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The Journal of Prosthetic Dentistry Jul 2023Intraoral scanning has been reported to be preferred by patients over conventional impression making. Nevertheless, information regarding patient-related outcomes for... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Intraoral scanning has been reported to be preferred by patients over conventional impression making. Nevertheless, information regarding patient-related outcomes for conventional impression making and digital scanning is sparse.
PURPOSE
The purpose of this systematic review and meta-analysis was to analyze patient-related outcomes of intraoral scanning and conventional impression methods. The primary outcomes evaluated were patient preference and satisfaction, and the secondary outcomes discomfort, nausea, unpleasant taste, breathing difficulty, pain, and anxiety.
MATERIAL AND METHODS
Electronic and manual searches were performed for clinical trials that evaluated patient-related outcomes for intraoral scanning and conventional impression making for prosthetic rehabilitation. The Cochrane Collaboration risk of bias tool and Newcastle-Ottawa scale were used to assess the quality of the studies. Random-effects models using mean difference were used for meta-analyses. Heterogeneity was assessed using the Cochran Q test and I statistics (α=.05).
RESULTS
The search strategy identified 1626 articles, and 11 studies were included in the meta-analyses. Patients preferred intraoral scanning to conventional impression making. The mean difference for patient preference was 15.02 (95% confidence interval of 8.33 - 21.73; P<.001). Discomfort, absence of nausea, absence of unpleasant taste, and absence of breathing difficulty were also significantly different (P<.05).
CONCLUSIONS
Intraoral scanning is a suitable alternative to conventional impression procedures, promoting less discomfort for patients sensitive to taste, nausea, and breathing difficulty than when conventional impression making techniques are used.
Topics: Humans; Dental Impression Technique; Patient Preference; Computer-Aided Design
PubMed: 34756424
DOI: 10.1016/j.prosdent.2021.08.022 -
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 Jun 2023The direct digitalization of completely edentulous arches rehabilitated with multiple implants still represents a limitation regarding obtaining accurate images for... (Review)
Review
STATEMENT OF PROBLEM
The direct digitalization of completely edentulous arches rehabilitated with multiple implants still represents a limitation regarding obtaining accurate images for prosthetic purposes.
PURPOSE
The purpose of this systematic review was to present the factors that may influence the accuracy of intraoral scanning of completely edentulous arches.
MATERIAL AND METHODS
This review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and registered with International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020171021). Three examiners performed an electronic search in the Medline/PubMed, Cochrane Library, Scopus, and Web of Science databases for articles published up to January 2021.
RESULTS
The electronic search resulted in 11 498 studies. After removing duplicates, 11 347 studies remained. Twelve studies were selected (10 in vitro and 2 in vivo) according to the eligibility criteria. Several factors were found to influence the performance of intraoral scanners (Carestream Dental and TRIOS, 3Shape presented the best results), the intraoral scanning technique (Promoting physical paths that join the digitization bodies can increase the accuracy of transferring the position of the implants), environmental conditions (temperature: 20 °C to 21 °C, air pressure: 750 to 760 ±5 mmHg, air humidity: 45%, angle and distance between the implants: up to 15 degrees and 16 to 22 mm, and the material of the scan body: PEEK more accurate).
CONCLUSIONS
The accuracy of the intraoral scanning of completely edentulous arches is affected by factors such as the type of intraoral scanner, scanning technique, environmental conditions, angle and distance between implants, and material of the scan bodies.
Topics: Humans; Imaging, Three-Dimensional; Computer-Aided Design; Dental Impression Technique; Models, Dental; Dental Implants; Mouth, Edentulous
PubMed: 34656307
DOI: 10.1016/j.prosdent.2021.09.001 -
Clinical Oral Investigations Dec 2021The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures... (Review)
Review
OBJECTIVES
The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes.
MATERIALS AND METHODS
Electronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available.
RESULTS
Seventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS.
CONCLUSIONS
Within the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes.
