Additively and subtractively manufactured implant‐supported fixed dental prostheses: A systematic review

Abstract

AimTo compare and report on the performance of implant‐supported fixed dental prostheses (iFDPs) fabricated using additive (AM) or subtractive (SM) manufacturing.MethodsAn electronic search was conducted (Medline, Embase, Cochrane Central, Epistemonikos, clinical trials registries) with a focused PICO question: In partially edentulous patients with missing single (or multiple) teeth undergoing dental implant therapy (P), do AM iFDPs (I) compared to SM iFDPs (C) result in improved clinical performance (O)? Included were studies comparing AM to SM iFDPs (randomized clinical trials, prospective/retrospective clinical studies, case series, in vitro studies).ResultsOf 2′184 citations, no clinical study met the inclusion criteria, whereas six in vitro studies proved to be eligible. Due to the lack of clinical studies and considerable heterogeneity across the studies, no meta‐analysis could be performed. AM iFDPs were made of zirconia and polymers. For SM iFDPs, zirconia, lithium disilicate, resin‐modified ceramics and different types of polymer‐based materials were used. Performance was evaluated by assessing marginal and internal discrepancies and mechanical properties (fracture loads, bending moments). Three of the included studies examined the marginal and internal discrepancies of interim or definitive iFDPs, while four examined mechanical properties. Based on marginal and internal discrepancies as well as the mechanical properties of AM and SM iFDPs, the studies revealed inconclusive results.ConclusionDespite the development of AM and the comprehensive search, there is very limited data available on the performance of AM iFDPs and their comparison to SM techniques. Therefore, the clinical performance of iFDPs by AM remains to be elucidated.

Group 2 ITI Consensus Report: Technological developments in implant prosthetics

“…Working Group-2 «Technology» of the 7th ITI Consensus Conference has addressed these questions. The aim was to systematically examine the available scientific literature on the three core topics: (Ioannidis et al, 2023) additive versus subtractive manufacturing of implant restorations; (Chantler et al, 2023) survival and complications rates as well as esthetic outcomes comparing prefabricated versus customized abutments; and (Pjetursson et al, 2023) clinical performance of implant-supported fixed dental prostheses with different prosthetic designs and restorative material for treatment of multiple missing teeth in the posterior area. In the context of the above-mentioned core topics, Group-2 also addressed the patient perspective.…”