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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 -
Journal of Clinical and Experimental... Aug 2020This systematic review aimed to evaluate the efficiency and accuracy of digital impression techniques for implant-supported restorations, and to assess their economic... (Review)
Review
BACKGROUND
This systematic review aimed to evaluate the efficiency and accuracy of digital impression techniques for implant-supported restorations, and to assess their economic feasibility.
MATERIAL AND METHODS
Two independent electronic database searches were conducted in the Pubmed/MedLine, Cochrane Library, and Lilacs databases complimented by a manual search, selecting relevant clinical and studies published between 1st January 2009 and 28st February 2019. All type of studies ( and ) were included in this systematic review.
RESULTS
Twenty-seven studies (8 and 19 studies) fulfilled the inclusion criteria. No meta-analysis was performed due to a large heterogeneity of the study protocols. The passive fit of superstructures on dental implants presented similar results between digital and conventional impression techniques. The studies considered that several factors influence the accuracy of implant impression taking: distance and angulation between implants, depth of placement, type of scanner, scanning strategy, characteristics of scanbody, and operator experience. Regarding the economic viability of intraoral scanning systems, only one study reported any benefit in comparison with conventional techniques.
CONCLUSIONS
Digital impressions of dental implants can be considered a viable alternative in cases of one or two contiguous dental implants. However, more studies are needed to evaluate the accuracy of digital techniques in full-arch implant-supported restorations. Intraoral scanner, dental implant, prosthesis, misfit, systematic review.
PubMed: 32913577
DOI: 10.4317/jced.57025 -
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 -
The Journal of Prosthetic Dentistry Aug 2016Limited evidence is available for the marginal and internal fit of fixed dental restorations fabricated with digital impressions compared with those fabricated with... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Limited evidence is available for the marginal and internal fit of fixed dental restorations fabricated with digital impressions compared with those fabricated with conventional impressions.
PURPOSE
The purpose of this systematic review was to compare marginal and internal fit of fixed dental restorations fabricated with digital techniques to those fabricated using conventional impression techniques and to determine the effect of different variables on the accuracy of fit.
MATERIAL AND METHODS
Medline, Cochrane, and EMBASE databases were electronically searched and enriched by hand searches. Studies evaluating the fit of fixed dental restorations fabricated with digital and conventional impression techniques were identified. Pooled data were statistically analyzed, and factors affecting the accuracy of fit were identified, and their impact on accuracy of fit outcomes were assessed.
RESULTS
Dental restorations fabricated with digital impression techniques exhibited similar marginal misfit to those fabricated with conventional impression techniques (P>.05). Both marginal and internal discrepancies were greater for stone die casts, whereas digital dies produced restorations with the smallest discrepancies (P<.05). When a digital impression was used to generate stereolithographic (SLA)/polyurethane dies, misfit values were intermediate. The fabrication technique, the type of restoration, and the impression material had no effect on misfit values (P>.05), whereas die and restoration materials were statistically associated (P<.05).
CONCLUSIONS
Although conclusions were based mainly on in vitro studies, the digital impression technique provided better marginal and internal fit of fixed restorations than conventional techniques did.
Topics: Computer-Aided Design; Dental Impression Technique; Dental Marginal Adaptation; Dental Prosthesis; Dental Restoration, Permanent; Humans; Prosthodontics
PubMed: 26946916
DOI: 10.1016/j.prosdent.2015.12.017 -
Frontiers in Pediatrics 2023The aim of this systematic review is to evaluate the perception of the patient, the chairside time, and the reliability and/or reproducibility of intraoral scanners for... (Review)
Review
PURPOSE
The aim of this systematic review is to evaluate the perception of the patient, the chairside time, and the reliability and/or reproducibility of intraoral scanners for full arch in pediatric patients.
