#Education 28. Oct 2025

Digital vs. analog protocols: Bone level changes in full-arch rehabilitation

A selected scientific recommendation by Dr. Marcin Maj: "Marginal bone level changes in full-arch rehabilitation: digital versus analog protocols – a 5-year retrospective study" by Nicola De Angelis, Paolo Pesce, Vito Carlo Alberto Caponio, Giulia Santamaria, Oriana Spanu, Maria Menini.

STUDY OBJECTIVES AND METHODS

The purpose of this study was to compare the clinical outcomes of analog impressions versus intraoral scanning in full-arch immediate loading rehabilitations. Specifically, it evaluates peri-implant marginal bone level (MBL) changes at different time intervals (implant placement, loading, and at 2 and 5 years), as well as rates of mechanical and prosthetic complications. The study included 62 patients who underwent full-arch rehabilitation with immediate implant placement between 2019 and 2020. Patients were divided into two groups: analog impression and digital intraoral scanning. All patients were rehabilitated with fixed titanium-PMMA screw retained restorations. Bone level was assessed through standardized intraoral radiographs at key time points. Additional parameters recorded included procedural time, prosthetic complications, and implant failures. Statistical analyses involved repeated measures ANOVA and post hoc Bonferroni tests.

RESULTS

  • The follow-up period was 5 years. Implant survival was 99.6%.
  • No significant differences were found in prosthetic complications.
  • MBL was slightly higher in the analog group at baseline (mean = 0.21, SD = 0.04 vs. digital mean = 0.17, SD = 0.04, t-test p-value < 0.001) than in the digital group.
  • Despite this, the overall bone loss remained within clinically acceptable limits during the follow-up period.
  • Digital impressions significantly reduced procedural time compared to analog methods.


CONCLUSIONS

Both impression techniques provided satisfactory clinical outcomes. Digital impressions demonstrated efficiency advantages but were associated with slightly greater bone loss over time. Analog impressions remain a reliable standard for full-arch immediate loading rehabilitations, though digital methods show promise for improved patient experience. Further randomized, long-term studies are needed.
Adapted from N De Angelis et al., Clin Implant Dent Relat Res. 2025 Aug;27(4):e70080, for more info about this publication, click HERE.

This review is part of the Straumann "Scientific Highlights Newsletter 5/25".

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