Patient‐reported outcome measures (PROMs) of implant‐supported reconstructions using digital workflows: A systematic review and meta‐analysis

Abstract

Objectives To summarize the existing evidence on patient‐reported outcome measures (PROMs) of implant‐supported restorations fabricated using a digital workflow in comparison to conventional manufacturing procedures. Methods A PICO strategy was executed using an electronic and manual search focusing on clinical studies evaluating PROMs of implant‐supported restorations. Only clinical trials assessing conventional versus digital workflows for implant‐supported restorations were included. PROMS on implant impression procedures and fabrication of final restorations were evaluated using random and fixed effects meta‐analyses, while implant planning/placement was reported descriptively. Results Among 1062 titles identified, 14 studies were finally included, and only seven studies were eligible for meta‐analysis. For implant planning and placement, only a qualitative analysis was possible due to heterogeneity between the studies. For impression procedures, the random effects model revealed statistically significant differences in taste, anxiety, nausea, pain, shortness of breath, and discomfort in favor of optical impressions. No significant difference in the subjective perception of the duration of an impression could be reported. For the final fabrication of restorations, no significant difference between veneered and monolithic posterior restorations was found in terms of esthetic, function, and general satisfaction. Conclusion Most of the studies reporting about PROMs were published during the last ten years and limited to implant‐supported single crowns in the posterior region. Based on PROMs, no scientifically proven recommendation for guided implant placement could be given at this time. Patients showed high preference for optical impressions, whereas no differences between veneered and monolithic restorations could be reported.

Clinical Outcome of Fully Digital Workflow for Single-Implant-Supported Crowns: A Retrospective Clinical Study

“…In fact, a digital workflow and digital impressions, as documented by Bishiti et al [ 32 ], are perceived as more comfortable and less invasive by patients.…”

Patient‐reported outcome measures compared to professional dental assessments of monolithic ZrO2 implant fixed dental prostheses in complete digital workflows: A double‐blind crossover randomized controlled trial

“…Honest and transparent patient communication from the outset with the alignment of expectations in the context of realistic outcomes is essential for modern patient-centered dentistry. 23 The study design with double-blinding of dentist and patient allows the best possible comparison of human perception of iFDPs. The randomized cross-over protocol increased the number of iFDPs studied by a factor of 3 to a remarkable total of 60, though only 20 patients were enrolled in this prospective clinical trial.…”

“…However, in the context of a double‐blind, triple‐armed RCT, this kind of long‐term follow‐up can only be realized at a disproportionately high effort for patients and practitioners. Honest and transparent patient communication from the outset with the alignment of expectations in the context of realistic outcomes is essential for modern patient‐centered dentistry 23 …”

“…[19][20][21][22] However, there is limited clinical evidence for the impact of digital versus conventional workflows on PROMs in patients treated with multiunit monolithic zirconium dioxide (ZrO 2 ) iFDPs. 23 The aim of this double-blind randomized controlled trial (RCT) with a crossover design was to analyze implant prosthetic treatment with monolithic ZrO 2 iFDPs performed using 2 proprietary completely digital workflows (Test-1 and Test-2) and 1 mixed analog-digital workflow (Control) in terms of PROMs compared with professional dental evaluation. The null hypotheses were that (1) subjective patient satisfaction would be similar when comparing iFDPs prepared using these 3 workflows; (2) patient satisfaction would not correlate with objective dental evaluation; and (3) patients would not have any preferences among the 2 IOS and the conventional implant impressions.…”

“…For treatment with implant fixed dental prostheses (iFDPs), recent randomized controlled trials could demonstrate superiority of complete digital implant workflows over conventional analog workflows in terms of clinical 15–18 as well as economic outcomes 19–22 . However, there is limited clinical evidence for the impact of digital versus conventional workflows on PROMs in patients treated with multiunit monolithic zirconium dioxide (ZrO 2 ) iFDPs 23 …”