METHODS
A data search was performed in four databases (Medline-Pubmed, Scopus, ProQuest and Web of Science) in accordance with the PRISMA 2020 statements. Studies were classified in three categories (patient perception, scanning or impression time and reliability and/or reproducibility). The resources, the data extraction and the quality assessment were carried out independently by two operators. The variables recorded were population characteristics, material and methods aspects and included country, study design and main conclusion. A quality assessment of the selected studies was performed with QUADAS-2 tool, and Kappa-Cohen Index was calculated to analyze examiner agreement.
RESULTS
The initial search obtained 681 publications, and finally four studies matching inclusion criteria were selected. The distribution of the studies in the categories was three for the analysis of the patient's perception and scanning or impression time; and two items to assess the reliability and/or reproducibility of intraoral scans. All included studies have a repeated measures-transversal design. The sample size ranged between 26 and 59 children with a mean age. The intraoral scanners evaluated were Lava C.O.S, Cerec Omnicam, TRIOS Classic, TRIOS 3-Cart and TRIOS Ortho. The quality assessment of the studies using QUADAS-2 tool revealed a low risk of bias while evaluating patient perception, but an unclear risk of bias in the analysis of accuracy or chairside time. In relation to the applicability concerns, the patient selection was of high risk of bias. All studies agreed that the patient perception and comfort is better with intraoral scanners in comparison with the conventional method. The accuracy or reliability of the digital procedure is not clear, being clinically acceptable. In relation with the chairside time, it depends on the intraoral scanner, with contradictory data in the different analyzed studies.
CONCLUSION
The use of intraoral scanners in children is a favorable option, finding a significantly higher patient perception and comfort with intraoral scanners compared to the conventional impression method. The evidence for reliability or reproducibility is not strong to date, however, the differences between the intraoral measurements and the digital models would be clinically acceptable.
PubMed: 37435173
DOI: 10.3389/fped.2023.1213072 -
The Journal of Prosthetic Dentistry Jul 2023Available studies comparing fit accuracy of zirconia fixed partial dentures (FPDs) fabricated from conventional impressions and digital scans provide contradictory... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Available studies comparing fit accuracy of zirconia fixed partial dentures (FPDs) fabricated from conventional impressions and digital scans provide contradictory results. In addition, studies have been heterogeneous and of a limited number to provide conclusive evidence.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare the marginal and intaglio fit of tooth-supported zirconia FPDs fabricated from conventional impressions and digital scans and to investigate the effect of different variables on the fit results.
MATERIAL AND METHODS
An electronic search was performed on the National Library of Medicine (NLM), Cochrane Central Register of Controlled Trials, and Scopus databases. In addition, a manual search was carried out. Studies comparing the fit of tooth-supported zirconia FPDs fabricated from conventional impressions and digital scans and reporting sufficient data for qualitative and quantitative analysis were included. Standard mean differences (SMDs) and 95% confidence intervals (CI) were calculated for meta-analysis. Subgroup analysis was performed to study the effect of variables including restoration form (monolithic or framework), units number, intraoral scanner (IOS) type, conventional impression material, spacer thickness, and abutments region.
RESULTS
The initial search resulted in a total of 608 articles. Nine articles were included in the analysis (1 clinical and 8 in vitro) evaluating 118 restorations. Digital scan displayed significantly better marginal fit (P<.001; SMD: -0.68; 95% CI: -0.92, -0.09) and intaglio fit (P=.020; SMD: -0.51; 95% CI: -0.94, -0.42). Test for subgroup difference showed a significant influence of only impression material type (P=.008) and units number (P=.030) on marginal fit. Digital scan showed significantly better marginal accuracy for 3-unit FPDs than 4-unit FPDs (P<.001; SMD: -1.02; 95% CI: -1.41, -0.63). In addition, digital scanning had significantly better marginal fit with polyvinyl siloxane than polyether (P<.001; SMD: -0.98; 95% CI: -1.32, -0.64). A cement spacer ≤50 μm improved both marginal and intaglio fit in the digital group. The TRIOS scanner resulted in the best performance in the digital group for marginal fit.
