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Comparative Study
. 2018 Nov 11:2018:4149107.
doi: 10.1155/2018/4149107. eCollection 2018.

Digital versus Traditional Workflow for Posterior Maxillary Rehabilitations Supported by One Straight and One Tilted Implant: A 3-Year Prospective Comparative Study

Francesco Ferrini  1 , Paolo Capparé  1 , Raffaele Vinci  1 , Enrico F Gherlone  1 , Gianpaolo Sannino  1
Affiliations
Comparative Study

Digital versus Traditional Workflow for Posterior Maxillary Rehabilitations Supported by One Straight and One Tilted Implant: A 3-Year Prospective Comparative Study

Francesco Ferrini et al. Biomed Res Int. .

Abstract

Objectives: The aim of the study was to evaluate and compare digital and traditional prosthetic workflow for posterior maxillary restorations supported by an upright and a distally tilted implant at 3-year follow-up.

Materials and methods: Twenty-four patients were treated in the posterior maxilla with 24 immediately loaded axial and 24 distally tilted implants supporting 3-unit or 4-unit screw-retained prostheses. Three months after initial loading patients were randomly stratified into two groups: definitive traditional impressions were carried out in the control group, while digital impressions were performed in the test group. The framework-implant connection accuracy was evaluated by means intraoral digital radiographs at 3, 6, 12, and 36 months of follow-up examinations. Outcome considerations comprised implant and prosthetic survival and success rates, marginal bone level changes, and required clinical time to take impressions.

Results: A total of 24 patients received immediately loaded screw-retained prostheses supported by an upright and a distally tilted implant (total 48 implants). No implant dropouts occurred, showing an overall survival rate of 100% for both groups. None of the 24 fixed prostheses were lost during the observation period (prosthetic survival rate of 100%). No statistically significant differences in marginal bone loss were found between control and test groups. The digital impression procedure required on average less clinical time than the conventional procedure.

Conclusions: Clinical and radiologic results suggest that digital impression is a predictable procedure for posterior maxillary restorations supported by an upright and a distally tilted implant.

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Figures

Figure 1
Figure 1
Presurgical radiographic view.
Figure 2
Figure 2
Prefabricated screw-retained, acrylic resin interim restorations were delivered immediately in all patients. The posterior implant was placed in second premolar position, distally tilted providing a first molar prosthetic emergence. The lack of parallelism between implants was compensated by means straight and angulated abutments.
Figure 3
Figure 3
In the test group scan bodies were splinted as impression guide for a digital implant level impression.
Figure 4
Figure 4
The impression guide was extraorally scanned by a laboratory scanner. A dental CAD software was then used to match the extraoral scanning to the intraoral impressions.
Figure 5
Figure 5
Digital planning. Prosthetic screw-access holes were placed in an occlusal or lingual location thanks to angulated abutments.
Figure 6
Figure 6
Occlusal view of definitive milled high-precision screw-retained zirconia-ceramic framework prosthesis screwed into the implants.
Figure 7
Figure 7
Vestibular and radiographic views of definitive restoration at 36-month follow-up.
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