit zirconia restorations resulted in better marginal accuracy than conventional techniques using elastomeric impression materials.
Topics: Computer-Aided Design; Crowns; Dental Impression Technique; Dental Marginal Adaptation; Dental Prosthesis Design; Zirconium
PubMed: 32284188
DOI: 10.1016/j.prosdent.2020.01.035 -
Biomaterial Investigations in Dentistry 2020To compare the fit and assess the accuracy of tooth-supported single and multi-unit FDPs in cobalt chromium fabricated using different manufacturing techniques. A... (Review)
Review
To compare the fit and assess the accuracy of tooth-supported single and multi-unit FDPs in cobalt chromium fabricated using different manufacturing techniques. A systematic search was performed in three databases; PubMed, Scopus, and Web of Science, using clearly specified search terms and inclusion criteria. The search yielded 1071 articles and included 18 articles in the analysis. Data regarding the fit analyses and the methods of manufacturing were extracted and the accuracy was defined as the fit result minus the pre-set cement spacer. Internal gap (IntG) was the mean of all the internal measuring points and total gap (TotG) was the mean of all measuring points (marginal, cervical, chamfer, axial, occlusal). The total gap results for fit and accuracy irrespective of manufacturing technique were 96 μm and 54 μm for single crowns, 107 μm and 54 μm for multi-unit FDPs, and 98 μm and 54 μm for both single crowns and multi-unit FDPs combined. For total gap of single crowns soft milling had the highest accuracy, for multi-unit FDPs additive manufactured restorations had the highest accuracy. With the results grouped by impression technique, the accuracy for total gap was highest for digital impressions and lower for conventional impressions. Due to the inherent limitations of this systematic review, it still remains unclear what effect the manufacturing technique has on the fit of FDPs. However, the descriptive results suggest that the marginal fit of cobalt chromium FDPs is not negatively affected by the manufacturing technique.
PubMed: 32083253
DOI: 10.1080/26415275.2020.1714445 -
PeerJ 2023To systematically evaluate the disinfection efficacy of the two most frequently used disinfectants, sodium hypochlorite and glutaraldehyde, and their effects on the...
Disinfection efficacy of sodium hypochlorite and glutaraldehyde and their effects on the dimensional stability and surface properties of dental impressions: a systematic review.
OBJECTIVE
To systematically evaluate the disinfection efficacy of the two most frequently used disinfectants, sodium hypochlorite and glutaraldehyde, and their effects on the surface properties of four different dental impression materials.
METHODS
A systematic literature search was performed in four databases until May 1st, 2022 to select the studies which evaluated disinfection efficacy of disinfectants or surface properties of dental impressions after chemical disinfection.
MAIN RESULTS
A total of 50 studies were included through electronic database searches. Of these studies, 13 studies evaluated disinfection efficacy of two disinfectants, and 39 studies evaluated their effects on the surface properties of dental impressions. A 10-minute disinfection with 0.5-1% sodium hypochlorite or 2% glutaraldehyde was effective to inactivate oral flora and common oral pathogenic bacteria. With regard to surface properties, chemical disinfection within 30 min could not alter the dimensional stability, detail reproduction and wettability of alginate and polyether impressions. However, the wettability of addition silicone impressions and the dimensional stability of condensation silicone impressions were adversely affected after chemical disinfection, while other surface properties of these two dental impressions were out of significant influence.
CONCLUSIONS
Alginate impressions are strongly recommended to be disinfected with 0.5% sodium hypochlorite using spray disinfection method for 10 min. Meanwhile, elastomeric impressions are strongly recommended to be disinfected with 0.5% sodium hypochlorite or 2% glutaraldehyde using immersion disinfection method for 10 min, however, polyether impression should be disinfected with 2% glutaraldehyde.
Topics: Sodium Hypochlorite; Glutaral; Disinfection; Time Factors; Disinfectants; Surface Properties; Silicones; Alginates; Bacteria
PubMed: 36846444
DOI: 10.7717/peerj.14868 -
Evidence-based Dentistry Sep 2023To analyze the clinical outcomes of implant-supported prostheses and tooth-supported fixed prostheses, fabricated from digital and conventional impression. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
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.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Artificial Limbs; Prosthesis Implantation
PubMed: 37369705
DOI: 10.1038/s41432-023-00904-5 -
The Journal of Prosthetic Dentistry Jan 2024Time and cost are factors that influence a patient's decision on dental prosthetic treatment. Evidence is needed to demonstrate that restoration using digital systems is... (Review)
Review
STATEMENT OF PROBLEM
Time and cost are factors that influence a patient's decision on dental prosthetic treatment. Evidence is needed to demonstrate that restoration using digital systems is more rapid and less costly than the conventional process.
PURPOSE
The purpose of this systematic review was to analyze and compare the duration and cost of fixed dental prostheses fabricated using digital and conventional methods from scanning or impression making to delivery of the prosthesis.
MATERIAL AND METHODS
A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P 2015) guidelines. The analysis methods and inclusion criteria were documented in a protocol registered in the Prospective International Register of Systematic Reviews (PROSPERO) (CRD42023458734). The bibliographic search was carried out using PubMed, Cochrane, and PROSPERO databases. The main keywords used were (Prosthodontic OR restorative dentistry OR denture) AND (CAD CAM OR Digital workflow OR Computer Dentistry OR Digital Design) AND (Economic OR cost OR Financial OR time efficiency). Two investigators undertook the different steps of article selection.
RESULTS
A total of 8 articles published between 2010 and 2023 were found for the qualitative synthesis by using the search criteria. Two studies showed that conventional impressions took more time than digital scans for the fabrication of a single crown, and 1 study showed the opposite. One study found that a digital scan was faster than conventional impression making for the fabrication of a 3-unit fixed partial denture, and another study showed the opposite. The dental laboratory technician spent more time on the conventional workflow than the digital workflow for the 3-unit framework and veneering process. No difference was found between conventional and digital workflows for clinical evaluation and chairside adjustment for the fabrication of a single crown. No articles have compared the cost of fixed prostheses.
CONCLUSIONS
The digital pathway can shorten the laboratory process. However, the duration of the impression or scan may vary depending on the technique used. Studies are needed to analyze the cost-effectiveness of the fabrication of tooth-supported restorations.
PubMed: 38302291
DOI: 10.1016/j.prosdent.2024.01.003