Main clinical considerations in restorative dentistry and aesthetic rehabilitation of implant-supported prostheses: a systematic review

Abstract

Introduction: In the field of restorative dentistry and aesthetic rehabilitation, the long-term success of a dental implant depends on the prosthesis. The key to obtaining perfect dentures depends on the passive seating between its connector and the implant itself. The compromised fit between the contact surfaces of implant-supported prostheses creates uncontrolled tensions in the peri-implant components and tissues, evoking biological and mechanical complications. Objective: Considering that choosing the most precise technique and material for each particular case has become a challenging task for professionals, this study aimed to review the literature on the types of impression used in implant prostheses for the best aesthetic rehabilitation. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from December 2025 to January 2026 in the Web of Science, Embase, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 228 articles were found, and 84 articles were evaluated in full, and 29 were included and developed in the present systematic review study. According to the GRADE instrument, most studies presented homogeneity in their results, with an X2 = 85.8% > 50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 90 studies that did not meet GRADE and AMSTAR-2. The choice of closed tray or open tray impression techniques depends on the number, depth, angulation, and relative parallelism of the implants. The materials of choice for making impressions, following the closed-tray and open-tray printing techniques, were polyether and polyvinylsiloxane. Most studies reported more accurate impressions with the splinting technique than with the non-splitting technique. Acrylic resin was the most frequently used material. Therefore, minimizing contraction appears to be the most important factor in ensuring an accurate impression for this technique. Digital printing has achieved high patient acceptance, reduces possible impression and master mold errors, reduces time in the chair, provides a three-dimensional image of the preparation, and ease of communication between the clinician and the laboratory. However, there is a dearth of scientific data regarding implant fingerprints and their accuracy. Research on implant fingerprinting has been limited to a few in vitro studies and case reports