Fully digital versus conventional workflow: Are removable complete overdentures equally good? A randomized crossover trial

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

Clinical Implant Dentistry and Related Research Pub Date : 2024-09-30 DOI:10.1111/cid.13398

Thomas Van de Winkel, Frans Delfos, Olleke van der Heijden, Ewald Bronkhorst, Luc Verhamme, Gert Meijer

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引用次数: 0

Abstract

Introduction

Implant-supported removable complete overdentures (IODs) are a common treatment in case of edentulism and malfunctioning of the conventional denture. Manufacturing IODs in a conventional way (C-IODs) is time-consuming, but in a digital workflow, this can be done in three sessions. Digitally produced IODs (3D-IODs) are also more advantageous than C-IODs because lost or broken 3D-IODs can be swiftly reproduced as the digital design is always available.

Purpose

To prove in a non-inferiority study, with a margin of 0.3 point per Oral Health Impact Profile-20 (OHIP-20) question, that IODs made according to a fully digital workflow (3D-IODs), function as good as C-IODs with respect to patient-reported outcome measures (PROMs).

Materials and Methods

This randomized crossover study included 36 fully edentulous patients who showed extreme resorption of the maxillary alveolar process, making denture retention difficult. After a maxillary bone augmentation and the installation of 4–6 implants, each patient wore both types of IOD for 1 year each, with the order reversed in two subsets of patients. The 3D-IODs and C-IODs were fabricated in advance for both jaws (at least two mandibular implants were already present).

The OHIP-20 survey was performed at baseline, after 1 year (before the IOD switch), and after 2 years to determine patient satisfaction scores using a visual analog scale (VAS). The general health status was assessed using the Short Form (SF-36) questionnaire.

Results

Regarding the PROMs, patients preferred the 3D-IOD: the improvement on the overall OHIP scale (0–4), expressed as a mean, was 0.26 points greater than for the C-IOD (p < 0.001). This applied also to the VAS scale (1–100) with an increase of 7.37 points (p < 0.001). Regarding the SF-36 scale, only for the item “emotional well-being,” the 3D-IOD scored significantly better (p = 0.033).

Conclusion

Compared with conventionally fabricated C-IODs, fully digitally produced 3D-IODs resulted in significantly higher OHIP-20 and satisfaction scores.

Abstract Image

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全数字化与传统工作流程：可摘全口覆盖义齿的效果是否一样好？随机交叉试验。

导言：种植体支持的可摘全口覆盖义齿（IOD）是一种常见的治疗方法，用于治疗缺牙症和传统义齿的故障。用传统方法（C-IODs）制作 IODs 非常耗时，但在数字化工作流程中，只需三次就能完成。数字制作的 IOD（3D-IOD）也比 C-IOD 更具优势，因为丢失或损坏的 3D-IOD 可以快速复制，因为数字设计始终可用。目的：在一项非劣效性研究中，以每个口腔健康影响档案-20（OHIP-20）问题 0.3 分的差值证明，根据全数字工作流程制作的 IOD（3D-IOD）在患者报告结果测量（PROM）方面与 C-IOD 一样好：这项随机交叉研究包括 36 名完全无牙颌的患者，他们的上颌骨牙槽突极度吸收，导致义齿难以固位。在进行上颌骨增量手术并安装 4-6 个种植体后，每位患者分别佩戴两种类型的 IOD 1 年，其中两组患者的佩戴顺序相反。3D-IOD和C-IOD是事先为两个下颌制作的（至少已有两个下颌种植体）。分别在基线期、1年后（IOD转换前）和2年后进行OHIP-20调查，使用视觉模拟量表（VAS）确定患者的满意度。一般健康状况采用简表（SF-36）问卷进行评估：结果：在PROMs方面，患者更倾向于3D-IOD：OHIP总评分（0-4分）的平均值比C-IOD高出0.26分（p 结论：与传统的C-IOD相比，3D-IOD的患者满意度更高：与传统制作的 C-IOD 相比，全数字化制作的 3D-IOD 的 OHIP-20 和满意度评分明显更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.