CLINICAL RELEVANCE
Reduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Technique; Humans; Patient Comfort; Prospective Studies; Prosthodontics
PubMed: 34568955
DOI: 10.1007/s00784-021-04157-3 -
The Journal of Prosthetic Dentistry Jan 2023Lithium disilicate crowns can be manufactured by computer-aided design and computer-aided manufacturing (CAD-CAM) or with the heat-pressed technique. The outcome of... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Lithium disilicate crowns can be manufactured by computer-aided design and computer-aided manufacturing (CAD-CAM) or with the heat-pressed technique. The outcome of studies comparing the effect of the manufacturing method on the marginal adaptation of these crowns is not clear.
PURPOSE
The purpose of this systematic review and meta-analysis was to investigate the effect of the CAD-CAM system and pressing technique on the marginal adaptation of lithium disilicate crowns.
MATERIAL AND METHODS
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A literature research was conducted in MEDLINE via PubMed and Scopus databases, relevant journal sites, and the authors' collected references, from January 2009 to April 2019.
RESULTS
The electronic and manual searches that could be read in full totaled 24 studies; of which, 9 were included in the systematic review and meta-analysis, 7 of which were in vitro and 2 in vivo. Statistical analyses were conducted by using Review Manager software program. Meta-analyses were performed with the random effects model (α=.05). In vitro studies showed no difference in the manufacturing (P>.001; 95% confidence interval -0.687 to 0.632), and no significant difference was found for in vivo studies (P=.7, 95% confidence interval 0.00 to 54.77). In the joint analysis of the in vivo and in vitro articles, there was a significant difference between the manufacturing methods (P<.001).
CONCLUSIONS
Differences were detected between the marginal adaptation of lithium disilicate crowns fabricated with the CAD-CAM system and the pressing technique, but the accuracy values were clinically acceptable.
Topics: Hot Temperature; Dental Prosthesis Design; Dental Impression Technique; Dental Marginal Adaptation; Dental Porcelain; Crowns; Computer-Aided Design
PubMed: 34147239
DOI: 10.1016/j.prosdent.2021.03.021 -
International Journal of Oral... May 2021To evaluate the accuracy of full-arch digital implant impressions taken using intraoral scanners and analyse the related variables.
PURPOSE
To evaluate the accuracy of full-arch digital implant impressions taken using intraoral scanners and analyse the related variables.
MATERIALS AND METHODS
An electronic search of studies on the accuracy of digital implant impressions in fully edentulous arches from 1 January 2012 to 29 February 2020 was conducted in PubMed, EMBASE and the Cochrane Library. Only peer-reviewed experimental or clinical studies written in English were included. Studies assessing the accuracy of restorations, case reports, clinical reports, technical reports and reviews were excluded. The literature screening, article reading and assessment of risk of bias were carried out by two reviewers. The data on the study characteristics, accuracy outcomes and investigated variables were extracted.
RESULTS
After removal of duplicates, a total of 166 studies were identified, of which 42 were initially selected for full-text reading and 30 were included in the final analysis (29 in vitro studies and one in vivo study). The trueness of digital implant impressions ranged from 7.6 to 731.7 μm, and the precision ranged from 15.2 to 204.2 μm. Angular deviations were between 0.13 and 10.01 degrees. Considering 100 μm and 0.4 degrees as clinically acceptable levels of deviation, 18 studies reported linear/distance/3D deviations larger than 100 μm and only two studies reported angular deviations below 0.4 degrees. The effect of interimplant distance/length of the arch scanned/scanning sequence/scanning range/implant position (nine studies), implant angulation (ten studies), implant depth (five studies), implant connection (two studies), operator experience (six studies), scan body type (three studies), intraoral scanner type (six studies), scanning strategy (two studies) and modification technique (three studies) was investigated.
