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

J Prosthodont. 2023 Jan;32(1):18-25. doi: 10.1111/jopr.13589. Epub 2022 Aug 23.

Abstract

Purpose: This double-blind randomized controlled trial analyzed patient-reported outcome measures in terms of subjective patient satisfaction compared to objective dental evaluation of prosthetic treatment with 3-unit monolithic zirconium dioxide implant fixed dental prostheses (iFDPs) in 3 digital workflows.

Material and methods: Twenty patients were restored with 3 iFDPs each on Straumann TL-implants with 2 completely digital workflows using different intraoral optical scanning systems with model-free fabrication of the restoration (Trios 3/3Shape [Test-1]; Virtuo Vivo/Straumann [Test-2]), and mixed analog-digital workflow with conventional impressions and digitized gypsum casts (Impregum/3M Espe [Control]). The order of impression-taking and the prosthetic try-in were randomly allocated. Sixty iFDPs were compared for patient satisfaction and dental evaluation using ANOVA.

Results: For iFDP evaluation, patients generally provided more favorable ratings than dental experts, regardless of the workflow. ANOVA revealed no significant difference for overall satisfaction when comparing Test-1, Test-2, or Control, either for patients (f-ratio: 0.13; p = 0.876) or dentist (f-ratio: 1.55: p = 0.221). Secondary, patients clearly favored the digital impression workflows over the conventional approach (f-ratio: 14.57; p < 0.001). Overall, the 3Shape workflow (Test-1) received the highest scores for all analyses.

Conclusions: The different digital workflows demonstrated minor influence on the subjective and objective evaluation of the monolithic zirconium dioxide iFDPs in nonesthetic regions; however, the dentist may significantly increase patient satisfaction by choosing intraoral scanning instead of conventional impressions. The dentist has to consider individual patients' needs to fulfill their expectations for a personalized solution.

Keywords: clinical research; dental implant; digital dentistry; fixed dental prosthesis (FDP); patient satisfaction.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Computer-Aided Design
  • Dental Implants*
  • Dental Impression Technique
  • Dental Prosthesis Design
  • Humans
  • Patient Reported Outcome Measures
  • Workflow

Substances

  • zirconium oxide
  • Dental Implants