Abstract

Simple SummaryImmediate loading is nowadays a diffused technique in implantology. At the same time, digital dentistry is rapidly spreading, especially in what concerns prosthetic rehabilitation. The present study aimed to compare, through a randomized clinical trial design, the analogical vs. the traditional workflow. Single-implant restorations have been run in 50 patients, with a 12-month maximum period of follow-up after implant placement. Data were analyzed through radiological, clinical, and customer satisfaction evaluation. Importantly, and surprisingly enough, no statistically significant differences emerged between the two kinds of workflow. When assessing customer satisfaction, however, patients clearly and significantly preferred the comfort of the digital vs. traditional workflow.The purpose of this randomized controlled trial was to compare the immediate-loading protocol, in single restorations in the esthetic zone, by comparing the digital workflow in a test group (TG) vs. the analogical workflow in a control group (CG). A total of 50 patients were enrolled, requiring single hopeless tooth extraction. Twenty-five patients (TG) were randomly assigned to the immediate-loading protocol using the digital workflow, and twenty-five patients (CG) were assigned to the conventional workflow. Clinical and radiographic parameters were evaluated at the time of implant insertion (baseline) and after 3, 6 and 12 months, respectively. A clinician blind to conditions measured the Pink Esthetic Score (PES), as well as patient satisfaction. At 12-month follow-up, a cumulative survival rate of 100% was reported for all implants. No failures or biological complications were observed. No statistically significant differences were detected in the mean values of marginal bone loss and PES between the TG (0.12 ± 0.66 mm for MBL, 7.75 ± 0.89 for PES) and the CG (0.15 ± 0.54 mm for MBL, 7.50 ± 0.89 for PES). In 11 cases of TG, and 10 cases of CG, a one-year follow-up period showed an increased marginal bone level. No statistically significant differences were found in the mean total PES between test (7.75 ± 0.89) and control (7.5 ± 0.81) conditions. Furthermore, a customer satisfaction survey showed that patients preferred the digital workflow over the conventional workflow procedure (97.6 ± 4.3 vs. 69.2 ± 13.8). Digital workflow was more time-efficient than conventional workflow (97.2 ± 7.3 vs. 81.2 ± 11.3). Within the limitations of this study, no statistically significant differences were found between digital and traditional workflow.

Highlights

  • Since the advent of modern implantology, surgical and prosthetic protocols have improved over time, leading to predictable treatment outcomes with well-documented long-term implant and prosthetic survival rates [1,2]

  • This study was designed as a prospective, randomized controlled trial, with a parallel arm design to compare digital versus analogical workflows in an immediate loading protocol, in single post-extractive implants in the esthetic zone

  • The present study shows that analogic and digital workflows can both lead to positive, comparable clinical results for what concerns the immediate loading procedure

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Summary

Introduction

Since the advent of modern implantology, surgical and prosthetic protocols have improved over time, leading to predictable treatment outcomes with well-documented long-term implant and prosthetic survival rates [1,2].Nowadays, implants are medical devices used in dental medicine but in many medical fields, such as cardiac implants [3], orthopedic implants [4] and brain implants [5].implant-prosthetic rehabilitations can be the optimal therapeutic solution in patients with systemic or immunocompromised diseases [6,7].Some studies [8,9] have shown that placement of implants into the previously grafted sockets is comparable to that into the non-grafted sites.Various authors [10,11] have described a high rate of success in immediate-loading implant restorations.In 2004, Pjetursson et al [12] completed a systematic review that evaluated the survival rate of implant-supported fixed single and partial prosthesis in the esthetic zone. Since the advent of modern implantology, surgical and prosthetic protocols have improved over time, leading to predictable treatment outcomes with well-documented long-term implant and prosthetic survival rates [1,2]. Implant-prosthetic rehabilitations can be the optimal therapeutic solution in patients with systemic or immunocompromised diseases [6,7]. Some studies [8,9] have shown that placement of implants into the previously grafted sockets is comparable to that into the non-grafted sites. Various authors [10,11] have described a high rate of success in immediate-loading implant restorations. In 2004, Pjetursson et al [12] completed a systematic review that evaluated the survival rate of implant-supported fixed single and partial prosthesis in the esthetic zone

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