Clinical Fitting and Adjustment Time for Implant-Supported Crowns Comparing Digital and Conventional Workflows.

Abstract

The aim of this prospective cohort study was to investigate clinical and laboratory performance of implant-supported reconstructions comparing the digital to the conventional workflow. Twenty study participants were treated in a cross-over design for single-tooth replacement in posterior sites, each with a customized titanium abutment plus computer-assisted design and computer-assisted manufacturing (CAD/CAM)-zirconia-suprastructure (test: digital workflow; n = 20) and a standardized titanium abutment plus PFM-crown (control: conventional pathway; n = 20). Evaluation of the 40 reconstructions included: 1) feasibility of laboratory cross-mounting of each abutment-crown-connection, and 2) assessment of adaptation time for clinical adjustments of interproximal and occlusal surfaces. Statistical analyses were performed using the exact Wilcoxon rank sum tests. Laboratory cross-mounting was feasible for three reconstruction pairings revealing a 15% vice versa transfer success rate. All implant crowns could be provided successfully within two clinical appointments, independently of the workflow used. The mean clinical adjustment time was significantly lower (p < .001) for test reconstructions from the digital workflow with 2.2 min (standard deviation [SD] ± 2.1) compared with the ones from the conventional pathway with 6.0 min (SD ± 3.9). The digital workflow was almost threefold more efficient than the established conventional pathway for fixed implant-supported crowns. Clinical fitting could be predictably achieved with no or minor adjustments within the digital process of intraoral scanning plus CAD/CAM technology.