CONCLUSIONS
Based on the results of the included studies, full-arch digital implant impressions taken using intraoral scanners are not sufficiently accurate for clinical application. Accuracy varies greatly with interimplant distance, scan body type, intraoral scanner type and operator experience, whereas implant angulation, implant connections and implant depth have no effect. The effects of scanning strategy and modification technique need further investigation.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Technique; Humans; Models, Dental; Mouth, Edentulous
PubMed: 34006079
DOI: No ID Found -
The Journal of Prosthetic Dentistry Nov 2022Evidence comparing the marginal and internal fit of single metal copings fabricated via selective laser sintering and conventional lost-wax casting is inadequate. (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Evidence comparing the marginal and internal fit of single metal copings fabricated via selective laser sintering and conventional lost-wax casting is inadequate.
PURPOSE
The purpose of this systematic review was to compare the fit of single metal copings fabricated via selective laser sintering and lost-wax casting. Moreover, the effects of different variables on fit accuracy were determined.
MATERIAL AND METHODS
Google Scholar, ScienceDirect, SpringerLink, and Wiley databases were searched electronically as well as manually. The mean absolute marginal gap, marginal gap, internal gap, axial gap, and occlusal gap values of single metal copings fabricated via selective laser sintering and lost-wax casting were statistically analyzed to determine and evaluate the factors affecting the fit accuracy (α=.05).
RESULTS
Single metal copings fabricated via selective laser sintering had mean absolute marginal gaps and occlusal gaps similar to those of copings fabricated via lost-wax casting, based on a subgroup meta-analysis of gaps evaluated using stereomicroscopy (P>.05). The fit of single metal copings was not affected by the type of tooth (P>.05). The conventional impression, the indirect digital scan, and the direct digital scan led to similar values of mean axial gap, internal gap, and marginal gap for the copings fabricated via lost-wax casting (P>.05). The indirect and direct digital scans led to similar values of mean axial gap, internal gap, and marginal gap for the copings fabricated via selective laser sintering (P>.05). Printed wax patterns provided significantly smaller mean axial gap values than milled plastic or milled wax patterns for the copings fabricated via lost-wax casting (P<.05). Printed, milled, and conventional wax patterns had similar mean marginal gaps and internal gaps for the copings fabricated via lost-wax casting (P>.05). For single copings fabricated via lost-wax casting, Ni-Cr and Co-Cr had similar mean internal gaps (P>.05).
CONCLUSIONS
No statistically significant differences were found between single metal copings fabricated via selective laser sintering and lost-wax casting. Selective laser sintering can satisfy the clinical requirement for single metal copings.
Topics: Dental Marginal Adaptation; Dental Casting Technique; Dental Prosthesis Design; Computer-Aided Design; Chromium Alloys; Lasers; Crowns
PubMed: 33789799
DOI: 10.1016/j.prosdent.2021.02.011 -
The Journal of Prosthetic Dentistry Oct 2022The technology behind optical scanners has greatly improved recently, making their dental application advantageous. While their accuracy is now comparable with that of... (Meta-Analysis)
Meta-Analysis Review
Patient preference and clinical working time between digital scanning and conventional impression making for implant-supported prostheses: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
The technology behind optical scanners has greatly improved recently, making their dental application advantageous. While their accuracy is now comparable with that of conventional impression materials, whether these techniques have other advantages is unclear.
PURPOSE
The purpose of this systematic review and meta-analysis was to determine whether digital scanning for implant-supported restorations is more time-efficient and convenient for the patient.
MATERIAL AND METHODS
The study was conducted on September 23, 2020 using 4 different databases (Medline, Cochrane, Web of Science, Scopus) searching for clinical studies that compared the time needed and/or patient perceptions between those who had undergone the digital scanning procedure and those who had undergone conventional impression making.
RESULTS
Twelve studies met the inclusion criteria for qualitative and quantitative analysis. Outcome variables were measured as standard mean differences (SMDs) by following a fixed-effects model or random-effects model (in the case of high heterogeneity). Digital scanning was more time-efficient and was preferred by patients for all 4 analyzed outcomes (comfort, anxiety, nausea, time perception).
