In Vivo and In Vitro Comparison of Internal and Marginal Fit of Digital and Conventional Impressions for Full-Coverage Fixed Restorations: A Systematic Review and Meta-analysis

Mahya Hasanzade; Mohammadjavad Shirani; Kelvin I Afrashtehfar; Parisa Naseri; Marzieh Alikhasi

doi:10.1016/j.jebdp.2019.04.003

In Vivo and In Vitro Comparison of Internal and Marginal Fit of Digital and Conventional Impressions for Full-Coverage Fixed Restorations: A Systematic Review and Meta-analysis

J Evid Based Dent Pract. 2019 Sep;19(3):236-254. doi: 10.1016/j.jebdp.2019.04.003. Epub 2019 Apr 25.

Authors

Mahya Hasanzade¹, Mohammadjavad Shirani², Kelvin I Afrashtehfar³, Parisa Naseri⁴, Marzieh Alikhasi⁵

Affiliations

¹ Postgraduate Prosthodontics Resident, Dental Research Center, Dentistry Research Institute and Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
² Postgraduate Prosthodontics Resident, Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
³ Visiting Research Associate, Department of Oral Surgery & Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland; Implant Fellow, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland. Electronic address: kelvin.afrashtehfar@zmk.unibe.ch.
⁴ Statistician, Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁵ Professor, Dental Research Center, Dentistry Research Institute, Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: malikhasi@razi.tums.ac.ir.

PMID: 31732100
DOI: 10.1016/j.jebdp.2019.04.003

Abstract

Purpose: This study aims to evaluate digital and conventional impressions for full-coverage restorations in terms of marginal and internal discrepancies.

Study selection: The analysis included in vivo and in vitro studies reporting the marginal or internal gap of full-coverage restorations that provide both the conventional and digital impression. The PubMed, Cochrane Trials, and Scopus databases were searched. The quality of clinical trials was rated using Cochrane Collaboration's tool, and the quality of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation tool. Heterogeneity among the studies was evaluated, and a meta-analysis with subgroup analysis was conducted whenever it was possible.

Results: Thirty-three articles (8 prospective clinical trials and 26 in vitro studies) were selected to extract data after applying the predefined selection criteria. The standard mean difference (SMD) of the meta-analysis for marginal adaptation was -0.76 (95% confidence interval: -1.23 to -0.29) and -0.59 (95% confidence interval: -0.93 to -0.24) for in vitro and in vivo studies, respectively, indicating digital impressions provided significantly less marginal gap than conventional impressions in in vitro studies (P = .002). The impression technique did not significantly influence the internal adaptation.

Conclusions: Differences in marginal adaptation between the digital and conventional groups are not significant for in vivo studies, but for in vitro studies, the digital impression resulted in better marginal adaptation. Based on the Grading of Recommendations, Assessment, Development, and Evaluation approach for marginal adaptation, clinical studies were classified as high confidence and in vitro studies were graded moderate because of the inconsistency. Furthermore, high-quality studies are needed to confirm our results (the International Prospective Register of Systematic Reviews; CRD42017077925).

Keywords: Dental impression technique; Dental marginal adaptation; Digital impression; Fixed dental prostheses; Internal adaptation.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Computer-Aided Design
Crowns
Dental Impression Technique*
Dental Marginal Adaptation*
Dental Prosthesis Design
Humans