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Journal of Prosthodontic Research Jan 2022This study comprehensively reviewed the current status of digital workflows in fabricating removable partial dentures (RPDs) using evidence from clinical trials and case...
PURPOSE
This study comprehensively reviewed the current status of digital workflows in fabricating removable partial dentures (RPDs) using evidence from clinical trials and case reports.
STUDY SELECTION
We performed a systematic review of the literature on the materials and fabrication of RPDs using digital technologies published in online databases from 1980 to 2020. We selected eligible articles from the search results, retrieved information on digital RPDs from these, and conducted a qualitative analysis. We report evidence from clinical papers and case reports, digital impression-taking methods, and maxillomandibular relationship (MMR) records.
RESULTS
A case report electronically published in 2019 introduced a clasp-retained RPD fabricated via a full-digital workflow without a gypsum definitive cast. Computer-aided design and computer-aided manufacturing of double-crown-retained RPDs with nonmetal materials were described in some case reports. Intraoral scanners were used to obtain digital impressions and MMR records in the fabrication of digital RPDs, which have potential advantages for reducing the number of clinical appointments and simplifying laboratory procedures. Evidence from clinical trials is scarce; a randomized controlled trial reported higher patient satisfaction with digital clasp-retained RPDs than with conventional RPDs.
CONCLUSIONS
Full-digital RPDs can be fabricated without a gypsum definitive cast. However, the indication for full-digital RPDs is limited to cases with Kennedy Class III/IV partially edentulous arches with several missing teeth. Challenges in digital impression-taking and MMR recording remain to be solved to extend these indications. More evidence from clinical trials is required to evaluate the efficacy and usefulness of digital RPDs.
Topics: Computer-Aided Design; Denture, Partial, Removable; Humans; Mouth, Edentulous; Randomized Controlled Trials as Topic
PubMed: 33504721
DOI: 10.2186/jpr.JPR_D_20_00116 -
Journal of Healthcare Engineering 2020The purpose of this systematic review was to compare the accuracy of the three-dimensional images among different scanners, scanning techniques, and substrates. .... (Review)
Review
INTRODUCTION
The purpose of this systematic review was to compare the accuracy of the three-dimensional images among different scanners, scanning techniques, and substrates. . Electronic databases (PubMed and Elsevier) were searched until March 2020. The systematic search was performed to identify the most precise method of obtaining a 3D image of the dentition.
RESULTS
Thirteen articles out of 221, considering the accuracy of 3D images, were selected. The main factors that are considered to have an influence on the precision are substrate type in the oral cavity, experience of the scanner's operator, direct vs. indirect scanning, and the reproducibility of the procedure.
CONCLUSION
Substrate type does have an impact on the overall accuracy of intraoral scans where dentin has the most and enamel the least accurately recorded dental structure. Experience of the operator has an influence on the accuracy, where more experienced operators and smaller scan sizes are made for more accurate scans. A conventional impression technique in a full-arch image provided the lowest deviation. The reproducibility of direct scanning was comparable to indirect scanning although a slight difference was noticeable (0.02 mm).
Topics: Computer-Aided Design; Dental Impression Technique; Humans; Imaging, Three-Dimensional; Models, Dental; Mouth; Reproducibility of Results; Research Design
PubMed: 33414902
DOI: 10.1155/2020/8854204 -
Journal of Prosthodontic Research Oct 2021Purpose To clarify the rate of posterior residual ridge resorption (PRRR) in different denture treatments and the factors that can affect PRRR.Study selection A...
Purpose To clarify the rate of posterior residual ridge resorption (PRRR) in different denture treatments and the factors that can affect PRRR.Study selection A bibliographical electronic search was conducted on MeSH, Web of Science, and Ovid databases. Hand searching was also conducted. Longitudinal studies recording the average rate of PRRR in the mandible were included. The effect size was calculated based on the mean rate of PRRR with standard deviation and group size. The random-effects analysis was used to perform meta-analyses across qualified studies.Results A total of 2245 eligible studies were collected from the MeSH, Web of Science, and Ovid databases and hand searching. In the end, 19 studies met the inclusion criteria and were extracted. The average rate of PRRR in different mandibular denture treatments was assessed in this systematic review. The mean combined effect size was -1.05 ± 0.5 (95% confidence interval [CI]: -3.18-1.08) between four-implant overdentures and two-implant overdentures. The combined effect size was -0.01 ± 0.22 (95% CI: -0.93-0.82) between complete dentures and two-implant overdentures. Body mass index, number of dentures used, denture wearing habit, impression technique, artificial tooth material, and peri-implant bone resorption showed no significant effect on the rate of PRRR. Gender, denture material, and relining frequency showed a significant effect on the rate of PRRR.Conclusions This review summarized different average rates of PRRR in mandibular denture treatments. Meta-analyses have reported that four-implant overdenture treatments can lower the rate of PRRR compared to two-implant overdenture treatments. However, there was no significant difference in the treatment effect between the complete denture and two-implant overdenture treatments.
