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Resultados relatados pelos pacientes para o fluxo de trabalho digital versus analógico nas próteses fixas sobre dentes: uma revisão sistemática

Trabalho resume as evidências sobre os desfechos relatados pelos pacientes (PROs) para o fluxo digital e e o analógico em próteses fixas sobre dentes.

AUTORES

Ingrid Andrade Meira
Doutora em Clínica Odontológica – FOP/Unicamp; Especialista em Prótese Dentária – Faculdade São Leopoldo Mandic.
Orcid: 0000-0002-3631-0030.

Milton Edson Miranda
Doutor em Odontologia e professor – Faculdade São Leopoldo Mandic; Especialista em Prótese Dentária – Associação Paulista de Cirurgiões Dentistas.
Orcid: 0000-0002-5410-6500.

Larissa Dolfini Alexandrino
Mestra e doutoranda em Clínica Odontológica – FOP/Unicamp; Especialista em Prótese Dentária – Faculdade São Leopoldo Mandic.
Orcid: 0000-0003-0289-1006.

Pedro de Penha Coutinho Nina Duarte
Mestre em Odontologia e professor – Faculdade São Leopoldo Mandic; Especialista em Prótese Dentária – Universidade Paulista.
Orcid: 0000-0002-3388-2105.

RESUMO

Objetivo: resumir as evidências sobre os desfechos relatados pelos pacientes (PROs) para o fluxo digital e e o analógico em próteses fixas sobre dentes. Métodos: esta revisão sistemática foi elaborada seguindo as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma) e registrada no International Prospective Register of Systematic Reviews (CRD42020182705). Cinco bases de dados e a literatura não revisada por pares foram pesquisadas até abril de 2022. Foram incluídos apenas estudos clínicos que avaliaram os PROs para o escaneamento intraoral e para a moldagem convencional, e/ou os PROs para a confecção de coroas unitárias e próteses parciais fixas sobre dentes (PFDs) obtidas por CAD/CAM e pelo fluxo analógico. O risco de viés foi avaliado com as ferramentas do Joanna Briggs Institute. Por fim, a abordagem de avaliação, desenvolvimento e avaliação de classificação de recomendações (GRADE) foi adotada para verificar a qualidade da evidência. Resultados: dos 4.238 registros selecionados, 20 foram lidos na íntegra e apenas cinco foram incluídos nesta revisão. Quatro estudos avaliaram os PROs para o escaneamento intraoral e para a moldagem convencional, sendo a satisfação com o tempo do procedimento o desfecho mais frequente. A maioria dos artigos encontrou pacientes significativamente mais satisfeitos e com maior preferência pelo escaneamento intraoral à moldagem convencional do arco completo. A qualidade da evidência para os PROs para a forma de obtenção do modelo foi muito baixa. Conclusão: há uma maior satisfação e preferência dos pacientes pelo escaneamento intraoral à moldagem convencional, entretanto novos estudos são necessários.

Palavras-chave – Desenho assistido por computador; Coroas; Prótese parcial fixa; Medidas de resultados relatados pelo paciente.

ABSTRACT

Objective: to summarize the evidence on patient-reported outcomes (PROs) for digital and analog workflows in fixed partial dentures. Material and methods: this systematic review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (Prisma) guidelines and registered in the International Prospective Register of Systematic Reviews (CRD42020182705). Five databases and the non-peer-reviewed literature were searched up to April 2022. Only clinical studies that evaluated PROs for intraoral scanning and/or PROs for the fabrication of single crowns and partial prostheses fixed supported by teeth (PFDs) made by CAD/CAM and by the analog flow were included. The risk of bias was assessed with the Joanna Briggs Institute critical appraisal tools. Finally, the grading of recommendations assessment, development and evaluation (GRADE) approach was used to test the quality of evidence. Results: from the 4,238 selected, 20 were fully registered and only 5 articles were included in this review. Four studies evaluated PROs for intraoral scanning and for conventional impression, with satisfaction being the most frequent variable, mainly with the procedure time. Most articles found patients significantly more satisfied and with greater preference for intraoral scanning to conventional full-arch impression. The quality of evidence for PROs on how to obtain the model was very low. Conclusion: therefore, there is greater patient satisfaction and preference for intraoral scanning to conventional impressions; however, further studies are necessary.

Key words – Computer-aided design; Crowns; Denture; Partial; Fixed; Patient reported outcome measures.

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