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Review
. 2023 Jun 4;12(11):3847.
doi: 10.3390/jcm12113847.

CAD/CAM Abutments in the Esthetic Zone: A Systematic Review and Meta-Analysis of Soft Tissue Stability

Diego Lops  1 , Eugenio Romeo  1 , Magda Mensi  2 , Giuseppe Troiano  3 , Khrystyna Zhurakivska  3 , Massimo Del Fabbro  4   5 , Antonino Palazzolo  1
Affiliations
Review

CAD/CAM Abutments in the Esthetic Zone: A Systematic Review and Meta-Analysis of Soft Tissue Stability

Diego Lops et al. J Clin Med. .

Abstract

Computer-aided design and computer-aided manufacturing customized abutments are increasingly used in everyday clinical practice. Nevertheless, solid scientific evidence is currently lacking regarding their potential advantages in terms of soft tissue stability. The main aim of this systematic review and meta-analysis was to compare the soft tissue outcomes of prefabricated versus customized (CAD/CAM) abutments. The present review was registered with PROSPERO (CRD42020161875) and the protocol was developed according to the PRISMA statement. An electronic search was performed on three databases (PubMed, Embase and Cochrane Central) up to May 2023. Data extraction was followed by qualitative and quantitative analysis of the included studies. Three randomized controlled clinical trials and three controlled clinical trials (number of patients = 230; number of dental implants = 230) with a follow-up of between 12 and 36 months were included. No significant differences were observed between prefabricated versus customized (CAD/CAM) abutments regarding midfacial mucosal recession, interproximal papillae and pink aesthetic score (PES) after 12 months. Conclusion: The potential benefits of CAD/CAM abutments on soft tissues should be better clarified in future investigations. The usage of customized CAD/CAM abutments in everyday clinical practice should be based on a careful case-by-case evaluation (CRD42020161875).

Keywords: computer-aided design; computer-aided manufacturing; dental implants; esthetic zone; soft tissue; titanium abutments; zirconia abutments.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram showing the screening process.
Figure 2
Figure 2
Forest plot of the overall pink esthetic score at 12 months. No statistically significant difference was found (MD −0.43; 95% CI −1.21, 0.35; p = 0.28) [23,24].
Figure 3
Figure 3
Forest plot of the marginal soft tissue level at 12 months. No statistically significant difference was found (MD −0.14; 95% CI −0.36, 0.08; p = 0.21) [23,24].
Figure 4
Figure 4
Forest plot of the value of interproximal papilla recession at 12 months. Studies were divided into two subgroups according to the study design. There was a significant difference in effect (p = 0.009), and significant heterogeneity (p = 0.03) between the two subgroups. Overall, no statistically significant difference was found in IntPapilla between using prefabricaded and customized CAD/CAM abutments (MD 0.15; 95% CI −0.26, 0.56; p = 0.48) [21,23,24].
See this image and copyright information in PMC

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