Feasibility Testing of the Automatic Design of Three-Unit Implant Fixed Dental Prostheses with Different Dental CAD Software: A Pre-Clinical Pilot Trial.

Abstract

Background/Objectives: The technical development of implant-supported fixed dental prostheses (iFDP) initially concentrated on the computer-aided manufacturing of prosthetic restorations (CAM). Advances in information technologies have shifted the focus for optimizing digital workflows to AI-based processes for design (CAD). This pre-clinical pilot trial investigated the feasibility of the automatic design of three-unit iFDPs using CAD software (Dental Manger 2021, 3Shape; DentalCAD 3.1 Rijeka, exocad GmbH). Methods: Two clinical scenarios based on a full dentition were created virtually. Physical models were produced and digitized using two intraoral scanners applying quadrant or full-arch scans (Trios3, 3Shape, Copenhagen, Denmark; and Primescan AC, Dentsply Sirona, Bensheim, Germany). For each scenario, iFDP designs were generated automatically using two laboratory software systems (Dental Manger 2021, 3Shape; DentalCAD 3.1 Rijeka, exocad GmbH), resulting in 80 STL datasets (2 scenarios × 2 scan strategies × 2 IOS systems × 5 scan repetitions × 2 software). The files were analyzed clinically for the contact schemes and pontic area. One of the automated designs for each scenario was manually post-processed and one iFDP design for each scenario was manually created by experienced dental technicians (control). The time required for all the design processes was recorded. Results: The automatic design of iFDPs without manual adjustment did not lead to clinically acceptable restorations. The time required for the automatically generated/manually adjusted iFDPs designs was not significantly different to that for the manually designed restorations. Conclusions: Current laboratory software can not automatically generate three-unit iFDPs with clinically acceptable results in terms of the interproximal and occlusal contacts and the pontic design. The automatic iFDP design process currently requires manual adjustment, which means there is no benefit in terms of the working time compared with manually created restorations.