Topics: Bone Resorption; Dental Prosthesis, Implant-Supported; Denture, Complete; Denture, Overlay; Humans; Mandible
PubMed: 33281173
DOI: 10.2186/jpr.JPR_D_20_00075 -
The Journal of Prosthetic Dentistry Dec 2021Parallel dental implants improve prosthesis longevity and facilitate the impression making steps when compared with angled implants. The effect of implant angulation on... (Review)
Review
STATEMENT OF PROBLEM
Parallel dental implants improve prosthesis longevity and facilitate the impression making steps when compared with angled implants. The effect of implant angulation on the accuracy of casts generated by using intraoral scanners has not been fully investigated.
PURPOSE
The present systematic review addressed following the patient, intervention, control, and outcome (PICO) question: Does implant position affect the intraoral scanning accuracy of arches that will receive complete-arch implant-supported fixed dental prostheses?
MATERIAL AND METHODS
A bibliographic search was performed in the Medline-PubMed, Scopus, Web of Science, and Cochrane Library databases by using specific descriptors for studies published until July 2020. All studies evaluated the intraoral scanning accuracy of arches rehabilitated with multiple implants through implant linear and/or angular deviation.
RESULTS
Eight in vitro studies that met the eligibility criteria were evaluated. Five publications showed lower linear and angular displacements for the digital scans compared with the conventional technique. Two studies showed that the digital scan presented higher angular and linear distortions than the conventional technique. Only 1 study did not find differences between the 2 recording methods.
CONCLUSIONS
Digital scanning is reliable. However, caution is needed concerning its indication, especially in patients where the angles between implants are greater than 15 degrees. The association of the implant angulation with the clinical factors needs to be further investigated. The absence of clinical evidence and methodological heterogeneity limited the results of this study.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Technique; Humans; Models, Dental; Mouth, Edentulous
PubMed: 33268069
DOI: 10.1016/j.prosdent.2020.09.008 -
The Journal of Prosthetic Dentistry Jan 2022Intraoral scanners have significantly improved over the last decade. Nevertheless, data comparing intraoral digital scans with conventional impressions are sparse. (Meta-Analysis)
Meta-Analysis Review
Comparative assessment of complete-coverage, fixed tooth-supported prostheses fabricated from digital scans or conventional impressions: A systematic review and meta-analysis.
STATEMENT OF PROBLEM
Intraoral scanners have significantly improved over the last decade. Nevertheless, data comparing intraoral digital scans with conventional impressions are sparse.
PURPOSE
The purpose of this systematic review and meta-analysis was to determine the impact of impression technique (digital scans versus conventional impressions) on the clinical time, patient comfort, and marginal fit of tooth-supported prostheses.
MATERIAL AND METHODS
The authors conducted a literature search based on the Population, Intervention, Comparison, and Outcome (PICO) framework in 3 databases to identify clinical trials with no language or date restrictions. The mean clinical time, patient comfort, and marginal fit values of each study were independently extracted by 2 review authors and categorized according to the scanning or impression method. The authors assessed the study-level risk of bias.
RESULTS
A total of 16 clinical studies met the inclusion criteria. The mean clinical time was statistically similar for digital scan procedures (784 ±252 seconds) and for conventional impression methods (1125 ±159 seconds) (P>.05). The digital scan techniques were more comfortable for patients than conventional impressions; the mean visual analog scale score was 67.8 ±21.7 for digital scans and 39.6 ±9.3 for conventional impressions (P<.05). The mean marginal fit was 80.9 ±31.9 μm and 92.1 ±35.4 μm for digital scan and conventional impressions, respectively, with no statistically significant difference (P>.05).
