Effect of immediate all-digital restoration of single posterior implants: The SafetyCrown concept on patient-reported outcome measures, accuracy, and treatment time—A randomized clinical trial

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Implant Dentistry and Related Research Pub Date : 2024-08-19 DOI:10.1111/cid.13374

Lukas Waltenberger, Sven Reich, Marcel Zwahlen, Stefan Wolfart

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Abstract

Objective

The SafetyCrown workflow facilitates the immediate restoration of posterior single sites with the one-abutment/one-time concept. This randomized clinical trial aimed to assess the direct effect of immediate restoration on dental patient-reported outcomes (dPROs), feasibility, implant accuracy, and time.

Materials and Methods

Participants with a single posterior edentulous site for late implant placement underwent optical impressions, shade selection, and cone beam computed tomography. After virtual treatment planning, they were randomized into the test group and the control group. For the test group, individual definitive hybrid abutments were prefabricated. The next step was a fully guided surgery with printed guides. After the implant was placed using guided surgery, the abutment was inserted. A chairside CAD/CAM workflow was used to provide the patient with a provisional restoration. Implants in the control group were left submerged to heal. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-G14, and dPRO was measured using a 10-item visual analog scale (VAS) questionnaire. Additional measurements of implant accuracy and time were performed. Follow-up was performed 7 to 10 days after implant placement.

Results

Thirty-nine participants with 45 restorations were included (test group: 23, control: 22). Immediate restoration was successful in 21 out of 23 implants (91.3%) in the test group. Both groups exhibited decreased OHRQoL without significant intergroup differences, while patient satisfaction was high overall. Test group participants perceived higher benefits and satisfaction with immediate loading than participants in the control group. Implant accuracy averaged 0.60 mm at the shoulder and 0.95 mm at the apex. Operative time was longer in the immediate loading group (61.9 min) than in the control group (32.1 min) (p < 0.001).

Conclusions

Considering the limitations, the immediate restoration of late placed posterior implants using the described workflow proved feasible in 21 out of 23 cases. Both groups achieved high patient satisfaction with no differences in OHRQoL during the first week. Patients who received immediate loading rated the benefits very highly and were satisfied with the provisional restoration during the healing period.

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单一后牙种植体即刻全数字化修复的效果：SafetyCrown概念对患者报告结果、准确性和治疗时间的影响--随机临床试验。

目的：安全冠（SafetyCrown）工作流程以一次修复/一次性理念促进了后牙单个部位的即刻修复。这项随机临床试验旨在评估即刻修复对牙科患者报告结果（dPROs）、可行性、种植体准确性和时间的直接影响：材料和方法：参与者有一个后部缺牙部位，需要晚期种植体植入，他们接受了光学印模、色调选择和锥形束计算机断层扫描。虚拟治疗规划后，他们被随机分为试验组和对照组。对于试验组，预制了单个确定性混合基台。下一步是使用打印导板进行全引导手术。使用引导手术植入种植体后，再插入基台。采用椅旁 CAD/CAM 工作流程为患者提供临时修复体。对照组的种植体则浸泡在水中等待愈合。口腔健康相关生活质量（OHRQoL）采用OHIP-G14进行评估，dPRO采用10项视觉模拟量表（VAS）问卷进行测量。此外，还对种植体的准确性和时间进行了测量。种植体植入后 7 到 10 天进行随访：39名参与者共进行了45次修复（试验组：23次，对照组：22次）。测试组的 23 个种植体中有 21 个（91.3%）成功进行了即刻修复。两组患者的 OHRQoL 都有所下降，但组间差异不大，患者的满意度总体较高。与对照组相比，试验组患者对即刻种植的益处和满意度更高。种植体精确度在肩部平均为 0.60 毫米，在顶点平均为 0.95 毫米。即刻加载组的手术时间（61.9 分钟）长于对照组（32.1 分钟）（p 结论：即刻加载组的手术时间（61.9 分钟）长于对照组（32.1 分钟）：考虑到手术的局限性，在 23 个病例中，有 21 个病例采用了所述的工作流程，证明对晚期植入的后部种植体进行即刻修复是可行的。两组患者的满意度都很高，第一周的 OHRQoL 没有差异。接受即刻加载的患者对其益处评价很高，并对愈合期间的临时修复表示满意。

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.