CONCLUSIONS
Digital scanning was found to be more time-efficient and convenient than conventional impression making for implant-supported restorations. Additional randomized controlled trials are needed to confirm the findings of this review.
Topics: Humans; Dental Impression Technique; Computer-Aided Design; Patient Preference; Dental Implants; Dental Impression Materials
PubMed: 33678434
DOI: 10.1016/j.prosdent.2020.11.042 -
Journal of Prosthodontics : Official... Jul 2021To systematically review clinical and laboratory studies that investigated the accuracy of intraoral scanners in recording denture bearing areas. (Review)
Review
PURPOSE
To systematically review clinical and laboratory studies that investigated the accuracy of intraoral scanners in recording denture bearing areas.
MATERIALS AND METHODS
Electronic and manual searches were conducted to identify all the available clinical and laboratory studies reporting the accuracy of digital impressions for recording denture related soft tissues. After the application of predetermined inclusion and exclusion criteria, the final list of articles was reviewed to meet the objective of this study.
RESULTS
The inclusion criteria were met by 18 studies out of which 8 were clinical and the rest were laboratory investigations. The eligible studies assessed the accuracy of intraoral scanners in recording both the denture supporting structures and the peripheral mobile tissues. The accuracy results were different among the various intraoral scanners. Likewise, the effect of several influencing factors, such as artificial markers, scanner head size, scanning strategy, and the operator's experience, were evaluated.
CONCLUSION
While the accuracy of intraoral scanners was comparable to the conventional techniques in recording bony structures with attached mucosa, they were not capable of accurately registering the mobile tissues. In addition, factors such as presence of a marker, larger scanner head size and specific scanning techniques appeared to improve the accuracy of the digital impression.
Topics: Computer-Aided Design; Dental Impression Technique; Dentures; Imaging, Three-Dimensional; Models, Dental
PubMed: 33554361
DOI: 10.1111/jopr.13345 -
The Journal of Prosthetic Dentistry Jul 2022A consensus on the accuracy of additively manufactured casts in comparison with those fabricated by using conventional techniques for fixed dental prostheses is lacking. (Review)
Review
STATEMENT OF PROBLEM
A consensus on the accuracy of additively manufactured casts in comparison with those fabricated by using conventional techniques for fixed dental prostheses is lacking.
PURPOSE
The purpose of this systematic review was to determine the accuracy of additively manufactured casts for tooth- or implant-supported fixed dental prostheses in comparison with that of gypsum casts.
MATERIAL AND METHODS
This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (CDR42020161006). Eight databases were searched in December 2019 and updated in September 2020. Studies evaluating the dimensional accuracy of additively manufactured casts for fixed dental prostheses in comparison with that of gypsum casts were included. An adapted checklist for reporting in vitro studies (Checklist for Reporting In vitro Studies guidelines) was used to assess the risk of bias.
RESULTS
Eight studies evaluating tooth-supported fixed dental prosthesis casts and 7 studies evaluating implant-supported fixed dental prosthesis casts were eligible for this review. Gypsum casts showed greater accuracy (trueness and precision) in most studies, although additively manufactured casts also yielded highly precise data. One study was associated with a low risk of bias, 9 with a moderate risk of bias, and 5 with a high risk of bias.
CONCLUSIONS
In vitro studies showed that additively manufactured casts and gypsum casts share similar accuracy within the acceptable range for the fabrication of casts. The quality of scanned data, additive manufacture technology, printing settings, and postprocessing procedures plays an essential role in the accuracy of additively manufactured casts. Clinical studies are required to confirm these findings.
Topics: Calcium Sulfate; Computer-Aided Design; Dental Impression Technique; Humans; Printing, Three-Dimensional; Prosthodontics; Workflow
PubMed: 33551140
DOI: 10.1016/j.prosdent.2020.12.008