Patient-Reported Outcomes of Digital Versus Conventional Impressions for Implant-Supported Fixed Dental Prostheses: A Systematic Review and Meta-Analysis.

Abstract

Background/Objectives: To compare patient-reported outcome measures (PROMs) between digital and conventional impression techniques for implant-supported fixed dental prostheses (iFDPs). Methods: A systematic literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Library databases up to June 2025, following PRISMA guidelines. Human clinical studies reporting PROMs between digital and conventional impression techniques for iFDPs were included. Studies using structured, but not necessarily validated, questionnaires were eligible. Two reviewers independently performed study selection, data extraction, and risk of bias assessment. Where possible, meta-analyses were conducted using a random-effects model to pool comparable outcomes across studies using mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CIs). Results: Out of 1784 records screened, eighteen studies were included. Most studies showed that digital impressions were associated with higher patient satisfaction, compared to conventional impressions. Ten studies contributed data to at least one outcome; pooled analyses included the following: overall satisfaction (k = 5), comfort (k = 7), gagging/nausea (k = 5), esthetic satisfaction (k = 2), unpleasant taste (k = 5), anxiety (k = 5), discomfort (k = 2), pain (k = 5), and overall discomfort (k = 5). Digital impressions were significantly favored (p < 0.05) for anxiety (MD = 13.3, 95% CI: -22 to -4.5), nausea (MD = -26.4, 95% CI -46.8 to -6.0), bad taste (MD = -34.8, 95% CI -58.3 to -11.3), discomfort (SMD = -2.24, 95% CI -3.51 to -0.98), comfort (SMD = 1.77, 95% CI: 0.60 to 2.94), perceived procedure time (SMD = 0.96; 95% CI 0.29 to 1.62), and overall satisfaction (SMD = 0.55; 95% CI 0.01 to 1.09). No statistically significant differences were found for pain or esthetic evaluation. Substantial between-study heterogeneity was observed among the included studies. Conclusions: Current evidence indicates that digital impression workflows enhance the overall patient experience for implant-supported fixed restorations, especially in domains linked to comfort and procedural efficiency. These findings support PROM-informed personalization of impression workflows: screening for gagging, anxiety, or intolerance to impression materials could guide patient-tailored use of intraoral scanning while acknowledging no consistent advantage for pain or esthetic perception.