Patient Satisfaction with Anterior Interim CAD-CAM Rehabilitations Designed by CAD Technician versus Trained Dentist-A Clinical Preliminary Study

The objective of this study was to assess the impact of digital waxing expertise on patient satisfaction with anterior interim computer-aided design and computer-aided manufacturing (CAD-CAM) prosthetic rehabilitations designed either by a CAD and dental technician or by a dental clinician with basic CAD-CAM training. This in vivo preliminary study was conducted on a total of 18 patients receiving anterior CAD-CAM rehabilitations (at least from canine to canine) with fixed bridges and/or single crowns. Only patients that had conventional chairside temporary restorations were enrolled. Three within-patient groups were defined at different time points: group CONTROL refers to all 18 patients at their first appointment, when they were using their initial temporary conventional prostheses; group DENT refers to all patients immediately after trying in a set of CAD-CAM prostheses designed by a dental clinician (with basic one-week CAD-CAM training); and group CAD refers to all patients after trying in a set of CAD-CAM prostheses for the same tooth elements but designed by an experienced CAD technician (who was also an experienced dental prosthetic technician). All CAD-CAM restorations were milled in polymethyl methacrylate (PMMA) with high translucency and strength properties (Prime, Zirkonzahn). Satisfaction with comfort and esthetics was assessed for all patients for the three different time points (groups CONTROL, DENT and CAD). Statistically significant differences among groups were assessed with the Friedmann's test. Group CAD significantly outperformed the other groups in both assessed variables (p = 0.001). The group DENT, in turn, outperformed group CONTROL for satisfaction with esthetics (p = 0.006) but not for comfort (p > 0.05). In conclusion, CAD operator background and expertise level significantly affect patient self-reported outcomes for anterior CAD-CAM rehabilitations. Single crowns and fixed bridges digitally designed by an experienced professional trained in both CAD-CAM and dental technology will likely offer high satisfaction and comfort to patients receiving anterior prosthetic rehabilitations.