Clinical Performance of CAD/CAM Monolithic Lithium Disilicate Implant‐Supported Single Crowns Using Solid or Predrilled Blocks in a Fully Digital Workflow: A Retrospective Cohort Study With Up To 33 Months of Follow Up

Abstract

Purpose: To assess the clinical performance of CAD/CAM monolithic implantsupported restorations manufactured using a fully digital workflow and two different types of ceramic blocks. Materials and Methods: One hundred and one patients received single-unit implantsupported restorations at a University predoctoral clinic. All restorations were designed and fabricated using either a predrilled LS 2 block (group P, n = 59) or a conventional solid LS 2 block with an occlusal opening drilled manually prior to crystallization (group M, n = 42). The mean follow-up time after restoration delivery was 18.4 ± 4.8 months (range 12 to 33 months). Patients with less than a 12-month follow-up were excluded. Electronic health records were reviewed to identify number and type of complications during the follow-up time. Clinical outcomes were classified as success, survival, and failure of the restoration. Chi-square tests were used to identify differences in success and survival rates between the groups. Nonparametric Mann-Whitney U tests were used to identify differences in the number of major and minor complications as well as the total number of complications that were observed among groups. Results: Overall success and survival rates were 80.2% and 97%, respectively. Seventy one restorations (70.3%) were complication-free. There were no significant differences between the groups with regards to the number of complications or success and survival rates. Conclusions: Single-unit CAD/CAM monolithic implant-supported restorations that are fabricated in a fully digital workflow present relatively high complication rates and moderate short-term clinical outcomes. Clinical studies with longer follow-up times are needed to evaluate long-term outcomes of these restorations.

Clinical performance of implant-supported single hybrid abutment crown restoration: A systematic review and meta-analysis

“…However, another study with a 3-year follow-up using non-original Ti-base abutments reported biological complications during the observation period. Among the other studies using original Ti-base abutments, three studies reported biological complications free of implant suprastructures [43,49,50], and two retrospective caries studies reported a peri-implant mucositis rate of 6.8% at a mean follow-up of 18 months and 10.4% at 32 months [45,48].…”

“…The 5-year results from a study by Strauss et al reported the loss of 2 implants due to peri-implantitis, whereas 11 of the remaining 22 patients with implants were diagnosed with peri-implant mucositis [32]. The other two retrospective studies observed peri-implant mucositis in 6.8% and 10.4% of patients with implants during follow-up [45,48] (Table 5).…”

“…Of the 22 included studies, three studies reported on the 1-, 3-, and 5-year outcomes of the same prospective cohort and were grouped as one [30][31][32]. Among the 20 studies, 12 were RCTs [33][34][35][36][37][38][39][40][41][42][43][44], one was a retrospective cohort study [45], one prospective controlled study [46], two retrospective studies [47,48], and four prospective case series [32,[49][50][51]. Only four RCTs directly compared hybrid abutment crowns and cementretained designs for SCs [36,41,43,44].…”

“…One non-randomized controlled study [46] and one cohort study [45] assessed using the ROBINS-I tool were found to have a severe and moderate risk of bias, respectively (Fig. 2b).…”

“…In this systematic review, prosthetic survival was defined as SCs in situ with or without modification, while success was defined as the absence of technical complications, including minor chipping, screw loosening, screw fracture, decementation from the Ti base, abutment fracture, and major chipping or crown fracture. The study by Bompolaki et al (2022) was excluded from the data synthesis because of different definitions of complications and success criteria, which prevented us from extracting relevant data [45]. Farrag et al (2021) did not report data on success and complication events, and their study was thus excluded from data synthesis for success and complication proportions [35].…”