Digitally prefabricated versus conventionally fabricated implant-supported full-arch provisional prosthesis: a retrospective cohort study

Abstract

Background To evaluate and compare the clinical outcomes of digitally prefabricated and conventionally fabricated implant-supported full-arch provisional prostheses. Methods In this retrospective study, a total of 39 patients (22 males and 17 females) who underwent implant-supported full-arch rehabilitation using the All-on-4 concept with an immediate loading protocol were included: 20 patients treated with digitally prefabricated provisional prostheses were assigned into Group A, and 19 patients treated with conventionally fabricated provisional prostheses were assigned into Group B. Implant/provisional prosthesis survival rates and complications were reviewed. Marginal bone loss (MBL) was investigated by CBCT. Surgical time, restorative time, and total operative time were analyzed. Postoperative pain and swelling were evaluated with the visual analog scale (VAS). The oral health impact profile (OHIP) questionnaire was administered before and after surgery. Results The implant/provisional prosthesis survival rate was 100%, and complications appeared with low frequency in both groups, while the mean MBL was 0.30 ± 0.29 mm in Group A and 0.31 ± 0.41 mm in Group B after 3~ 6 months (P > 0.05). The average restorative time in Group A (116.16 ± 16.61 min) was significantly shorter than that in Group B (242.11 ± 30.14 min) (P < 0.05). Patients in Group A showed lower pain/swelling VAS scores after surgery than Group B (P < 0.05). Low OHIP scores with high satisfaction with the overall effects were shown in both groups. Conclusion Prefabricated prostheses reduced the prosthetic time and postoperative discomfort in patients whose immediate rehabilitation was based on the All-on-4 concept. This prefabrication technology may be a predictable alternative to improve the short-term clinical outcome of implant-supported full-arch provisional rehabilitation.

Study of individual healing abutment with standard impression and fully digital CAD-CAM healing abutment

“…The use of osseointegrated dental implants for prosthetic purposes was first proposed in 1969. Understanding and awareness of the nature of soft and hard tissue biology allow practitioners to perform rehabilitation with dental implants in a more predictable way [1,2,3]. Nowadays, advances in imaging and 3D imaging combined with implant planning software have created an interdisciplinary environment through which better patient care and a more predictable outcome are achieved [4].…”

“…These advances have led to advantages such as the predictability of treatment, simplifying clinical steps, and quick and easy communication between different specialists (radiologists, implantologists, surgeons, prosthetists, and periodontists). In addition, treatment options, including digital workflow, are developing with new materials and technologies-3D for printing and milling structures [1,7]. The literature describes the mechanical advantages of using digital technologies from a biomechanical point of view: final restorations are produced according to the exact gingival architectonics of the patient, achieving an optimal emergence profile and a better aesthetic result for patients; it is also easier to correct the angulation of implants; Fewer patient visits are needed with a shorter visit time, greater comfort for the patient [8,9,10].…”