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"Complete dentures"
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Assessment of Conventionally and Digitally Fabricated Complete Dentures: A Comprehensive Review
CAD/CAM technology is gaining popularity and replacing archaic conventional procedures for fabricating dentures. CAD/CAM supports using a digital workflow reduce the number of visits, chair time, and laboratory time, making it attractive to patients. This study aimed to provide a comparative review of complete dentures manufactured using CAD/CAM and conventional methods. The PubMed/Medline, Science Direct, Cochrane, and Google Scholar databases were searched for studies published in English within the last 11 years (from 2011 to 2021). The keywords used were “computer-engineered complete dentures”, “CAD/CAM complete dentures”, “computer-aided engineering complete dentures”, and “digital complete dentures”. The search yielded 102 articles. Eighteen relevant articles were included in this review. Overall, computer-engineered complete dentures have several advantages over conventional dentures. Patients reported greater satisfaction with computer-engineered complete dentures (CECDs) due to better fit, reduced chair time, shorter appointments, and fewer post-insertion visits. CAD/CAM allows for precision and reproducibility with fewer procedures compared to conventional dentures. Polymethyl methacrylate is used as the denture base material for conventional dentures. For CECDs, the resin can be modified and cross-linked to improve its mechanical properties. The advantages of CECDs include a reduced number of appointments, saving chairside time, a digital workflow allowing easy reproducibility and greater patient satisfaction with a better fit.
Journal Article
Patient satisfaction and oral health-related quality of life for prefabricated teeth versus CAD-CAM milled acrylic resin denture teeth. A crossover clinical trial
Background
Artificial teeth replicate the appearance of natural teeth and restore proper alignment, oral function, and speech. Over the years, dental materials and prosthetic design advancements have transformed the creation and effectiveness of complete denture teeth. This evolution showcases a continued commitment to developing materials and methods that enhance the comfort, functionality, and visual appeal for patients without teeth. This study evaluated and compared patient satisfaction and oral health-related quality of life (OHRQL) between prefabricated and computer-aided design and computer-aided manufacturing (CAD-CAM) milled acrylic resin denture teeth.
Materials and methods
This crossover clinical study included 10 completely edentulous patients rehabilitated with complete dentures (CDs). Two types of acrylic resin teeth were used: prefabricated and CAD-CAM-milled artificial teeth. Crossover design is a research method that minimizes variability among participants by assessing the impact of various treatments on the same individual. This methodological approach facilitates the identification and measurement of the treatment effects. Following six months of complete denture wear, patient satisfaction and oral health-related quality of life were evaluated using the Visual Analogue Scale (VAS) and the Oral Health Impact Profile (OHIP-EDENT-19). Statistical analysis was conducted using the Wilcoxon signed-rank test in SPSS software, with statistical significance established at
P
< 0.05.
Results
There was no statistical difference between the groups in the total VAS scores and items, except for chewing efficiency, with a
P-value
of 0.035, where CAD-CAM milled resin teeth had statistically higher scores. In contrast, prefabricated teeth had a statistically higher aesthetic score (
p
= 0.033). Regarding OHIP-EDENT-19, many items showed no statistical differences between the two groups, except for functional limitations and difficulty chewing, which had a
P-value
of 0.05 and were statistically higher in prefabricated teeth. In contrast, psychological discomfort (
P
= 0.034) and social disability (
P
= 0.046) had significantly higher scores for the CAD-CAM milled teeth.
Conclusion
This study suggests that prefabricated and CAD-CAM milled resin teeth are viable treatment options for complete dentures. Prefabricated teeth are advisable when aesthetics is the patient’s primary concern. Conversely, CAD-CAM milled teeth are preferable when chewing efficiency is the primary concern.
Clinical trial registration
Registered at
www.clinicaltrials.gov
:
(
NCT06179615) (11-12-2023).
Journal Article
Prognosis of removable complete dentures considering the level of mandibular residual ridge resorption: a systematic review and meta-analysis
Objective
To compare clinical outcomes in atrophic (AM) and non-atrophic (NAM) mandibles of edentulous patients rehabilitated with mandibular removable complete dentures (CD) or implant mandibular overdentures (IMO).
Materials and methods
Non-randomized clinical studies were searched in 8 databases. Articles were assessed by the risk of bias in non-randomized studies of interventions. Datasets for CDs comparing AM and NAM were plotted [masticatory function, maximum occlusal biting force (MOBF), oral health-related quality of life (OHRQoL)]. Residual ridge (AM and NAM) data (masticatory function, OHRQoL, implant survival, marginal bone loss, and maintenance events) in IMO were also combined.
Results
23 studies were included. Only 1 was classified as low risk of bias. Superior masticatory performance was observed in the NAM group rehabilitated with CD (
P
<.001). NAM group rehabilitated with CD exhibited increased MOBF (
P
<.05). Once patients were treated with IMO, improvements were observed in swallowing threshold (number of cycles and time) in the NAM group (
P
<.05). Comparable results of OHRQoL were noted for both groups (AM and NAM) and rehabilitations (CD and IMO). Similar peri-implant outcomes were displayed for IMO rehabilitation in AM and NAM patients. Most common event for IMO wearers (AM and NAM) was replacement of retention insert.
Conclusion
AM patients presented suboptimum masticatory function whether using CD or IMO. CD wearers with AM also had a reduced MOBF compared with NAM patients.
