Title	Traditional Two-Step Impression Technique May Be Unnecessary and More Costly to Patients Compared to a Simplified One-Step Impression Technique for Fabrication of Complete Dentures
Clinical Question	In a medically uncompromised complete denture patient, how does the traditional two-step impression technique compare to a simplified one-step impression technique in regards to successful fabrication of the complete denture, clinical success, and patient satisfaction?
Clinical Bottom Line	For a medically uncompromised complete denture patient, complete dentures fabricated by the traditional two-step impression technique offer no significant benefit and are more expensive compared to dentures fabricated by a simplified one-step impression technique. This is supported by a systematic review of seven randomized control trials representing 257 patients that show no significant differences in patient satisfaction, masticatory ability, and denture quality between the two methods.
Best Evidence
PubMed ID Author / Year Patient Group Study type (level of evidence) 27328133 Regis/2016 257 patients in 7 included studies Systematic review of randomized trials Key results This systematic review included seven randomized control trials and reported on 257 patients. These randomized control trials evaluated differences in patient satisfaction, mastication ability, cost of fabrication, and denture quality in complete dentures fabricated using a traditional two-step impression method versus a simplified impression method. Patients were equally satisfied with their complete denture, regardless of the impression method. Differences in masticatory function and the quality of the complete dentures were indistinguishable between patients with complete dentures fabricated by traditional and simplified impression methods. Complete dentures fabricated using the simplified impression technique required significantly less time, fewer resources, and were less expensive than traditionally fabricated complete dentures.
Evidence Search	(("denture, complete"[MeSH Terms] OR ("denture"[All Fields] AND "complete"[All Fields]) OR "complete denture"[All Fields] OR ("complete"[All Fields] AND "denture"[All Fields])) AND impression[All Fields] AND technique[All Fields]) AND systematic[sb]
Comments on The Evidence	Validity: Seven randomized control trials representing 257 patients were located for this systematic review. Risk of bias exists because of the inability to blind patients and clinicians, but in all of the included studies the evaluators were blinded when assessing denture outcomes. A meta-analysis was not completed. Perspective: Even though the two-step impression technique for complete denture fabrication may be more costly and provide no significant benefit to uncomplicated patients, medically compromised and otherwise complex cases may show significant benefit from this method. The two-step impression method remains the standard of care, and deviation from this method is at the risk of the clinician.
Applicability	In clinical practice, the large number of edentulous patients who may benefit from complete dentures is undeniable. The ability to fabricate complete dentures for these patients that fulfill requirements related to masticatory ability, patient satisfaction, and overall quality while requiring less time and money may motivate more patients to seek treatment.
Specialty	(General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords	Complete denture, impression technique, simplified, traditional, two-step, one-step, cost, satisfaction
ID#	3185
Date of submission	04/10/2017
E-mail	smithr8@livemail.uthscsa.edu
Author	Reagan Smith
Co-author(s)
Co-author(s) e-mail
Faculty mentor	Joseph Connor, DDS
Faculty mentor e-mail	connorj@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?) None available
Comments and Evidence-Based Updates on the CAT (FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) None available