Supervisors info:
Γιαννακόπουλος Νικόλαος Νικήτας, Αναπληρωτής Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ
Κούρτης Στέφανος, Αναπληρωτής Καθηγητής, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΕΚΠΑ
Μπακοπούλου Αθηνά, Αναπληρώτρια Καθηγήτρια, Τμήμα Οδοντιατρικής, Σχολή Επιστημών Υγείας, ΑΠΘ
Summary:
Background: Dental impression accuracy is critical, especially in the field of fixed prosthodontics. Currently, many systematic reviews have been published, related to the accuracy of digital and conventional impressions. However, the quality of evidence and methodology of those reviews have not been comprehensively evaluated yet.
Aim: The aim of this overview of systematic reviews is to perform a systematic critical evaluation of the methodological quality of existing systematic reviews, to summarize the data, and to quantitatively compare the accuracy of digital and conventional impressions in terms of marginal fit, internal fit, trueness, and precision of fixed tooth- and implant-supported fixed restorations, in partially and/or completely edentulous patients.
Methods: The study protocol was registered in PROSPERO (CRD42022381490). A comprehensive search was conducted on PubMed (MEDLINE), Scopus, Web of Science, Google Scholar, and gray literature (OpenGray and IADR congress abstracts), until November 28th, 2022. Planning and reporting of the overview were undertaken according to the Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines. A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) was used to assess the methodological quality of included systematic reviews and the overlap of primary studies was assessed using a citation matrix. Jadad’s decision algorithm was applied to choose the best body of evidence Study selection and data extraction were accomplished by two reviewers. It was not possible to perform a quantitative metanalytic synthesis due to great heterogeneity. Included systematic reviews were categorized into three groups according to their main review question, accuracy of tooth-supported fixed restorations, accuracy of implant-supported fixed restorations, and accuracy of both tooth- and implant-supported fixed restorations.
Results: Finally, 28 systematic reviews, 12 of which with meta-analysis, were included, published between 2014 and 2022. According to AMSTAR 2 tool, only one systematic review was appraised as high-quality, three as moderate-quality, five as low-quality, and 19 as critically low-quality. Regarding the accuracy of tooth-supported fixed restorations, there were no significant differences in terms of marginal and internal fit between digital and conventional impression groups. For implant-supported fixed restorations, both impression techniques provide clinically acceptable fit under 120μm. An increasing span length seems to have a negative impact on the accuracy of digital impressions.
Conclusion: In general, no differences were found between conventional and digital dental impressions. The findings of this overview should be interpreted with caution, due to the low methodological quality of included reviews and the great heterogeneity among them. Future primary studies should follow standardized protocols and use proper outcome measures in order to gradually mitigate heterogeneity. Systematic reviews should be conducted according to appropriate published guidelines and checklists in order to follow explicit, systematic, and transparent research methodology.
Keywords:
Impression accuracy, Conventional impression, Digital impression, Tooth, Implant
