Assistant Professor, Department of Prosthodontics, Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
PhD Candidate, Department of Ecology and Genetics, Faculty of Science, University of Oulu, Oulu, Finland.
J Prosthet Dent. 2021 Sep;126(3):360-368. doi: 10.1016/j.prosdent.2020.07.007. Epub 2020 Sep 12.
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.
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.
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.
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.
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.
先前的研究已经比较了用于确定印象和固定义齿（FDP）制造的数字和传统选项。 但是，缺乏具有确定哪种方法提供最小内部和边缘适应性的总结数据的全面综述。
本系统评价和体内外研究的荟萃分析旨在比较数字和传统印模和制造方法对全冠和多单位 FDP 的边缘和内部适应性的影响。
审查方案已在国际前瞻性系统评价注册处（PROSPERO）中注册，并遵循系统评价和荟萃分析的首选报告项目（PRISMA）声明。 使用 PubMed，Cochrane 试验，Scopus 和 Open Grey 数据库来识别相关文章。 根据固定修复体印模和制造方法，将每个研究的组分为 4 组：常规印模和制造（CC），常规印模和数字制造（CD），数字扫描和常规制造（DC）和数字扫描和制造（DD）。 使用 Cochrane 协作临床试验工具和改良的非随机研究方法学指数（MINORS）评估偏倚风险体外研究。 评估了研究之间的异质性，并使用随机效应模型进行了荟萃分析（α=0.05）。 当可能时进行了亚组分析。
有 8 项临床试验和 21 项体外研究符合分析条件。 边缘适应性方面，CD 和 DD 临床组之间没有统计学差异（P=.149）； 但是，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 配对之间的边缘适应性没有显著差异（P=.437，P=.387，P=.587），但是在 CD 与 DD 组的比较中，DD 组的边缘适应性明显更好（P=.001）。 所有比较的体外组在内部适应性方面均相似。
印模和制造技术可能会影响全冠固定修复体的拟合精度。 完全数字化工作流程产生的修复体具有可比或更好的边缘适应性，优于其他方法。
