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Comparação da efetividade na utilização dos scanners intraorais para a elaboração de próteses dentossuportadas e implantossuportadas: revisão sistemática
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Os scanners intraorais apresentam-se como uma alternativa promissora às impressões convencionais na prática clínica da medicina dentária, com potenciais benefícios em termos de precisão, conforto do paciente e eficiência clínica. No entanto, sua efetividade na fabricação de diferentes tipos de próteses dentárias fixas permanece incerta. O objetivo deste trabalho é comparar a efetividade dos scanners intraorais na elaboração de próteses dento e implanto-suportadas. Fez-se uma revisão sistemática acompanhada de meta-análise registada no PROSPERO com o número CRD42025101131 para responder a questão de investigação: “Serão os scanners intraorais mais efetivos para a confeção de próteses dento-suportadas ou implanto-suportadas?”. Foram utilizadas as bases de dados PubMed, Scopus, Cochrane Library, B-On, Semantic Scholar e Google Scholar, utilizando estratégias específicas e filtros adaptados. Foram incluídos estudos clínicos com adultos reabilitados com próteses fixas utilizando scanners intraorais, publicados a partir de 2019, em revistas indexadas com fator de impacto elevado (Quartis 1 e 2) e redigidos em português, francês ou inglês. Foram excluídos todos os trabalhos que não atendiam a esses critérios. A seleção dos artigos foi conduzida de acordo com as recomendações PRISMA. A definição das variáveis foi feita com base em 10 artigos representativos. Após a recolha dos dados, fez-se a análise estatística com comparação indireta entre os grupos e metaregressão. A pesquisa resultou em 287 estudos, dos quais, após as diferentes fases de triagem, 22 foram incluídos na análise estatística. A amostra analisada inclui 585 pacientes, com número de pacientes por estudo variando de 1 a 66 e número de digitalização entre 10 e 145; 63% dos estudos incluídos realizaram as digitalizações com um único operador e 41,4% utilizaram scanners intraorais de terceira geração. A análise estatística mostrou que as próteses implanto-suportadas apresentam melhores resultados em comparação às próteses dento-suportadas, com menor desvio linear, maior satisfação dos pacientes e menor tempo clínico (p < 0,05). O uso de scanners de gerações mais recentes esteve associado a menor desvio linear e maior satisfação dos pacientes (p < 0,05). Um maior número de impressões esteve associado a menor desvio linear e menor tempo clínico (p < 0,05). Conclui-se que os scanners intraorais tendem a ser mais efetivos em próteses implanto‑suportadas. A experiência do operador e a geração do scanner influenciam positivamente os resultados. A elevada heterogeneidade entre os estudos destaca a necessidade de protocolos mais padronizados.
Intraoral scanners appear as a promising alternative to conventional impressions in the clinical practice of dentistry with potential benefits in terms of accuracy, patient comfort, and clinical efficiency. However, their effectiveness in the fabrication of different types of fixed dental prostheses remains uncertain. The aim of this study was to compare the effectiveness of intraoral scanners in the fabrication of tooth-supported and implant-supported prostheses. A systematic review and meta-analysis was conducted and registered on PROSPERO under the number CRD42025101131, to answer the research question: “Are intraoral scanners more effective for the fabrication of tooth-supported or implant-supported prostheses?”. The databases PubMed, Scopus, Cochrane Library, B-On, Semantic Scholar, and Google Scholar were searched using specific strategies and adapted filters. Clinical studies were included if they involved adults rehabilitated with fixed prostheses using intraoral scanners, were published from 2019 onwards, appeared in indexed journals with a high impact factor (Quartiles 1 and 2), and were written in Portuguese, French, or English. Studies that did not meet these criteria were excluded. The selection of articles followed PRISMA guidelines. Variables were defined based on 10 representative studies. After data collection, statistical analysis was performed, including indirect comparisons between groups and meta-regression. The search yielded 287 studies, of which 22 were included in the statistical analysis after the screening phases. The analyzed sample included 585 patients, with the number of patients per study ranging from 1 to 66, and the number of scans from 10 to 145. In 63% of the included studies, digital impressions were performed by a single operator, and 41.4% used third-generation intraoral scanners. Statistical analysis showed that implant-supported prostheses achieved better outcomes than tooth-supported prostheses, with lower linear deviation, higher patient satisfaction, and shorter clinical time (p < 0.05). The use of more recent scanner generations was associated with lower linear deviation and higher patient satisfaction (p > 0.05). A higher number of impressions was associated with reduced linear deviation and shorter clinical time (p < 0.05). It is concluded that intraoral scanners tend to be more effective for implant-supported prostheses. Operator experience and scanner generation positively influence outcomes. The high heterogeneity among studies highlights the need for more standardized protocols.
Intraoral scanners appear as a promising alternative to conventional impressions in the clinical practice of dentistry with potential benefits in terms of accuracy, patient comfort, and clinical efficiency. However, their effectiveness in the fabrication of different types of fixed dental prostheses remains uncertain. The aim of this study was to compare the effectiveness of intraoral scanners in the fabrication of tooth-supported and implant-supported prostheses. A systematic review and meta-analysis was conducted and registered on PROSPERO under the number CRD42025101131, to answer the research question: “Are intraoral scanners more effective for the fabrication of tooth-supported or implant-supported prostheses?”. The databases PubMed, Scopus, Cochrane Library, B-On, Semantic Scholar, and Google Scholar were searched using specific strategies and adapted filters. Clinical studies were included if they involved adults rehabilitated with fixed prostheses using intraoral scanners, were published from 2019 onwards, appeared in indexed journals with a high impact factor (Quartiles 1 and 2), and were written in Portuguese, French, or English. Studies that did not meet these criteria were excluded. The selection of articles followed PRISMA guidelines. Variables were defined based on 10 representative studies. After data collection, statistical analysis was performed, including indirect comparisons between groups and meta-regression. The search yielded 287 studies, of which 22 were included in the statistical analysis after the screening phases. The analyzed sample included 585 patients, with the number of patients per study ranging from 1 to 66, and the number of scans from 10 to 145. In 63% of the included studies, digital impressions were performed by a single operator, and 41.4% used third-generation intraoral scanners. Statistical analysis showed that implant-supported prostheses achieved better outcomes than tooth-supported prostheses, with lower linear deviation, higher patient satisfaction, and shorter clinical time (p < 0.05). The use of more recent scanner generations was associated with lower linear deviation and higher patient satisfaction (p > 0.05). A higher number of impressions was associated with reduced linear deviation and shorter clinical time (p < 0.05). It is concluded that intraoral scanners tend to be more effective for implant-supported prostheses. Operator experience and scanner generation positively influence outcomes. The high heterogeneity among studies highlights the need for more standardized protocols.
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Palavras-chave
Scanner intraoral Impressão digital Prótese fixa Prótese dento-suportada Prótese implanto-suportada Intraoral scanner Digital impression Fixed prosthesis Tooth-supported prosthesis Implant-supported prosthesis