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| Title |
Digitally Fabricated Complete Dentures Have Better Trueness of Fit (Accuracy) Than Conventionally Processed Complete Dentures |
| Clinical Question |
For patients needing complete dentures, do CAD-CAM (milled/3D-printed) dentures as compared to conventional (compression molded) dentures provide better accuracy/trueness of fit? |
| Clinical Bottom Line |
Based on the current literature, digital denture fabrication methods show either similar or better trueness of fit over conventionally fabricated dentures. However, no consensus has been reached so far regarding the extent of denture base adaptation that is clinically acceptable (Wang et al., J Prosthet Dent, 2021). Denture base adaptation is also influenced by the shape of the cast and region of the intaglio surface under consideration, and this aspect needs further evaluation. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 32115218 | Wang/2021 | 14 In vitro studies/ Completely edentulous | Systematic review of in vitro studies | | Key results | This systematic review was based upon 14 in vitro studies and suggested that digitally fabricated complete dentures showed better accuracy than conventional dentures. The range of denture base adaptation was between 0.058 mm and 0.29 mm for digital methods and between 0.105 mm and 0.30 mm for conventional methods. The greatest misfit was seen in the posterior palatal seal area and border seal areas. | | #2) 34400250 | Srinivasan/2021 | 28 Publications/ Completely edentulous | Systematic review | | Key results | The results of this study suggested that there was no statistically significant difference between milled complete dentures and conventional flask-pack-press (p = .053) / injection- molded complete dentures (p = .854) for trueness of fit. However, the trueness of fit was superior for 3D printed dentures than for conventional flask-pack-press (p = 0.039), but the difference was not statistically significant when 3D printed dentures were compared to injection molded complete dentures (p = .954). | |
| Evidence Search |
(CAD CAM) OR (Digital) AND (complete denture) AND ((accuracy) OR (trueness of fit)) |
Comments on
The Evidence |
Wang et al. 2021 systemically reviewed the available literature from January 2009 to October 2019 through PubMed/MEDLINE. The inclusion criteria involved only those in vitro studies which were available in English, and which compared trueness, precision, or denture base adaptation of digital dentures to conventional dentures. Eight studies compared the adaptation of the denture base between digital and conventional methods, 4 studies evaluated the occlusal discrepancies, 4 compared the trueness or adaptation of the denture fabricated with CAD-CAM milling and 3D printing, 1 compared the denture adaptation with 4 different CAD-CAM systems, and 2 evaluated the adaptation of the denture base before and after incubation in artificial saliva. A meta-analysis was not performed due to high degree of heterogenicity.
The systemic review by Srinivasan et al. 2021 comprised of an analysis of 73 studies which followed the inclusion criteria. Out of these, 28 studies evaluated the trueness of fit. A predefined list of inclusion and exclusion criteria was used, and search was conducted using online databases PubMed, MEDLINE, Embase and CENTRAL, Internet search engines like Google Scholar, and hand searches in dental journals. Risk of Publication bias was assessed using the funnel plot, and descriptive analysis was performed on all studies to report their outcomes. 39 studies out of 73 were considered suitable for inclusion in meta-analysis (15 out of 28 studies for trueness of fit).
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| Applicability |
The adaptation of the denture base (the space between the intaglio surface of the denture and the reference cast) is essential for adequate retention and stability. Complete denture conventional fabrication techniques are time consuming, and the accuracy is diminished by the waxing and investing procedures, complexity of manipulation and shrinkage of the heat-cured PMMA. Digital dentures can not only reduce the chair side time and denture fabrication time but also the polymerization shrinkage of the PMMA and therefore offer a better fit of the intaglio surface. |
| Specialty/Discipline |
(General Dentistry) (Prosthodontics) |
| Keywords |
CAD/CAM, digital dentures, complete dentures, trueness, accuracy
|
| ID# |
3481 |
| Date of submission: |
11/30/2021 |
| E-mail |
guptav1@uthscsa.edu |
| Author |
Vrinda Gupta |
| Co-author(s) |
Aaron Haah |
| Co-author(s) e-mail |
haah@uthscsa.edu |
| Faculty mentor/Co-author |
Panagiotis Gakis |
| Faculty mentor/Co-author e-mail |
gakis@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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