Within the specialty of prosthodontics, oral impressions are ubiquitous tools utilized to transfer intraoral characteristics such as teeth, implants, and soft tissue into a physical state (stone cast) that is processable in a laboratory setting for the fabrication of dental restorations. In recent years, optical impression systems have become ubiquitous in clinical practice replacing the conventional method of impression making. The purpose of the present study was to evaluate the feasibility and accuracy of computerized optical impression making of edentulous jaws in an in vivo setting. 29 edentulous patients (27 maxillae and five mandibles) underwent conventional impressions as well as computerized optical impressions. The conventional impressions and the resulting stone casts were digitized and superimposed over the computerized/digitized optical impressions in order to obtain information on differences between the two datasets. Statistical analyses were performed to identify relevant deviations. The overall mean difference between the stone cast, digital scans and the computerized optical scans were 336.7 ± 105.0 µm (n = 32), 363.7 ± 143.1 µm (n = 24), and 272.1 ± 168.5 µm (n = 29), respectively. The visual evaluations revealed highest deviations (≥ 500 µm) in the areas of the soft palate, the sublingual areas, and the vestibule (peripheral seal zone). Within the limitations of the present study, the investigated scanners were not able currently to fully replace a conventional impression for the fabrication of a complete denture.
The purpose of the study was to compare conventional to digital workflows of occlusal splint production regarding time efficiency, overall fit, and wear. Fifteen Michigan splints were fabricated with a conventional and digital method. The duration for the dentist’s and the dental technician’s workload was recorded. Subsequently, the overall fit was examined with a four-level score (1–4). Paired t-tests were used to compare the time results for the conventional and digital workflows and the sign test to compare the overall fit. The mean time (16 min 58 s) for computerized optical impressions was longer than for conventional impressions (6 min 59 s; p = 0.0001). However, the dental technician needed significantly less mean time for the digital splint production (47 min 52 s) than for the conventional (163 min 32 s; p = 0.001). The overall fit of the digitally-fabricated splints was significantly better compared to the conventionally-fabricated splints (p = 0.002). There was no impact of the different materials used in the conventional and digital workflow on the wear (p = 0.26). The results suggest that the digital workflow for the production of occlusal splints is more time efficient and leads to a better fit than the conventional workflow.
Although CAD/CAM ceramics present a promising alternative to metal-ceramic fixed dental prostheses, little is known about their mid- and long-term clinical performance. This systematic review aims to estimate the survival and success rates and describes the underlying complication characteristics for CAD/CAM tooth-supported zirconia- and lithium disilicate-based fixed dental prostheses (FDPs). We systematically searched MEDLINE and Web of Science to find relevant prospective studies with a follow-up of at least one year. We estimated pooled 1-, 5-, and 10-year survival and success rates by combining the collected data in a Poisson regression model. Descriptive statistics were conducted to evaluate the distribution of failures and complications in the included studies. Risk of bias for the included studies was assessed with an adapted checklist for single-arm trials. Pooled estimated 1-, 5-, and 10-year survival rates ranged from 93.80% to 94.66%, 89.67% to 91.1%, and 79.33% to 82.20%, respectively. The corresponding success rates excluding failures, but including any other types of intervention were 94.53% to 96.77%, 90.89% to 94.62%, and 81.78% to 89.25%. Secondary caries was the most frequent cause of failure, followed by chipping of the veneering. The most common cause of complication excluding failures but requiring intervention was chipping of the veneering. Risk of bias was generally acceptable for the included studies, with seven studies associated with low risk of bias, eight studies with a moderate risk of bias, and three studies with serious risk of bias. The current meta-analysis on CAD/CAM-supported FDPs revealed satisfying survival and success rates for up to 10 years of exposure. More prospective studies focusing on long-term performance are needed to strengthen the evidence currently available in the literature.