Efficiency and geometric fidelity of library-selected anatomical prefabricated abutments and stock abutments relative to custom CAD-CAM abutments in posterior implant restorations

Abstract

PURPOSE. This study evaluated the clinical efficiency and geometric fidelity of the library-selected anatomical prefabricated abutments (LAPA) compared with custom abutments (CA) and stock abutments (SA) by using a novel sector-based deviation analysis (SBDA) method. MATERIALS AND METHODS. Two posterior single-implant cases, the mandibular left first molar and right second premolar, were selected forin vitro analysis. Twenty-four dental professionals (15 prosthodontic residents and 9 board-certified prosthodontists) performed three tasks: CA design, LAPA selection, and SA selection. The recorded time required for CA design and LAPA selection was compared. Overall geometric conformity was assessed using in-tolerance analysis (+/- 0.50 mm, +/- 0.70 mm), and margin-level fidelity was evaluated by sector-based and vector-based deviation analyses. The Wilcoxon signed-rank test was used to evaluate the clinical efficiency and geometric fidelity at a significance level of alpha = 0.05. RESULTS. LAPA required significantly less design time than the custom abutment (CA) (P < .001). Both LAPA and SA showed high overall conformity to CA within clinically acceptable limits. Sector-and vector-based analyses demonstrated that LAPA more closely replicated CA margin positions than SA, indicating superior morphological consistency with greater time efficiency. CONCLUSION. Within the limitations of this in vitro study, the library-selected anatomical prefabricated abutment showed a balanced performance between clinical efficiency and morphological fidelity.