CAD/CAM Prosthetic Options in Rehabilitation of Compromised Ridges with Implants: A Scoping Review

Abstract

Introduction: Ridges compromised by tumour resection, trauma and severe atrophy are clinically challenging in prosthetic rehabilitation, predominantly owing to increased crown height space that acts as a stress magnifier. The use of Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) in rehabilitating compromised ridges with implants is on the rise. A search of literature revealed few studies that collated the various Computer Aided Design/Computer Aided Manufacturing options available. Aim: The aim of this scoping review was to enumerate the various CAD/CAM prostheses available in rehabilitation of compromised maxilla and mandible with implants. Materials and Methods: A systematic search was conducted in MEDLINE and Embase between 2005 to 2018 for all articles that were published in English satisfying the eligibility criteria of rehabilitation of compromised ridges with implant supported/ retained prostheses fabricated using CAD/CAM technology. We also searched Google Scholar and internet for industry brochures. Data was entered into covidence systematic review software for screening and extraction. We included studies that utilised CAD/CAM technology in fabrication of either implant prosthesis or prosthetic components such as frameworks, attachments or suprastructures in patients with compromised ridge. Results: Nineteen studies were included in the review, of which 15 were case reports and 4 were prospective cohort studies. An additional search yielded 4 industrial reports which were included separately. Majority of the studies reported implantsupported fixed prosthesis with CAD/CAM milled framework and supra structures as a reliable option in terms of patient satisfaction and functional outcome. Three studies reported implant supported overdentures with bar attachments to compensate for the increased crown height space. Conclusion: This evidence mapping review, hence enumerates the various options and designs of CAD/CAM fabricated implant prostheses available for rehabilitating compromised maxilla and mandible.

Keywords

• atrophic ridge
• fixed prosthesis
• implant overdenture