ABSTRACT
PURPOSE: This randomized controlled trial (RCT) aimed to compare treatment time of single-implant crowns for both digital and conventional workflows. In addition, prostheses made of polymer-infiltrated ceramic-network (PICN; Enamic®, Vita, Bad Säckingen, Germany) and lithium disilicate (LS2; NICE®, Straumann AG, Basel, Switzerland) were compared in each group. MATERIALS AND METHODS: A total of 40 patients (n=40) who needed a single-implant crown on posterior regions were considered and randomly divided into digital workflows (n=20) with an intraoral scanner (IOS, iTero Elements 5D®, Align Technologies, San José, CA, USA) and conventional workflows (n=20) with impressions using polyether (Impregum™ Penta™, 3M ESPE, Landsberg am Lech, Germany). Then, each group was again distributed into 2 subgroups based on the crown materials used: PICN (n=10) and LS2 (n=10). Treatment time was calculated for both digital and conventional workflows. Analysis was done at 5% confidence interval (p-value <0.05). An independent two-sample t-test was used to compare treatment time between the groups. The Kruskal-Wallis test was used to compare clinical try-in time among sub-groups. Any of the implant crowns that had to be remade in each subgroup, were evaluated by the Fisher Exact test. RESULTS: The entire process of digital and conventional workflows required 104.31 ± 20.83 minutes and 153.48 ± 16.35 minutes, respectively. Digital workflows were 39.2% more timesaving than the conventional protocol for the implant single crown treatment (p <0.0001). CONCLUSIONS: Both digital and conventional workflow protocols can achieve a successful outcome of single-implant monolithic crowns in posterior areas. The digital protocol yielded a greater time saving over the conventional procedure in data acquisition and laboratory steps while the time for a clinical try-in and delivery were similar.
ABSTRACT
OBJECTIVES: The aim of this randomized controlled trial (RCT) was to analyze patient-reported outcome measures (PROMs) of prosthetic therapy with monolithic implant crowns in completely digital workflows (test) with intraoral optical scanning (IOS) and conventional workflows (control) with conventional impressions. Secondary, an objective evaluation of the final implant restorations was performed using the Functional Implant Prosthodontic Score (FIPS). MATERIALS AND METHODS: Forty patients who required an implant-supported single crown on posterior regions were randomly divided into test (n = 20) and control (n = 20) groups for impression taking. Each group was then equally separated into two subgroups according to the restorative material used: lithium disilicate (LS2, N!CE®, Straumann AG, Basel, Switzerland) or polymer-infiltrated ceramic networks (PICN, Enamic®, Vita, Bad Säckingen, Germany). Patient satisfaction was evaluated using PROM questionnaires with visual analog scales (VAS) after impression-taking and 1 week after prosthetic delivery. Patient satisfaction with the impression technique was assessed in six domains: length, comfort, anxiety, taste, nausea, and pain, whereas patient satisfaction with the final restoration was assessed in four domains: overall treatment outcome, functionality, esthetics, and cleanability. In addition, the final implant restorations were objectively assessed by an independent prosthodontist using the FIPS. Mann-Whitney U test was used to analyze the defined outcomes. Statistical analysis was completed with a level of significance set at α=0.05. RESULTS: PROMs focusing on the impression technique demonstrated higher levels of patient satisfaction for IOS compared to conventional impressions, especially in terms of "taste irritation" (p = 0.036); whereas no significant differences were found between both restorative CAD/CAM-materials. Mean FIPS values demonstrated similar results among subgroups. CONCLUSIONS: Within the limitation of this study, both completely digital and conventional protocols provided great levels of patient satisfaction in implant rehabilitation of single-tooth gaps in posterior sites with monolithic implant crowns. The restorative material, LS2 versus PICN, does not impact patient satisfaction with their treatment. However, a long-term follow up is needed to draw more specific conclusions on patient satisfaction with the restorations.
