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PURPOSE: Additive cast-fabrication has yet to be used as commonly in implant prosthodontics as conventional methods. This review aimed to investigate the accuracy of additive cast-fabrication in implant prosthodontics. STUDY SELECTION: The study protocol was registered in the PROSPERO database (CRD42022374972). Reporting was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, following the Cochrane Handbook. Two-arm interventional studies that matched the PICO were included (Population: dental typodonts with implants, Intervention: additive cast-fabrication, Comparator: conventional cast-fabrication, Outcome: positional deviations). A systematic search was conducted in three databases: PubMed (MEDLINE), EMBASE, and the Cochrane Library (CENTRAL). RESULTS: Seven papers were included in the analysis of horizontal, vertical, and root mean square (RMS) deviations. No significant differences were observed between groups. The overall vertical mean deviation of the intervention group was -4.15 µm [-24.88; 16.57], and the pooled mean absolute deviation was 22.43 µm [8.33; 36.54]. In the control group, these values were 19.67 µm [-32.71; 72.04] and 24.62 µm [0.00; 59.42], respectively. The overall horizontal mean deviation in the intervention group was 21.29 µm [-77.10; 119.68], and the pooled mean absolute deviation was 26.96 µm [0.00; 70.81]. In the control group, the overall mean was 1.45 µm [-32.26; 35.15] and the pooled mean absolute deviation was 25.05 µm [9.08; 41.01]. The mean RMS was only slightly larger in the intervention group, with the value of 14.74 µm [-107.26; 136.74]. CONCLUSIONS: Additive cast-fabrication is as accurate as the conventional method for the position of implant analogs.
RESUMO
STATEMENT OF PROBLEM: With increasing esthetic needs, patients prefer missing anterior teeth to be restored as soon as possible, but how the timing of implantation and prosthetic loading influences peri-implant tissue and the esthetic results remains unclear. PURPOSE: The purpose of this systematic review and network meta-analysis of randomized controlled trials was to investigate and rank the hard-tissue and soft-tissue outcomes, esthetics, and patient satisfaction of single maxillary implant placement and loading protocols. MATERIAL AND METHODS: A systematic search was conducted to identify studies with at least a 1-year follow-up that compared different implant placement and loading protocols and reported on survival, marginal bone loss (MBL), soft tissue, and esthetics. A random effects model and a Bayesian approach were applied to compare protocols by using mean differences (MD) with 95% credible intervals (CrI) and surface under the cumulative ranking curve (SUCRA) values. RESULTS: A total of 43 articles were included, with a follow-up of 1 to 5 years. All protocols had high survival rates and no significant differences for 1-year or 2-year MBL. Immediate placement with immediate loading ranked first in pink and white esthetic scores and satisfaction and was statistically significantly better than immediate placement with delayed loading or late placement protocols in pink esthetic scores, where its advantage over late placement with late loading was also clinically relevant [MD: -1.74, CrI: -2.34 to -1.15]. CONCLUSIONS: Immediate implantation with immediate loading showed a considerable esthetic advantage over later rehabilitation, whereas only a slight difference in MBL resulted from different protocols.
RESUMO
Problem: Several types of 3D printers with different techniques and prices are available on the market. However, results in the literature are inconsistent, and there is no comprehensive agreement on the accuracy of 3D printers of different price categories for dental applications. Aim: This study aimed to investigate the accuracy of five different 3D printing systems, including a comparison of budget- and higher-end 3D printing systems, according to a standardized production and evaluation protocol. Material and methods: A maxillary reference model with prepared teeth was created using 16 half-ball markers with a diameter of 1 mm to facilitate measurements. A reference file was fabricated using five different 3D printers. The printed models were scanned and superimposed onto the original standard tesselation language (.stl) file, and digital measurements were performed to assess the 3-dimensional and linear deviations between the reference and test models. Results: After examining the entire surface of the models, we found that 3D printers using Fused filament fabrication (FFF) technology -120.2 (20.3) µm create models with high trueness but high distortion. Distortions along the z-axis were found to be the highest with the stereolithography (SLA)-type 3D printer at -153.7 (38.7) µm. For the 4-unit FPD, we found 201.9 (41.8) µm deviation with the digital light processing (DLP) printer. The largest deviation (-265.1 (55.4) µm) between the second molars was observed for the DLP printer. Between the incisor and the second molar, the best results were produced by the FFF printer with -30.5 (76.7) µm. Conclusion: Budget-friendly 3D printers are comparable to professional-grade printers in terms of precision. In general, the cost of a printing system is not a reliable indicator of its level of accuracy.