CONCLUSIONS
Digital scan techniques are comparable with conventional impressions in terms of clinical time and marginal fit but are more comfortable for patients than conventional impression techniques.
Topics: Computer-Aided Design; Databases, Factual; Dental Impression Materials; Dental Impression Technique; Dental Marginal Adaptation; Dental Prosthesis Design; Humans
PubMed: 33143901
DOI: 10.1016/j.prosdent.2020.09.017 -
Clinical Implant Dentistry and Related... Dec 2020Accurate implant placement is essential in reducing post-treatment complications and in ensuring a successful treatment outcome. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Accurate implant placement is essential in reducing post-treatment complications and in ensuring a successful treatment outcome.
PURPOSE
To compare the accuracy of fully-guided static computer-assisted implant surgery (s-CAIS) using partially- and fully-digital workflows.
MATERIALS AND METHODS
Electronic and manual literature searches were performed to collect evidence concerning the accuracy of fully-guided s-CAIS procedures utilizing tooth-supported guides. Quantitative analysis was conducted to evaluate the accuracy of partially- and fully-digital workflows, and survival rates and complications were qualitatively analyzed.
RESULTS
Thirteen studies, including 6 randomized controlled trials and 7 prospective clinical studies, were selected for quantitative and qualitative synthesis. A total of 669 implants in 325 patients using s-CAIS were available for review. Meta-analysis of the accuracy revealed a total mean angular deviation of 2.68° (95% CI: 2.32°-3.03°); mean global coronal deviation of 1.03 mm (95% CI: 0.88-1.18 mm); mean global apical deviation of 1.33 mm (95% CI: 1.17-1.50 mm); and mean depth deviation of 0.59 mm (95% CI: 0.46-0.70 mm). Minimal differences were found between the two different workflows. Few complications were reported, and survival rates were between 97.8% to 100% (range of follow-up: 12 to 24 months) in the available studies.
CONCLUSION
Similar accuracy is obtained when implants are placed in partially edentulous patients using fully-guided s-CAIS, independently of the workflow utilized.
Topics: Computer-Aided Design; Computers; Dental Implantation, Endosseous; Dental Implants; Humans; Prospective Studies; Surgery, Computer-Assisted; Workflow
PubMed: 32964614
DOI: 10.1111/cid.12937 -
The Journal of Prosthetic Dentistry Sep 2021Digital and conventional options for definitive impressions and for the fabrication of fixed dental prostheses (FDPs) have been compared in previous studies. However, a... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Digital and conventional options for definitive impressions and for the fabrication of fixed dental prostheses (FDPs) have been compared in previous studies. However, a comprehensive review with concluding data that determined which method provided the minimal internal and marginal adaptation is lacking.
PURPOSE
The purpose of this systematic review and meta-analysis of in vivo and in vitro studies was to compare the marginal and internal adaptation of complete-coverage single-unit crowns and multiunit FDPs resulting from digital and conventional impression and fabrication methods.
MATERIAL AND METHODS
The review protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Cochrane Trials, Scopus, and Open Grey databases were used to identify relevant articles. Based on fixed prostheses impression and fabrication methods, groups from each study were categorized into 4 groups: conventional impression and fabrication (CC), conventional impression and digital fabrication (CD), digital scanning and conventional fabrication (DC), and digital scanning and fabrication (DD). The risk of bias was assessed by using the Cochrane Collaboration tool for clinical trials and the modified Methodological Index for Non-Randomized Studies (MINORS) for in vitro studies. Heterogeneity was evaluated among studies, and meta-analysis was performed with random-effect models (α=.05). Subgroup analysis was conducted when possible.
RESULTS
Eight clinical trials and 21 in vitro studies were eligible for analysis. There was no significant difference between the CD and DD clinical groups for marginal adaptation (P=.149); However, the DD group had significantly less internal discrepancy than the CD group (P=.009). The in vitro studies found no significant difference in marginal adaptation among the CC-CD, CC-DC, and CC-DD pairs (P=.437, P=.387, P=.587), but in the comparison CD versus DD group, a significantly better marginal adaptation was observed for the DD group (P=.001). All the compared in vitro groups were similar in terms of internal adaptation.
CONCLUSIONS
Impression and fabrication techniques may affect the accuracy of fit of complete-coverage fixed restorations. A completely digital workflow yielded restorations with comparable or better marginal adaptation than the other methods.
