Time efficiency and cost analysis between digital and conventional workflows for the fabrication of fixed dental prostheses: A systematic review

STATEMENT OF PROBLEM: Time and cost are factors that influence a patient's decision on dental prosthetic treatment. Evidence is needed to demonstrate that restoration using digital systems is more rapid and less costly than the conventional process. PURPOSE: The purpose of this systematic review was to analyze and compare the duration and cost of fixed dental prostheses fabricated using digital and conventional methods from scanning or impression making to delivery of the prosthesis. MATERIAL AND METHODS: A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P 2015) guidelines. The analysis methods and inclusion criteria were documented in a protocol registered in the Prospective International Register of Systematic Reviews (PROSPERO) (CRD42023458734). The bibliographic search was carried out using PubMed, Cochrane, and PROSPERO databases. The main keywords used were (Prosthodontic OR restorative dentistry OR denture) AND (CAD CAM OR Digital workflow OR Computer Dentistry OR Digital Design) AND (Economic OR cost OR Financial OR time efficiency). Two investigators undertook the different steps of article selection. RESULTS: A total of 8 articles published between 2010 and 2023 were found for the qualitative synthesis by using the search criteria. Two studies showed that conventional impressions took more time than digital scans for the fabrication of a single crown, and 1 study showed the opposite. One study found that a digital scan was faster than conventional impression making for the fabrication of a 3-unit fixed partial denture, and another study showed the opposite. The dental laboratory technician spent more time on the conventional workflow than the digital workflow for the 3-unit framework and veneering process. No difference was found between conventional and digital workflows for clinical evaluation and chairside adjustment for the fabrication of a single crown. No articles have compared the cost of fixed prostheses. CONCLUSIONS: The digital pathway can shorten the laboratory process. However, the duration of the impression or scan may vary depending on the technique used. Studies are needed to analyze the cost-effectiveness of the fabrication of tooth-supported restorations.