Statement of problem

Digital and conventional options for definitive impressions and for the fabrication of fixed dental prostheses (FDPs) have been compared in previous studies. However, a comprehensive review with concluding data that determined which method provided the minimal internal and marginal adaptation is lacking.

Purpose

The purpose of this systematic review and meta-analysis of in vivo and in vitro studies was to compare the marginal and internal adaptation of complete-coverage single-unit crowns and multiunit FDPs resulting from digital and conventional impression and fabrication methods.

Material and methods

The review protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. PubMed, Cochrane Trials, Scopus, and Open Grey databases were used to identify relevant articles. Based on fixed prostheses impression and fabrication methods, groups from each study were categorized into 4 groups: conventional impression and fabrication (CC), conventional impression and digital fabrication (CD), digital scanning and conventional fabrication (DC), and digital scanning and fabrication (DD). The risk of bias was assessed by using the Cochrane Collaboration tool for clinical trials and the modified Methodological Index for Non-Randomized Studies (MINORS) for in vitro studies. Heterogeneity was evaluated among studies, and meta-analysis was performed with random-effect models (α=.05). Subgroup analysis was conducted when possible.

Results

Eight clinical trials and 21 in vitro studies were eligible for analysis. There was no significant difference between the CD and DD clinical groups for marginal adaptation (P=.149); However, the DD group had significantly less internal discrepancy than the CD group (P=.009). The in vitro studies found no significant difference in marginal adaptation among the CC-CD, CC-DC, and CC-DD pairs (P=.437, P=.387, P=.587), but in the comparison CD versus DD group, a significantly better marginal adaptation was observed for the DD group (P=.001). All the compared in vitro groups were similar in terms of internal adaptation.

Conclusions

Impression and fabrication techniques may affect the accuracy of fit of complete-coverage fixed restorations. A completely digital workflow yielded restorations with comparable or better marginal adaptation than the other methods.

中文翻译：

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使用数字和传统工作流程对单牙冠和固定义齿进行边缘和内部适应：系统评价和荟萃分析

问题陈述

在之前的研究中已经比较了用于确定印模和制造固定义齿 (FDP) 的数字和传统选项。然而，缺乏对确定哪种方法提供最小内部和边际适应的结论数据的全面审查。

目的

这项对体内和体外研究的系统评价和荟萃分析的目的是比较由数字和传统印模和制造方法产生的完全覆盖的单单元牙冠和多单元 FDP 的边缘和内部适应性。

材料与方法

审查方案已在国际前瞻性系统评价注册 (PROSPERO) 中注册，并遵循系统评价和元分析的首选报告项目 (PRISMA) 声明。PubMed、Cochrane Trials、Scopus 和 Open Gray 数据库用于识别相关文章。基于固定假体印模和制作方法，每项研究的组被分为4组：常规印模和制作（CC）、常规印模和数字制作（CD）、数字扫描和常规制作（DC）以及数字扫描和制作（DD）。偏倚风险通过使用 Cochrane 协作工具进行临床试验和改良的非随机研究方法学指数 (MINORS) 进行体外研究评估。研究之间评估了异质性，使用随机效应模型 (α=.05) 进行荟萃分析。在可能的情况下进行亚组分析。

结果

八项临床试验和 21 项体外研究符合分析条件。CD 和 DD 临床组在边缘适应方面没有显着差异（P = .149）；然而，DD 组的内部差异明显小于 CD 组（P = .009）。体外研究发现 CC-CD、CC-DC 和 CC-DD 对之间的边际适应没有显着差异（P = .437、P = .387、P = .587），但在比较 CD 与 DD 中组中，DD 组观察到明显更好的边缘适应（P = .001）。所有比较的体外组在内部适应方面都相似。

结论

印模和制造技术可能会影响完全覆盖固定修复体的配合精度。与其他方法相比，完全数字化的工作流程产生的修复体具有可比或更好的边缘适应性。