CONCLUSIONS
Digital scanning provides significantly better marginal and intaglio fit than conventional impression making for fabricating zirconia FPDs up to 4 units, either in monolithic form or frameworks and at any region of the arch. However, further clinical studies are recommended to obtain more substantial results.
Topics: Computer-Aided Design; Dental Marginal Adaptation; Dental Impression Technique; Zirconium; Denture, Partial, Fixed; Dental Impression Materials; Dental Prosthesis Design
PubMed: 34696907
DOI: 10.1016/j.prosdent.2021.08.025 -
The Journal of Prosthetic Dentistry Feb 2018Limited evidence is available comparing digital versus conventional impressions from the point of view of patient preference. (Comparative Study)
Comparative Study Review
STATEMENT OF PROBLEM
Limited evidence is available comparing digital versus conventional impressions from the point of view of patient preference.
PURPOSE
The purpose of this systematic review was to identify and summarize the available literature related to patient-centered outcomes for digital versus conventional impression techniques.
MATERIAL AND METHODS
The databases Medline, Cochrane, Science Direct, Scopus, and Embase were electronically searched and complemented by hand searches. All published papers available on the databases from 1955 to July 2016 were considered for title and abstract analysis.
RESULTS
A total of 2943 articles were initially identified through database searches, of which only 5 met the inclusion criteria for qualitative analysis. Four studies comparing patient-reported outcome measures (PROMs) between conventional and digital impressions revealed that the digital technique was more comfortable and caused less anxiety and sensation of nausea. Only 1 study reported no difference between the techniques regardless of patient comfort. Two studies reported a shorter procedure for the conventional technique, whereas 3 studies reported a shorter procedure for the digital technique.
CONCLUSIONS
A lack of clinical studies addressing patient outcomes regarding digital prosthodontic treatments was observed among the included articles. However, current evidence suggests that patients are more likely to prefer the digital workflow than the conventional techniques.
Topics: Computer-Aided Design; Dental Impression Technique; Dental Prosthesis Design; Humans; Time Factors; Treatment Outcome
PubMed: 28967407
DOI: 10.1016/j.prosdent.2017.07.007 -
The International Journal of Oral &... 2014To compare the accuracy of digital and conventional impression techniques for partially and completely edentulous patients and to determine the effect of different... (Comparative Study)
Comparative Study Review
PURPOSE
To compare the accuracy of digital and conventional impression techniques for partially and completely edentulous patients and to determine the effect of different variables on the accuracy outcomes.
MATERIALS AND METHODS
An electronic and manual search was conducted to identify studies reporting on the accuracy of implant impressions. Pooled data were descriptively analyzed. Factors affecting the accuracy were identified, and their impact on accuracy outcomes was assessed.
RESULTS
The 76 studies that fulfilled the inclusion criteria featured 4 clinical studies and 72 in vitro studies. Studies were grouped according to edentulism; 41 reported on completely edentulous and 35 on partially edentulous patients. For completely edentulous patients, most in vitro studies and all three clinical studies demonstrated better accuracy with the splinted vs the nonsplinted technique (15 studies, splint; 1, nonsplint; 9, no difference). One clinical study and half of the in vitro studies reported better accuracy with the open-tray vs the closed-tray technique (10 studies, open-tray; 1, closed-tray; 10, no difference). For partially edentulous patients, one clinical study and most in vitro studies showed better accuracy with the splinted vs the nonsplinted technique (8 studies, splint; 2, nonsplint; 3, no difference). The majority of in vitro studies showed better accuracy with the open-tray vs the closed-tray technique (10 studies, open-tray; 1, closed-tray; 7, no difference), but the only clinical study reported no difference.
