Abstract
Aim To compare the outcome of digital versus analog procedures for the restoration of single implants. Methods Over a two-year period (2014-2016), all patients who had been treated in a dental center with a single implant were randomly assigned to receive either a monolithic zirconia crown, fabricated with digital workflow (test group), or a metal-ceramic crown, fabricated with analog workflow (control group). All patients were followed for 1 year after the delivery of the final crown. The outcomes were success, complications, peri-implant marginal bone loss (PIMBL), patient satisfaction, and time and cost of the treatment. Results 50 patients (22 males, 28 females; mean age 52.6±13.4 years) were randomly assigned to one of the groups (25 per group). Both workflows showed high success (92%) and low complication rate (8%). No significant differences were found in the mean PIMBL between test (0.39±0.29mm) and control (0.54±0.32mm) groups. Patients preferred digital impressions. Taking the impression took half the time in the test group (20±5min) than in the control (50±7min) group. When calculating active working time, workflow in the test group was more time-efficient than in the control group, for provisional (70±15min versus 340±37min) and final crowns (29±9min versus 260±26min). The digital procedure presented lower costs than the analog (€277.3 versus €392.2). Conclusions No significant clinical or radiographic differences were found between digital and analog procedures; however, the digital workflow was preferred by patients; it reduced active treatment time and costs. The present study is registered in the ISRCTN (http://www.isrctn.com/ISRCTN36259164) with number 36259164.
Highlights
The world of dentistry is experiencing a revolution, thanks to the rapid establishment of digital technologies [1, 2]
New acquisition devices (intraoral scanners [3], face scanners, and cone-beam computed tomography (CBCT) [4] allow the capture of three-dimensional (3D) images of patients, which are processed in computer-assisted design/computer-assisted manufacturing (CAD/Computer assisted manufacturing (CAM)) software [5]—this is in order to be able to design and produce, through subtractive technologies or additive (3D printing) methods, prosthetic restorations [1, 2, 5,6,7], surgical templates [8], orthodontic aligners [9], and a whole series of other custom-made devices
The outcomes of the present randomized controlled trial were clinical and radiographic in nature, such as the implant-crown success, the biologic and prosthetic complications encountered during the observation period, and the peri-implant marginal bone loss (PIMBL); the present study investigated patient satisfaction with and the time and cost aspect of the prosthetic treatment
Summary
The world of dentistry is experiencing a revolution, thanks to the rapid establishment of digital technologies [1, 2]. Digital technologies today allow one to capture an accurate impression of the implant with intraoral scanners and with structured light or laser only, without having to use conventional impression trays and materials [2, 3, 5, 12] This new procedure is absolutely pleasing to patients, because it can reduce discomfort and stress while in the dental chair [2, 3, 5, 13, 14]; it is appreciated by the clinicians, as, besides being a powerful marketing tool with patients, it simplifies the clinical procedures and allows one to communicate in a more efficient and dynamic way with the dental laboratory [2, 3, 13, 15]. These restorations, appropriately characterized, will be sent to the dentist for clinical application [2,3,4,5,6, 13,14,15,16,17,18]
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