Clinical relevance
Clinicians should carefully monitor residual ridge resorption to guide treatment planning and prognosis, particularly in cases of AMs. Our findings indicate that AMs may negatively impact the clinical performance of both CD and IMO rehabilitations.
Journal Article
3D printed complete removable dental prostheses: a narrative review
Background
The purpose of this paper is to review the available literature on three-dimensionally printed complete dentures in terms of novel biomaterials, fabrication techniques and workflow, clinical performance and patient satisfaction.
Methods
The methodology included applying a search strategy, defining inclusion and exclusion criteria, selecting studies and forming tables to summarize the results. Searches of PubMed, Scopus, and Embase databases were performed independently by two reviewers to gather literature published between 2010 and 2020.
Results
A total of 126 titles were obtained from the electronic database, and the application of exclusion criteria resulted in the identification of 21 articles pertaining to printed technology for complete dentures. Current innovations and developments in digital dentistry have successfully led to the fabrication of removable dental prostheses using CAD/CAM technologies. Milled dentures have been studied more than 3D printed ones in the currently available literature. The limited number of clinical studies, mainly case reports, suggest current indications of 3D printing in denture fabrication process to be custom tray, record bases, trial, interim or immediate dentures but not definitive prostheses fabrication. Limitations include poor esthetics and retention, inability to balance occlusion and low printer resolution.
Conclusions
Initial studies on digital dentures have shown promising short-term clinical performance, positive patient-related results and reasonable cost-effectiveness. 3D printing has potential to modernize and streamline the denture fabrication techniques, materials and workflows. However, more research is required on the existing and developing materials and printers to allow for advancement and increase its application in removable prosthodontics.
Journal Article
Intraoral scanning to fabricate complete dentures with functional borders: a proof-of-concept case report
Background
The utilization of intraoral scanning for manufacturing of complete dentures (CD) has been reported recently. However, functional border molding still cannot be supported digitally. A proof-of-concept trial shows two possible pathways to overcome this limitation by integrating a relining procedure into the digital workflow for CD manufacturing.
Case presentation
Intraoral scans and additional facial scans were performed with two various scanning systems for the rehabilitation of an edentulous male patient. The obtained raw data was aligned and used for the computer aided design (CAD) of the CD. The virtually constructed dentures were materialized in two various ways, considering rapid manufacturing and digital relining approaches in order to apply functionally molded borders.
Conclusion
The use of intraoral edentulous jaws scans in combination with the digital relining procedure may allow for fabrication of CD with functional borders within a fully digital workflow.
Journal Article
Removable prosthodontics at a glance
Removable Prosthodontics at a Glance provides a comprehensive and accessible guide to the practical elements of complete and partial denture provision.It serves as the perfect illustrated guide for learners, and a handy revision guide for subsequent undergraduate and postgraduate studies.
eBook
Denture care attitudes, hygiene levels and oral mucosal lesions in complete denture wearers from a single-institution cross‐sectional study
This study investigated denture care attitudes, dental visit habits, oral mucosal lesions, and hygiene levels in 118 complete denture users treated at a university dentistry faculty. Data on demographics, smoking, denture use duration, dentist visits, and hygiene habits were collected via a questionnaire. A specialist examined mucosal lesions and assessed denture hygiene level using the Budtz-Jorgensen and Bertram method. Categorical data were analyzed with Yates’s correction, Pearson’s chi-square, and Fisher–Freeman–Halton tests; multiple comparisons used the Bonferroni Corrected Z Test. Participants’ mean age was 51.61. Most were non-smokers (55.1%), visited dentists only for complaints (44.9%), cleaned dentures daily (70.3%), and removed them at night (56.8%). Good hygiene was observed in 40.68%. Females cleaned dentures more frequently than males, and 96.3% of those with poor hygiene reported bad denture odor. This study revealed significant deficiencies in denture care habits and inadequate hygiene practices of participants in a university dentistry faculty clinic. Most participants visited dentists only for complaints and had bad habits such as sleeping with their dentures at night and using inappropriate denture hygiene habits. Promoting proper denture hygiene habits and emphasizing the importance of regular dental visits can contribute to better oral health.
Journal Article
Retention of 3D-printed versus conventional metal-reinforced acrylic mandibular denture bases: a comparative study
Objective
To evaluate the retention of complete mandibular dentures produced via 3D-printing in comparison to those constructed from metal-reinforced acrylic resin regarding their retention.
Materials and methods
This in vivo study involved the selection of twenty patients who were completely edentulous from the outpatient clinic of the Removable Prosthodontics Department at Misr University of Science and Technology. The participants were divided into two groups, each containing an equal number of patients; the first group received complete dentures produced via 3D printing technology. For the second patient group, metal-reinforced acrylic resin was used to make mandibular dentures, while conventional maxillary dentures were constructed. The evaluation of retention was carried out for both groups.
Results
A study of various types of dentures revealed that 3D-printed dentures exhibited a statistically significant improvement in retention (
P
< 0.05) relative to acrylic resin dentures that were reinforced with metal. Moreover, pairwise comparisons revealed significant increases in mean retention values at the one-month and three-month follow-up assessments.
Conclusion
The results of this clinical study led to the following conclusions: Compared to complete denture bases manufactured via conventional manufacturing techniques, those fabricated via 3D-printing offer superior fit and retention. The retention of dentures, irrespective of their type, tends to improve over time.
Journal Article