Advantages of CAD/CAM versus Conventional Complete Dentures - A Review (original) (raw)
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Assessment of Conventionally and Digitally Fabricated Complete Dentures: A Comprehensive Review
Materials
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) du...
CAD/CAM Complete Denture Systems and Physical Properties: A Review of the Literature
Journal of Prosthodontics, 2021
Purpose: CAD/CAM complete dentures have increased in popularity and a wide variety of systems are currently available. These prostheses present many advantages for clinicians, technicians and patients. Subtractive manufacturing is used by most of the available systems while a few manufacturers use an additive manufacturing technique. This article describes the currently available systems and materials available for the fabrication of CAD/CAM complete dentures and reviews the literature relative to their physical properties. Methods: A comprehensive review of the literature was completed to enumerate the currently available techniques to fabricate CAD/CAM complete dentures and discuss their physical properties. A search of English language peer-reviewed literature was undertaken This article is protected by copyright. All rights reserved. 3 using MEDLINE and PubMed on research articles published between 2000 and 2019. A hand search of relevant dental journals was also completed. Results: The literature indicates the physical properties of CAD/CAM milled poly(methylmethacrylate) or PMMA as it is commonly described is superior to conventionally processed PMMA for the fabrication of complete dentures. Conclusion: The incorporation of CAD/CAM technology into complete denture design and fabrication streamlines the clinical and laboratory processes and provides improved physical properties that enhance denture quality. An important factor in the emergence of a completely new technology for making complete dentures was the use of computer-aided design (CAD) and computer-aided manufacturing (CAM) into many other aspects of dentistry. 1-4 That extensive use of CAD/CAM processes along with a shortage of qualified dental laboratory technicians with expertise in removable prosthodontics, 5 led both clinicians and dental laboratory technicians to explore the use of CAD/CAM technology for the fabrication of digital complete dentures. According to the Glossary of Digital Dental Terms, a digital denture is a complete denture created by or through automation using CAD, CAM and CAE (computer-aided engineering). 6 The term CAE is defined as the field of engineering where the accumulation and analysis of data is applied to design processes used to create dental prostheses. 7 Laboratory studies Maeda et al. 8 were the first to apply the 3D laser lithography (LL) technique to assess the use of a computer-aided system to design and fabricate complete dentures. They created a This article is protected by copyright. All rights reserved. 4 plastic shell of the dentition and a record base from photopolymerizing resin and the denture teeth were then fabricated using tooth colored composite resin material. Three years later, Kuwahata et al. 9 improved the duplication technique of a removable prosthesis using a computerized numerical control (CNC) machine to mill a denture using modeling wax. In their conclusion, they admitted that the technique still needs some enhancement. Another study incorporated scans of record bases and wax occlusion rims provided by a dentist into a CAD software program. They designed the virtual dentures (bases and teeth) and printed the
CAD/CAM complete dentures: a review of two commercial fabrication systems
Journal of the California Dental Association, 2013
The use of computer-aided design and computer-aided manufacturing (CAD/CAM) has become available for complete dentures through the AvaDent and Dentca systems. AvaDent uses laser scanning and computer technology. Teeth are arranged and bases formed using proprietary software.The bases are milled from prepolymerized pucks of resin. Dentca uses computer software to produce virtual maxillary and mandibular edentulous ridges, arrange the teeth and form bases. The dentures are fabricated using a conventional processing technique.