CONCLUSION
The splinted impression technique is more accurate for both partially and completely edentulous patients. The open-tray technique is more accurate than the closed-tray for completely edentulous patients, but for partially edentulous patients there seems to be no difference. The impression material (polyether or polyvinylsiloxane) has no effect on the accuracy. The implant angulation affects the accuracy of implant impressions, while there are insufficient studies for the effect of implant connection type. Further accuracy studies are needed regarding digital implant impressions.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Technique; Humans; In Vitro Techniques; Jaw, Edentulous, Partially; Mouth, Edentulous
PubMed: 25032763
DOI: 10.11607/jomi.3625 -
European Journal of Orthodontics Aug 2016The development of 3D technology and the trend of increasing the use of intraoral scanners in dental office routine lead to the need for comparisons with conventional... (Comparative Study)
Comparative Study Review
BACKGROUND
The development of 3D technology and the trend of increasing the use of intraoral scanners in dental office routine lead to the need for comparisons with conventional techniques.
OBJECTIVE
To determine if intra- and inter-arch measurements from digital dental models acquired by an intraoral scanner are as reliable and valid as the similar measurements achieved from dental models obtained through conventional intraoral impressions.
SEARCH METHODS
An unrestricted electronic search of seven databases until February 2015.
SELECTION CRITERIA
Studies that focused on the accuracy and reliability of images obtained from intraoral scanners compared to images obtained from conventional impressions.
DATA COLLECTION AND ANALYSIS
After study selection the QUADAS risk of bias assessment tool for diagnostic studies was used to assess the risk of bias (RoB) among the included studies.
RESULTS
Four articles were included in the qualitative synthesis. The scanners evaluated were OrthoProof, Lava, iOC intraoral, Lava COS, iTero and D250. These studies evaluated the reliability of tooth widths, Bolton ratio measurements, and image superimposition. Two studies were classified as having low RoB; one had moderate RoB and the remaining one had high RoB. Only one study evaluated the time required to complete clinical procedures and patient's opinion about the procedure. Patients reported feeling more comfortable with the conventional dental impression method.
LIMITATIONS
Associated costs were not considered in any of the included study.
CONCLUSIONS AND IMPLICATIONS
Inter- and intra-arch measurements from digital models produced from intraoral scans appeared to be reliable and accurate in comparison to those from conventional impressions. This assessment only applies to the intraoral scanners models considered in the finally included studies. Digital models produced by intraoral scan eliminate the need of impressions materials; however, currently, longer time is needed to take the digital images.
REGISTRATION
PROSPERO (CRD42014009702).
FUNDING
None.
Topics: Calcium Sulfate; Dental Arch; Dental Impression Technique; Dental Occlusion; Humans; Imaging, Three-Dimensional; Models, Dental; Reproducibility of Results
PubMed: 27266879
DOI: 10.1093/ejo/cjw033 -
Materials (Basel, Switzerland) Apr 2020The advent of new technologies in the field of medicine and dentistry is giving improvements that lead the clinicians to have materials and procedures able to improve... (Review)
Review
The advent of new technologies in the field of medicine and dentistry is giving improvements that lead the clinicians to have materials and procedures able to improve patients' quality of life. In dentistry, the last digital techniques offer a fully digital computerized workflow that does not include the standard multiple traditional phases. The purpose of this study is to evaluate all clinical trials and clinical randomized trials related to the digital or dental impression technique in prosthetic dentistry trying to give the readers global information about advantages and disadvantages of each procedure. Data collection was conducted in the main scientific search engines, including articles from the last 10 years, in order to obtain results that do not concern obsolete impression techniques. Elsevier, Pubmed and Embase have been screened as sources for performing the research. The results data demonstrated how the working time appears to be improved with digital workflow, but without a significant result (P = 0.72596). The papers have been selected following the Population Intervention Comparison Outcome (PICO) question, which is related to the progress on dental impression materials and technique. The comparison between dentists or practitioners with respect to classic impression procedures, and students open to new device and digital techniques seem to be the key factor on the final impression technique choice. Surely, digital techniques will end up supplanting the analogical ones altogether, improving the quality of oral rehabilitations, the economics of dental practice and also the perception by our patients.
PubMed: 32340384
DOI: 10.3390/ma13081982