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.

Referências

Uzun G. An overview of dental CAD/CAM systems. Biotechnology & Biotechnological Equipment 2008;22(1):530-5.

Yuzbasioglu E, Kurt H, Turunc R, Bilir H. Comparison of digital and conventional impression techniques: evaluation of patients’ perception, treatment comfort, effectiveness and clinical outcomes. BMC Oral Health 2014;14:10.

Luthardt R, Weber A, Rudolph H, Schone C, Quaas S, Walter M. Design and production of dental prosthetic restorations: basic research on dental CAD/CAM technology. Int J Comput Dent 2002;5(2-3):165-76.

Benic GI, Mühlemann S, Fehmer V, Hämmerle CH, Sailer I. Randomized controlled within-subject evaluation of digital and conventional workflows for the fabrication of lithium disilicate single crowns. Part I: digital versus conventional unilateral impressions. J Prosthet Dent 2016;116(5):777-82.

Christensen GJ. Impressions are changing: deciding on conventional, digital or digital plus in-office milling. J Am Dent Assoc 2009;140(10):1301-4.

Sailer I, Benic GI, Fehmer V, Hämmerle CHF, Mühlemann S. Randomized controlled within-subject evaluation of digital and conventional workflows for the fabrication of lithium disilicate single crowns. Part II: CAD-CAM versus conventional laboratory procedures. J Prosthet Dent 2017;118(1):43-8.

Joda T, Ferrari M, Bragger U, Zitzmann NU. Patient reported outcome measures (PROMs) of posterior single-implant crowns using digital workflows: a randomized controlled trial with a three-year follow-up. Clin Oral Implants Res 2018;29(9):954-61.

Mühlemann S, Benic GI, Fehmer V, Hämmerle CHF, Sailer I. Clinical quality and efficiency of monolithic glass ceramic crowns in the posterior area: digital compared with conventional workflows. Int J Comput Dent 2018;21(3):215-23.

Berrendero S, Salido MP, Ferreiroa A, Valverde A, Pradíes G. Comparative study of all-ceramic crowns obtained from conventional and digital impressions: clinical findings. Clin Oral Investig 2019;23(4):1745-51.

Cheng CW, Ye SY, Chien CH, Chen CJ, Papaspyridakos P, Ko CC. Randomized clinical trial of a conventional and a digital workflow for the fabrication of interim crowns: an evaluation of treatment efficiency, fit, and the effect of clinician experience. J Prosthet Dent 2021;125(1):73-81.

Forrer FA, Schnider N, Brägger U, Yilmaz B, Hicklin SP. Clinical performance and patient satisfaction obtained with tooth-supported ceramic crowns and fixed partial dentures. J Prosthet Dent 2020;124(4):446-53.

Sakornwimon N, Leevailoj C. Clinical marginal fit of zirconia crowns and patients’ preferences for impression techniques using intraoral digital scanner versus polyvinyl siloxane material. J Prosthet Dent 2017;118(3):386-91.

Haddadi Y, Bahrami G, Isidor F. Evaluation of operating time and patient perception using conventional impression taking and intraoral scanning for crown manufacture: a split-mouth, randomized clinical study. Int J Prosthodont 2018;31(31):55-9.

Cosyn J, Thoma DS, Hämmerle CH, De Bruyn H. Esthetic assessments in implant dentistry: objective and subjective criteria for clinicians and patients. Periodontol 2000 2017;73(1):193-202.

Lang NP, Zitzmann NU, Working Group 3 of the VIII European Workshop on Periodontology. Clinical research in implant dentistry: evaluation of implant-supported restorations, aesthetic and patient-reported outcomes. J Clin Periodontol 2012;39(suppl.12):133-8.

McGrath C, Lam O, Lang N. An evidence-based review of patient-reported outcome measures in dental implant research among dentate subjects. J Clin Periodontol 2012;39(suppl.12):193-201.

Field J, Holmes MM, Newell D. PROMs data: can it be used to make decisions for individual patients? A narrative review. Patient Relat Outcome Meas 2019;10:233-41.

Greenhalgh J, Gooding K, Gibbons E, Dalkin S, Wright J, Valderas J et al. How do patient reported outcome measures (PROMs) support clinician-patient communication and patient care? A realist synthesis. J Patient Rep Outcomes 2018;2:42.

Leles CR, Silva JR, Curado TFF, Schimmel M, McKenna G. The potential role of dental patient-reported outcomes (dPROs) in evidence-based prosthodontics and clinical care: a narrative review. Patient Relat Outcome Meas 2022;13:131-43.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71.

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4(1):1.

Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ 2005;331(75240:1064-65).

Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev 2016;5(1):210.

Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z (Editors). JBI Manual for Evidence Synthesis. JBI, 2020.

Polmann H, Domingos FL, Melo G, Stuginski-Barbosa J, Guerra ENS, Porporatti AL et al. Association between sleep bruxism and anxiety symptoms in adults: a systematic review. J Oral Rehabil 2019;46(5):482-91.

Ryan R, Hill S. How to GRADE the quality of the evidence. Cochrane Consumers and Communication Group, Version 3.0. 2016 [On-line]. Disponível em http://cccrg.cochrane.org/author-resources . Acesso em: 18-3-2021.

Meira IA, Gama LT, Prado-Tozzi DA, Pinheiro MA, Rodrigues Garcia RCM. Speech in implant-supported and removable complete denture wearers: a systematic review. J Prosthet Dent 2022;128(6):1230-8.

Amaral CF, Pinheiro MA, de Moraes M, Garcia RCMR. Psychometric analysis and masticatory efficiency of elderly people with single-implant overdentures. Int J Oral Maxillofac Implants 2018;33(6):1383-9.

Su S, Lipsky MS, Licari FW, Hung M. Comparing oral health behaviors of men and women in the United States. J Dent 2022;122:104157.

La Monaca G, Pranno N, Annibali S, Massimo C, Polimeni A, Patini R et al. Survival and complication rates of tooth-implant versus freestanding implant supporting fixed partial prosthesis: a systematic review and meta-analysis. J Prosthodont Res 2021;65(1):1-10.

Schepke U, Meijer HJ, Kerdijk W, Cune MS. Digital versus analog complete-arch impressions for single-unit premolar implant crowns: operating time and patient preference. J Prosthet Dent 2015;114(3):403-6.e1.

de Paris Matos T, Wambier LM, Favoreto MW, Rezende CEE, Reis A, Loguercio AD et al. Patient-related outcomes of conventional impression making versus intraoral scanning for prosthetic rehabilitation: a systematic review and meta-analysis. J Prosthet Dent 2021;S0022-3913(21)00493-5.

Bishti S, Tuna T, Rittich A, Wolfart S. Patient-reported outcome measures (PROMs) of implant-supported reconstructions using digital workflows: a systematic review and meta-analysis. Clin Oral Implants Res 2021;32(suppl.21):318-35.

Manicone PF, De Angelis P, Rella E, Damis G, D’addona A. Patient preference and clinical working time between digital scanning and conventional impression making for implant-supported prostheses: a systematic review and meta-analysis. J Prosthet Dent 2022;128(4):589-96.