CAD-CAM milled dentures: The Geneva protocols for digital dentures
The Journal of Prosthetic Dentistry
Initial attempts to fabricate complete dentures (CDs) with computer-aided design and computer-aided manufacturing (CAD-CAM) technology began in the 1990s 1-3 ; since then, there has been an evolution of the techniques and the associated technologies. 4-10 The infusion of CAD-CAM techniques into CD fabrication methods has led to the evolution of modified and easier clinical protocols, 11,12 the use of materials with improved properties, 13-18 better fit and retention of the CDs, 19-29 reduction in the chairside and laboratory times, 12,30-32 and overall reduction in clinical and laboratory costs. 30 High patient and clinician satisfaction with CAD-CAM CDs has been reported. 33-35 The CAD-CAM clinical protocols used are modified versions of the conventional clinical steps followed during the fabrication of CDs. Although promoted by various manufacturers as being more straightforward and easier, the CAD-CAM protocols require extended time to learn the procedure and to digitize the analog clinical procedures. 34,36 Elaborate instruments, depending on the manufacturing system, are often required to carry out these novel clinical protocols.
Use of CAD-CAM technology for the fabrication of complete dentures: An alternative technique
Computer-aided design and computer-aided manufacturing (CAD-CAM) technology is available for the fabrication of complete dentures as an alternative to conventional fabrication techniques. This report describes a work flow for a technique that combines the use of conventional impressions and maxillomandibular relationship records with CAD-CAM technology for the fabrication of maxillary and mandibular complete dentures.
Assessment of CAD-CAM polymers for digitally fabricated complete dentures
The Journal of Prosthetic Dentistry, 2020
Statement of problem. Information on the mechanical properties of the materials used for manufacturing computer-engineered complete dentures is scarce. Purpose. The purpose of this in vitro study was to evaluate the mechanical properties of 3 prepolymerized polymethyl methacrylate (PMMA) resins used in the fabrication of computeraided design and computer-aided manufacturing (CAD-CAM) milled complete dentures (CDs), as well as 2 denture base polymers used for conventionally fabricated CDs. Material and methods. Three CAD-CAM materials were evaluated: Degos Dental L-Temp, IvoBase CAD, and Zirkonzahn Temp Basic Tissue. Two materials used for conventionally manufactured dentures were also included as controls (Palapress and Paladon 65). Each material type was sectioned into bars for flexural strength, nanohardness, elastic modulus, and surface microhardness evaluation (n=8/material). Half of the specimens were stored in water for 30 days while the other half was dry-stored. A 2-way analysis of variance (ANOVA) was conducted to detect the effect of material and storage on the evaluated properties (α=.05). Linear contrasts were conducted to compare the differences among the 3 CAD-CAM materials and the conventional ones. Results. Material type and storage had a significant influence on the flexural strength, nanohardness, elastic modulus, and surface hardness of the materials investigated (P<.001). The post hoc Scheffé test for flexural strength revealed a nonsignificant difference in the interaction 3 between Degos L-Temp and Paladon (P=1.000). In terms of nanohardness, no difference was found when comparing Palapress with Paladon, as well as IvoBase CAD with Zirkonzahn Temp Basic (P=1.000). A nonsignificant interaction in terms of surface hardness was also found between IvoBase CAD and Palapress (P=.575). Conclusions. The tested materials showed variation in their mechanical properties with satisfactory behavior of the CAD-CAM materials. However, the results obtained when testing the materials used for the conventional fabrication of complete dentures suggest that their use might still be advisable. CLINICAL IMPLICATIONS The mechanical behavior of the materials used for the fabrication of computer-engineered complete dentures varies among different CAD-CAM systems. The results presented here should allow clinicians to make comparisons between the systems investigated with the aim of improving patient care and satisfaction, as well as achieving more predictable treatment outcomes.