Topics: Computer-Aided Design; Crowns; Dental Impression Technique; Dental Marginal Adaptation; Dental Prosthesis Design; Workflow
PubMed: 32928518
DOI: 10.1016/j.prosdent.2020.07.007 -
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 -
Journal of Indian Prosthodontic Society 2020Intraoral scanner (IOS) is a medical device used for capturing direct optical impressions and composed of a handheld camera (hardware), a computer and software. Digital... (Review)
Review
BACKGROUND
Intraoral scanner (IOS) is a medical device used for capturing direct optical impressions and composed of a handheld camera (hardware), a computer and software. Digital impressions by intraoral scanning have become an increasingly popular alternative to conventional impressions. The aim of this systematic review is to assess the studies regarding the various available technologies for IOS and evaluate the most accurate IOS system for cases with multiple implants and identify the factors that can influence its accuracy.
MATERIALS AND METHODS
A comprehensive electronic search was done in online databases, 'Pubmed', 'Google Scholar' and 'Cochrane' based on pre-determined eligibility criteria. In-vitro studies, In-vivo studies and Randomized controlled trials assessing the accuracy of intra-oral scanner technology were selected after thorough screening. The search strategy covered all studies published until February 2019 and yielded a total of 11 articles out of which 8 studies were determined to fulfil the inclusion criteria and were selected for this review. Data extraction from the included studies was conducted by the primary author and reviewed by the second author.
RESULTS
The information collected included sample size and population, study design, intervention, scanning methods, comparisons and outcome measures. 5 out of 8 included studies compared the distance deviation of the acquired scans from the true values while the remaining 3 studies gave trueness and precision values as the outcome variables. A forest plot on scanner precision displayed slightly higher precision levels in the TRIOS scanner compared to the other intraoral scanners.
CONCLUSION
Despite the limitations this study, it can be concluded that active wavefront sampling is more accurate than the other intraoral scanning technology employed by commercial scanners.
PubMed: 32655218
DOI: 10.4103/jips.jips_379_19 -
Journal of Prosthodontics : Official... Oct 2020To systematically review in vitro and clinical studies comparing quantitatively the 3D accuracy (global implant deviations) of digital vs conventional implant... (Meta-Analysis)
Meta-Analysis
PURPOSE
To systematically review in vitro and clinical studies comparing quantitatively the 3D accuracy (global implant deviations) of digital vs conventional implant impressions for partially and completely edentulous patients.
MATERIALS AND METHODS
Electronic and manual searches were conducted to identify in vitro and clinical studies, reporting on the 3D accuracy between digital and conventional implant impressions. Secondary outcomes were the effect of implant angulation, type of conventional impression technique, and type of intraoral scanner on the accuracy of implant impressions.
RESULTS
The inclusion criteria were met by 9 in vitro studies and 1 clinical study reporting on completely edentulous impressions, while 6 in vitro and 2 clinical studies reported on partially edentulous impressions. Quantitative meta-analysis was performed for 5 completely edentulous and 6 partially edentulous studies. The studies exhibited high values for heterogeneity. A random effects model was conducted to estimate the effect size. Based on 5 in vitro studies on completely edentulous impressions, the mean 3D implant deviation between conventional and digital impressions was 8.20 µm (95% CI: -53.56, 37.15) and the digital impressions had nominally less deviation (p = 0.72). Based on 1 clinical and 5 in vitro studies on partially edentulous impressions, the mean 3D implant deviation between conventional and digital impressions was 52.31 µm (95% CI: 6.30, 98.33) and the conventional impressions had nominally less deviation (p = 0.03). Five in vitro and 2 clinical studies were not included in the quantitative analysis due to heterogeneity in the methodology. Implant angulation affected the accuracy in favor of the partially edentulous conventional impressions whereas the effect of different scanners was not statistically significant on the completely edentulous impressions (p = 0.82).
CONCLUSIONS
Digital scans appear to have comparable 3D accuracy with conventional implant impressions based mainly on in vitro studies. However, clinical trials are recommended to investigate the clinical accuracy of digital scans and digitally fabricated interim or prototype prostheses, before digital implant scans can be recommended for routine clinical use.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Materials; Dental Impression Technique; Humans; Models, Dental; Mouth, Edentulous
PubMed: 32613641
DOI: 10.1111/jopr.13211