A Double-Blind Crossover RCT Analyzing Technical and Clinical Performance of Monolithic ZrO2 Implant Fixed Dental Prostheses (iFDP) in Three Different Digital Workflows

Abstract

This double-blind randomized controlled trial with a crossover design analyzed the technical and clinical performance of three-unit monolithic ZrO2 implant-fixed dental prostheses (iFDPs), prepared using two complete digital workflows (Test-1, Test-2) and one mixed analog–digital workflow (Control). Each of the 20 study patients received three iFDPs, resulting in 60 restorations for analysis. The quality of the restorations was assessed by analyzing laboratory cross-mounting and calculating the chairside adjustment time required during fitting. All iFDPs could be produced successfully with all three workflows. The highest cross-mounting success rate was observed for the original pairing iFDP/model of the Control group. Overall, 60% of iFDPs prepared with Test-1 workflow did not require chairside adjustment compared with 50% for Test-2 and 30% for Controls. The mean total chairside adjustment time, as the sum of interproximal, pontic, and occlusal corrections was 2.59 ± 2.51 min (Control), 2.88 ± 2.86 min (Test-1), and 3.87 ± 3.02 min (Test-2). All tested workflows were feasible for treatment with iFDPs in posterior sites on a soft tissue level type implant system. For clinical routine, it has to be considered that chairside adjustments may be necessary, at least in every second patient, independent on the workflow used.

Conventional, Speed Sintering and High-Speed Sintering of Zirconia: A Systematic Review of the Current Status of Applications in Dentistry with a Focus on Precision, Mechanical and Optical Parameters

“…In a changing dental field undergoing digital transformation, dentists and patients are facing major social changes, where the aesthetic and economic performance indicators (EPI) [ 31 ] become relevant factors to be considered when planning a dental rehabilitation. Dentists aim to keep up with the high competitiveness by creating unique selling points and keeping the value chain in-house.…”

“…Dentists aim to keep up with the high competitiveness by creating unique selling points and keeping the value chain in-house. For the patient, functional rehabilitation is assumed and the main focus is on minimal- or non-invasiveness, aesthetics, costs and time [ 31 ].…”

Patient‐reported outcome measures compared to professional dental assessments of monolithic ZrO2 implant fixed dental prostheses in complete digital workflows: A double‐blind crossover randomized controlled trial

“…This investigation is part of a triple‐arm double‐blind RCT with a crossover design analyzing different outcomes on the same population. 24 , 25 The present manuscript reports on subjective patient satisfaction and professional dental assessments for prosthetic treatment with 3‐unit monolithic ZrO 2 iFDPs in the posterior region. The Ethics Committee Basel, Switzerland (EKNZ‐ID 2019‐00706) approved the study protocol; and it was registered at ClinTrials.gov (NCT04029025).…”

“…The detailed trial setting has been described previously. 24 , 25 Inclusion criteria were 2 dental implants intended for a 3‐unit iFDP (Tissue Level Implant System RN/WN, Institut Straumann AG, Basel, Switzerland) with baseline at the start of the prosthetic therapy. Briefly, 20 study patients received 3 iFDPs each, resulting in a total of 60 restorations.…”

“…The detailed trial setting has been described previously. 24,25 The sequence of the worksteps, whether beginning with Test-1, Test-2, or Control, as well as the order of sequence for the restorations' try-in, were randomly assigned per study patient using the envelope-technique. The principal investigator (TJ) performed the random allocation sequence.…”