This systematic review aimed to assess the impact of printing orientation on the accuracy and properties of additively manufactured provisional restorations. A systematic literature search databases (PubMed, Scopus, Web of Science, and Cochrane) were conducted in July 2024 without language restrictions. The included studies were evaluated using the modified CONSORT checklist, and the effect measures and synthetic methods were employed to assess the accuracy of resin provisional restorations printed at various orientations. The web search resulted in 8228 records, and 15 records were ultimately included in the analysis. The printing orientation of provisional restorations has an impact on various factors such as the internal and marginal gap, trueness, precision, and accuracy. To achieve optimal results, it is recommended to utilize printing orientations of 180°, 150°, and 210°, as they showed lower marginal and internal gaps and higher accuracy. Caution should be exercised during the virtual positioning of supporting pillars, as this may also influence the overall accuracy. Horizontally and slightly tilted orientations have demonstrated superior accuracy. To achieve optimal results, factors such as printing layer thickness, printing technology, materials, and supportive pillars should be taken into consideration, besides the printing orientations. The selection of the optimum printing parameters overall printing orientations, layer thickness, and supportive pillar position can generate prosthetic and restorative dental parts with a long survival rate, saving time and effort by avoiding fracture, loss of retention, and consequent clinical complications.
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