Intrasubject comparison of digital vs. conventional workflow for screw-retained single-implant crowns: Prosthodontic and patient-centered outcomes.

Abstract

The aim of this intrasubject clinical study was to measure and compare prosthodontic and patient-reported outcome measures (PROMs) in the fabrication of implant-supported, all-ceramic single crowns with a full digital workflow and a conventional workflow. Thirty-one patients were subjected to first a digital (test group) and then a conventional impression (control group) at the same visit. From the intraoral optical scanner (IOS), a screw-retained, monolithic crown was delivered according to a complete digital workflow (no cast), whereas a veneered crown on a zirconia (Zi) frame was provided as a control treatment. Both crowns were assessed during the clinical stages of try-in. Prosthodontic outcomes (contact points, occlusion, PROMs, and esthetic results using the white esthetic score [WES]) were assessed. Occlusion and interproximal contacts showed comparable results for the two workflows (p=0.37 and p=0.36, respectively), whereas the global WES was significantly higher (p<0.0001) in the control group. Patient satisfaction scores, using visual analog scales (VAS), were significantly better for IOS than for conventional impressions (p=0.0098). On the contrary, patients' perception of the esthetic outcomes showed significantly higher value (p<0.0001) in the control group. Both workflows allowed the delivery of ceramic crowns within two appointments. The clinical fit was acceptable in both groups. A better esthetic outcome, in both patients' and clinicians' opinions, was found in the control group. PROMs showed higher satisfaction with the IOS.