Fully Digital versus Conventional Workflows for Fabricating Posterior Three-Unit Implant-Supported Reconstructions: A Prospective Crossover Clinical Trial

Ali Mahmoud Hashemi, Hamid Mahmoud Hashemi, Hakimeh Siadat, Ahmadreza Shamshiri, Kelvin Ian Afrashtehfar () and Marzieh Alikhasi ()
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Ali Mahmoud Hashemi: Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
Hamid Mahmoud Hashemi: Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
Hakimeh Siadat: Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
Ahmadreza Shamshiri: Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran 1417614411, Iran
Kelvin Ian Afrashtehfar: Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Berne, Switzerland
Marzieh Alikhasi: Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran

IJERPH, 2022, vol. 19, issue 18, 1-14

Abstract: This study assessed the clinical variables influencing the success of three-unit implant-supported fixed dental prostheses (ISFDPs) fabricated using either fully digital or conventional workflows. The clinical trial evaluated 10 patients requiring three-unit ISFDPs in the posterior mandible. Maxillomandibular relation records, and digital and conventional impressions were obtained from each patient using an intraoral scanner (IoS) and polyvinylsiloxane (PVS), and the frameworks were fabricated using zirconia and cobalt–chromium, respectively. A 2 µm accuracy scanner scanned the conventional master casts and standard reference models. The stereolithography (STL) files of the digital and conventional impressions were superimposed on the standard model file, and the accuracy was calculated with the best-fit algorithm. The framework adaptation and passivity were assessed using the one-screw and screw resistance tests. The time required for occlusal adjustment of both types of reconstructions, including the duration of the whole treatment, was recorded. The aesthetic appearance of ISFDPs was rated by each patient and clinician using a self-administered visual analogue scale questionnaire and the FDI World Dental Federation aesthetic parameters, respectively. The sample size was based on the power calculation, and alpha was set at 0.05 for the statistical analyses. The impression accuracy, framework adaptation and passivity, and reconstructions aesthetics did not significantly differ between the digital and conventional approaches. The total fabrication time was significantly shorter using the digital workflow. Within the limitations of this clinical study, the fully digital workflow can be used for the fabrication of ISFDPs with a clinical outcome comparable to that of the conventional workflow.

Keywords: computer-aided design; implant-supported dental prosthesis; dental impression technique; patient satisfaction; CAD-CAM (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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