What it is
A digital workflow makes an implant crown or bridge from digital data instead of physical impressions and stone models.1 The main steps are:
- Intraoral scan. A handheld scanner records the teeth and implant position.1
- CAD (computer-aided design). The crown or bridge is designed on screen.1
- CAM (computer-aided manufacturing). The restoration is milled or printed from the design.1
A complete digital workflow uses no physical model at any step.1 A mixed workflow combines digital and conventional steps.1
Time
A 2017 systematic review found one randomized trial on implant crowns.1 The complete digital workflow took 75.3 minutes, compared with 156.6 minutes for the mixed analog-digital workflow.1 The review found few randomized trials overall and none on multi-unit bridges.1
What the updated evidence supports
A 2023 update reviewed 16 studies with 440 patients and 658 restorations.2 Almost two-thirds of the studies involved implants.2
- Current evidence supports complete digital workflows for monolithic implant crowns in back teeth.2
- Digitally made implant crowns were at least comparable to conventional and hybrid workflows for time, production cost, precision and patient satisfaction.2
- The number of trials remains low, particularly for multi-unit restorations.2
Scanning a full arch
The ITI Group 5 consensus (2018) stated that intraoral scanner results in fully edentulous cases depend on the protocol followed.3 It also found the precision of intraoral scans and CBCT measurements not high enough on its own for the accuracy required in guided surgery.3
Monolithic crowns
A meta-analysis of 1,116 monolithic ceramic implant crowns found a combined failure and complication rate of 2 percent.4 Monolithic zirconia and lithium disilicate crowns did not differ.4
Questions to ask
- Is the impression scanned or taken with trays.
- Is the crown designed and milled in the office or at a lab.
- Which crown material is planned and why.
General information about dental implants. Treatment decisions are made with a licensed dentist.
Sources
- Joda T et al. The complete digital workflow in fixed prosthodontics: systematic review. BMC Oral Health 2017. pubmed.ncbi.nlm.nih.gov
- Bernauer SA et al. The complete digital workflow in fixed prosthodontics updated: systematic review. Healthcare (Basel) 2023. pubmed.ncbi.nlm.nih.gov
- Wismeijer D et al. Group 5 ITI Consensus Report: Digital technologies. Clin Oral Implants Res 2018. pubmed.ncbi.nlm.nih.gov
- Lemos CAA et al. Monolithic ceramic implant-supported single crowns and fixed partial dentures: systematic review. J Prosthet Dent 2024. pubmed.ncbi.nlm.nih.gov
