J Prosthet Dent. 2025 Oct 10:S0022-3913(25)00727-9. doi: 10.1016/j.prosdent.2025.09.005. Online ahead of print.
ABSTRACT
STATEMENT OF PROBLEM: Immediate loading of dental implants in the esthetic zone combines implant placement and the interim restoration in a single stage, addressing the demand for reduced treatment duration and enhanced outcomes. The impact of prosthetic workflows, traditional versus digital, on marginal bone loss, esthetic success, and patient satisfaction remains unclear.
PURPOSE: The purpose of this systematic review and meta-analysis was to compare the clinical and patient-centered outcomes of traditional versus digital prosthetic workflows in the immediate loading of implants in the esthetic zone, focusing on marginal bone loss, esthetic outcomes, and patient satisfaction.
MATERIAL AND METHODS: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, randomized controlled trials and non-randomized comparative studies published between January 2015 and January 2025 were identified through searches in the PubMed, Cochrane Library, and Scopus databases. Studies reporting on marginal bone loss, Pink and White Esthetic Scores, and patient satisfaction for immediate implant loading were included. Two reviewers independently extracted data and assessed the risk of bias. A qualitative and quantitative synthesis of findings was conducted. Review Manager (RevMan) was used to conduct the meta-analysis. The results were presented with a 95% confidence interval (CI), and the mean difference (MD) was calculated as the summary statistic for continuous outcomes.
RESULTS: Four studies, comprising 2 randomized controlled trials and 2 non-randomized prospective studies, satisfied the inclusion criteria. The meta-analysis showed a non-significant trend favoring digital workflows for patient satisfaction (SMD: 0.26, 95% CI: -0.01 to 0.53; P=.06, I²=0%). Digital workflows demonstrated significant improvements in esthetic outcomes, with higher Pink Esthetic Scores (MD: 0.14, 95% CI: 0.05 to 0.24; P=.003, I²=17%) and White Esthetic Scores (MD: 0.09, 95% CI: 0.01 to 0.17; P=.02, I²=0%). Marginal bone loss was significantly reduced with digital workflows (MD:-0.08, 95% CI: -0.15 to -0.01; P=.02, I²=0%), indicating superior precision compared to conventional workflows.
CONCLUSIONS: Digital workflows for implant placement showed significant advantages in esthetic outcomes and less marginal bone loss, with a trend toward higher patient satisfaction. These findings support the growing adoption of digital workflows in clinical dental practice.
PMID:41076437 | DOI:10.1016/j.prosdent.2025.09.005
