Review of the Accuracy of Digital Complete Dentures

 

TAKE-HOME MESSAGE

  • This systematic review looked at 14 in vitro studies to compare the fitting and occlusal accuracy of digital or CAD/CAM complete dentures compared with conventional complete dentures.

  • The systematic review suggested that the CAD/CAM complete dentures are just as accurate as or more accurate than conventional complete dentures, especially with regard to tissue adaptation and occlusion. The tissue adaptation, especially in the posterior palatal seal area, is much better in the CAD/CAM denture group compared with the conventional one. Clinicians may consider prescribing CAD/CAM dentures when they have a full understanding of the fabrication process. Note that, while the material properties of CAD/CAM dentures are superior to conventional ones, the milled dentures may have issues with undercut areas in some edentulous patients. In the future, 3D printed dentures may become the go-to technology for denture fabrication.
–  Sompop Bencharit, DDS, MS, PhD, FACP

STATEMENT OF PROBLEM

Reports on digital complete dentures (CDs) are increasing. However, systematic reviews on their accuracy and influencing factors are lacking.

PURPOSE

The purpose of this systematic review was to evaluate the accuracy of digital CDs and to summarize influencing factors.

MATERIAL AND METHODS

An electronic search of the English language literature from January 2009 to October 2019 was performed in the database PubMed/MEDLINE, with the results enriched by manual searches and citation mining. Factors investigated in the selected articles included the fabrication technique, type of computer-aided design and computer-aided manufacturing (CAD-CAM) system, shape of reference model, long-term service, analytical method, and statistical indicators.

RESULTS

A total of 522 articles were identified, of which 14 in vitro articles met the inclusion criteria. Eight articles 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.

CONCLUSIONS

Most of the studies reported clinically acceptable values for the occlusal trueness and adaptation of digital CDs. The digital CDs showed similar or better adaptation than conventionally fabricated CDs, and the greatest misfit of the intaglio surface was reported in the posterior palatal seal area and border seal area. The fabrication technique, CAD-CAM system, and long-term service were statistically significant in relation to denture accuracy. Clarification is needed concerning the accuracy of digital CDs according to the shape of the cast, the parameters related to the CAD-CAM process, the analytical method, and the statistical indicators. No clear conclusions can be drawn about the superiority of CAD-CAM milling and 3D printing regarding denture accuracy.

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