Nour Chellaoui, Siham Sadik, Bouabid Morchad
Digital design of fixed prostheses offers an alternative to traditional conventional methods. However, the lack of consensus and the heterogeneity of current data do not allow for the confirmation of its superiority. Standardized long-term clinical results are needed to confirm these findings and clarify the optimal indications for the digital workflow.
INTRODUCTION: The digital transformation in dentistry has profoundly changed the design protocols for fixed, tooth-supported prostheses. The integration of computer-aided design and manufacturing (CAD/CAM) technologies raises the question of their effectiveness compared to conventional methods. The objective of this systematic review is to analyze, through a review of the literature, the impact of the digital workflow on the design of fixed prostheses in comparison with the conventional workflow.
MATERIALS AND METHODS: A literature search was conducted in the PubMed and Scopus databases over a 10-year period (2016-2026). The following inclusion/exclusion criteria were applied: in vivo and in vitro studies focusing on tooth-supported fixed prostheses that evaluated either digital impressions or a fully digital workflow, comparing it to a conventional workflow. Studies were selected following the PRISMA chronology (identification, selection, eligibility, inclusion). Extracted data included: study characteristics, sample type, objectives, evaluated outcomes, quantitative results, measurement methods, and conclusions.
RESULTS: A total of 11 studies were included in this review. The analysis of the results highlights significant heterogeneity in methodologies and evaluation criteria, particularly regarding impression accuracy, marginal adaptation, chairside time, and reproducibility. Overall, the available data do not provide sufficient evidence to demonstrate the superiority of the digital workflow over the conventional workflow. However, some studies suggest comparable, or even superior, performance of the digital workflow under specific conditions.
CONCLUSION: Digital design of fixed prostheses offers an alternative to traditional conventional methods. However, the lack of consensus and the heterogeneity of current data do not allow for the confirmation of its superiority. Standardized long-term clinical results are needed to confirm these findings and clarify the optimal indications for the digital workflow.