Comparative Analysis of Periodontal Parameters and Patient Satisfaction Utilising Different Temporary Crown Fabrication Techniques: A Parallel-Group Randomised Controlled Trial

Abstract

Aim The study aims to evaluate the efficacy of different techniques for temporary crown fabrication in maintaining periodontal health and patient satisfaction, addressing a critical gap in the existing literature and informing evidence-based clinical practices. Materials and methods This study, conducted in accordance with CONSORT guidelines, was a parallel-group randomised trial conducted at a dental institute in India. In total, 36 participants aged 18-65 requiring anterior tooth region crowns were randomly assigned to three groups: direct (control), indirect (Test Group 1) and direct-indirect (Test Group 2) fabrication techniques. Participants were selected from outpatient departments based on eligibility criteria, and interventions were allocated using randomization tables. Outcome assessments included gingival health metrics and patient satisfaction levels, with statistical analyses performed using the Kruskal-Wallis test. Results Significant differences were observed in the pink esthetic score (PES) and patient satisfaction (P=0.029) among the three groups, with the direct-indirect technique group demonstrating the highest median PES (9 out of 10). However, no significant disparities were noted in the plaque index (PI) or probing depth (PD) among the groups. Conclusion The direct-indirect technique demonstrated superior PES and patient satisfaction, indicating potential benefits for periodontal health and patient experiences. Integration of virtual preparation workflows may optimise outcomes, but further research is needed for validation and guideline development.

Keywords: direct-indirect technique; health; patient satisfaction; periodontal health; pink esthetic score (pes); quality of life (qol); temporary crowns.

Figure 1. Workflow of each technique depicting the chair-side manual fabrication for Group 1 (direct technique), laboratory-based CAD/CAM for Group 2 (indirect technique), and digital fabrication with chair-side relining for Group 3 (direct-indirect technique).

CAD/CAM: computer-aided design and computer-assisted manufacturing Image credit: Amrutha Shenoy

Figure 2. Tooth preparation (A), gingival retraction (B), wax mock-up of tooth to receive temporary crown using direct technique (C), prepared tooth for indirect technique (D), virtual tooth preparation workflow to obtain temporary crown using the direct-indirect method (E), temporary crown fabricated through direct-indirect technique (F).

Figure 3. Flow diagram summarising participant enrollment, randomization, group assignment, intervention allocation, dropout details, and the final number of participants for analysis.

Figure 4. Difference in the median PES scores between the three groups at the one-week follow-up. Significant difference was seen between the groups (DI = I > D).

The p-value was derived using a non-parametric Kruskal Wallis test. PES: pink esthetic score; DI: direct-indirect; I: indirect; D: direct

Figure 5. Difference in the median plaque scores recorded between the three groups at the one-week follow-up analysed using the Kruskal-Wallis test. No significant difference was found between the three groups.

Figure 6. The difference in the median probing depth recorded between the three groups at the one-week follow-up was analysed using the Kruskal-Wallis test. No significant difference was found between the three groups.