Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.
Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.
J Prosthodont. 2020 Oct;29(8):660-678. doi: 10.1111/jopr.13211. Epub 2020 Jul 16.
To systematically review in vitro and clinical studies comparing quantitatively the 3D accuracy (global implant deviations) of digital vs conventional implant impressions for partially and completely edentulous patients.
Electronic and manual searches were conducted to identify in vitro and clinical studies, reporting on the 3D accuracy between digital and conventional implant impressions. Secondary outcomes were the effect of implant angulation, type of conventional impression technique, and type of intraoral scanner on the accuracy of implant impressions.
The inclusion criteria were met by 9 in vitro studies and 1 clinical study reporting on completely edentulous impressions, while 6 in vitro and 2 clinical studies reported on partially edentulous impressions. Quantitative meta-analysis was performed for 5 completely edentulous and 6 partially edentulous studies. The studies exhibited high values for heterogeneity. A random effects model was conducted to estimate the effect size. Based on 5 in vitro studies on completely edentulous impressions, the mean 3D implant deviation between conventional and digital impressions was 8.20 µm (95% CI: -53.56, 37.15) and the digital impressions had nominally less deviation (p = 0.72). Based on 1 clinical and 5 in vitro studies on partially edentulous impressions, the mean 3D implant deviation between conventional and digital impressions was 52.31 µm (95% CI: 6.30, 98.33) and the conventional impressions had nominally less deviation (p = 0.03). Five in vitro and 2 clinical studies were not included in the quantitative analysis due to heterogeneity in the methodology. Implant angulation affected the accuracy in favor of the partially edentulous conventional impressions whereas the effect of different scanners was not statistically significant on the completely edentulous impressions (p = 0.82).
Digital scans appear to have comparable 3D accuracy with conventional implant impressions based mainly on in vitro studies. However, clinical trials are recommended to investigate the clinical accuracy of digital scans and digitally fabricated interim or prototype prostheses, before digital implant scans can be recommended for routine clinical use.
系统回顾比较数字化与传统种植体印模在部分和完全无牙患者中三维精度（整体种植体偏差）的体外和临床研究。
通过电子和手动搜索，确定了报告数字化与传统种植体印模三维精度的体外和临床研究。次要结果为种植体角度、传统印模技术类型和口内扫描仪类型对种植体印模精度的影响。
符合纳入标准的完全无牙印模研究有 9 项体外研究和 1 项临床研究，部分无牙印模研究有 6 项体外研究和 2 项临床研究。对 5 项完全无牙和 6 项部分无牙研究进行了定量荟萃分析。这些研究的异质性值较高。采用随机效应模型来估计效应量。基于 5 项完全无牙的体外研究，传统和数字化印模之间的平均三维种植体偏差为 8.20 µm（95%CI：-53.56，37.15），数字化印模的偏差略小（p=0.72）。基于 1 项临床和 5 项部分无牙的体外研究，传统和数字化印模之间的平均三维种植体偏差为 52.31 µm（95%CI：6.30，98.33），传统印模的偏差略小（p=0.03）。由于方法学的异质性，5 项体外研究和 2 项临床研究未纳入定量分析。种植体角度对精度有影响，有利于部分无牙的传统印模，而不同扫描仪对完全无牙印模的影响在统计学上无显著性差异（p=0.82）。
基于体外研究，数字化扫描似乎具有与传统种植体印模相当的三维精度。然而，建议进行临床试验以研究数字化扫描和数字化制作的临时或原型修复体的临床精度，然后才能推荐数字化种植体扫描用于常规临床应用。