The Journal of Prosthetic Dentistry, 2012
The clinical impression procedures described in this article provide a method of recording the morphology of the intaglio and cameo surfaces of complete denture bases and also identify muscular and phonetic locations for the prosthetic teeth. When the CAD/CAM technology for fabricating complete dentures becomes commercially available, it will be possible to scan the denture base morphology and tooth positions recorded with this technique and import those data into a virtual tooth arrangement program where teeth can be articulated and then export the data to a milling device for the fabrication of the complete dentures. A prototype 3-D tooth arrangement program is described in this article that serves as an example of the type of program than can be used to arrange prosthetic teeth virtually as part of the overall CAD/CAM fabrication of complete dentures. (J Prosthet Dent 2012;107:34-46)
This review compared Computer-aided designand Computer-aided manufactured (CAD-CAM) and conventionally constructed removable complete dentures (CDs). Data: Seventy-three studies reporting on CAD-CAM (milled/3D-printed) CDs were included in this review. The most recent literature search was performed on 15/03/2021. Sources: Two investigators searched electronic databases [PubMed (MEDLINE), Embase, CENTRAL], online search engines (Google) and research portals. Hand searches were performed to identify literature not available online. Study selection: Studies on CAD-CAM CDs were included if they reported on trueness of fit, biocompatibility, mechanical, surface, chemical, color , microbiological properties, time-cost analysis, and clinical outcomes. Interinvestigator reliability was assessed using kappa scores. Meta-analyses were performed on the extracted data. Results: The kappa score ranged between 0.897-1.000. Meta-analyses revealed that 3D-printed CDs were more true than conventional CDs (p = 0.039). Milled CDs had a higher flexural-strength than conventional and 3Dprinted CDs (p < 0.0001). Milled CDs had a higher flexural-modulus than 3D-printed CDs (p < 0.0001). Milled CDs had a higher yield-strength than injection-molded (p = 0.004), and 3D-printed CDs (p = 0.001). Milled CDs had superior toughness (p < 0.0001) and surface roughness characteristics (p < 0.0001) than other CDs. Rapidly-prototyped CDs displayed poor color-stability compared to other CDs (p = 0.029). CAD-CAM CDs d displayed better retention than conventional CDs (p = 0.015). Conventional CDs had a higher strain at yield point than milled CDs (p < 0.0001), and had superior esthetics than 3D-printed (p < 0.0001). Fabrication of CAD-CAM CDs required less chairside time (p = 0.037) and lower overall costs (p < 0.0001) than conventional CDs. Conclusions: This systematic review concludes that CAD-CAM CDs offer a number of improved mechanical/ surface properties and are not inferior when compared to conventional CDs. Clinical significance: CAD-CAM CDs should be considered for completely edentulous patients whenever possible, since this technique offers numerous advantages including better retention, mechanical and surface properties but most importantly preserves a digital record. This can be a great advantage for older adults with limited access to dental care.
Trial of a CAD/CAM system for fabricating complete dentures
Dental materials …, 2011
The purpose of this study was to evaluate the fabrication of a complete denture using a CAD/CAM system. Cone beam CT was used to measure the complete denture and the artificial teeth. After a 3D complete denture image was structured using 3D CAD software, we factored out the artificial teeth and obtained a 3D denture base image. A machining center cut an acrylic resin block, and fabricated an acrylic complete denture base. The artificial teeth were bonded to the cut denture base using resin cement. A 3D digitizer digitized the fabricated acrylic denture. We measured the deviations between the master 3D complete denture image and the 3D data of the fabricated acrylic denture. The average deviations from the master 3D image were 0.50 mm for the occlusal surface. This present study indicates that it is possible to fabricate a complete denture using a CAD/CAM system.
The Journal of prosthetic dentistry, 2016
Reports of sound, evidence-based treatment outcomes of computer-aided design/computer-aided manufacture (CAD/CAM) of complete dentures (CD) are lacking in publication databases. The purpose of this retrospective survey study was to assess patient preferences and satisfaction when treated with digitally fabricated CDs, by using a questionnaire. A total of 50 patients who received digital CDs were included in this study. A 10-item questionnaire was sent to the patients in order to assess their satisfaction with their digital CD experience. The items, or statements listed, were concerned with patient satisfaction and also the treatment technique and final outcome. Results of patient satisfaction questions were evaluated using descriptive statistics, means, and medians. All statistical tests were performed using commercially available software. Responses to the questionnaire provided by patients were analyzed using the Mantel-Haenszel chi-squared test (α=.05). The questionnaire was sent...