Clinical evidence and Science 49 Chairside digital workflow A chairside digital workflow saves time for the patient by providing the dental restoration within one visit. A randomized clinical trial performed by Zhang et al. (2019) evaluated quantitatively the benefits of the chairside digital workflow (5). The study compared the clinical adjustments and the time consumption on fabricating and placing a posterior single crown between chairside digital workflow and hybrid digital workflow. The chairside digital workflow included intraoral scanning, CAD/CAM fabrication of a lithium disilicate crown, and mounting the restoration within one visit. With the hybrid digital workflow, the position of the implants was transferred via impression taking to a stone model which was then scanned to design the crown. The zirconia crown was milled and sintered by outsourcing manufacturing and individually veneered and finalized in the lab. Afterwards the restorations bonded to titanium bases were placed on CAMLOG® SCREW-LINE implants in a second visit. After the clinical fitting and adjustments to obtain adequate interproximal and occlusal contacts the 3D deviations of the pre and post crown (superimposed data file) were measured. The outcome of 33 patients showed statistically significant differences. The chairside digital workflow resulted in fewer adjustments and especially precision of the occlusal surface. Additionally, the total time consumption was a fifth of the hybrid digital workflow (Tab. 5). Although both workflows led to successful treatment results, increased digitized steps seem to be the future in implant dentistry and save treatment time for the patient. KEY TAKE OUTS: DIGITAL WORKFLOW With the use of digitized processes and guided surgery the patients can be treated more gently and time and cost effectively. Template-guided implant placement was proven to be accurate for the CAMLOG® and CONELOG® Implant System and can be recommended to achieve predictable prosthetic restorations. Tab. 5_ Overview of adjustments and time consumption for digital workflows (adapted from Zhang et al. 2019) * p = 0.001 Test group Chairside digital workflow Control group Hybrid digital workflow Implant restorations n = 17 n = 16 Median adjustment count* 2.00 ± 1.09 3.00 ± 1.05 Total active working time (min) 92.3 146.3 Total time for workflow (min) 113.7 684.5 1. Schnutenhaus S, Edelmann C, Rudolph H, Dreyhaupt J, Luthardt RG. 3D accuracy of implant positions in template-guided implant placement as a function of the remaining teeth and the surgical procedure: a retrospective study. Clin Oral Investig. 2018;22(6):2363–72. 2. Beretta M, Poli PP, Maiorana C. Accuracy of computer-aided template-guided oral implant placement: a prospective clinical study. J Periodontal Implant Sci. 2014;44(4):184–93. 3. Schnutenhaus S, Brunken L, Edelmann C, Dreyhaupt J, Rudolph H, Luthardt RG. Alveolar ridge preservation and primary stability as influencing factors on the transfer accuracy of static guided implant placement: a prospective clinical trial. BMC Oral Health. 2020;20(1):178. 4. Schnutenhaus S, Edelmann C, Rudolph H. Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study. Int J Implant Dent. 2021;7(1):42. 5. Zhang Y, Tian J, Wei D, Di P, Lin Y. Quantitative clinical adjustment analysis of posterior single implant crown in a chairside digital workflow: A randomized controlled trial. Clin Oral Implants Res. 2019;30(11):1059–66. DIGITAL WORKFLOW References
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