Use of a Digitally Planned and Fabricated Mandibular Complete Denture for Easy Conversion to an Immediately Loaded Provisional Fixed Complete Denture. Part 1. Planning and Surgical Phase (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...
Journal of Prosthodontics, 2020
Purpose: The purpose of this retrospective, cross-sectional study is to evaluate if there is a difference in number of visits (including fabrication and postoperative) and remake rate when comparing conventionally fabricated and digitally fabricated complete dentures by dental students in a predoctoral student dental clinic. Materials and methods: This two-year retrospective cross-sectional study consisted of a chart review for patients receiving maxillary and/or mandibular complete dentures between 2017 and 2019 (n = 314) at the UNC Adams School of Dentistry predoctoral student clinic. No control group was determined for this study. Data were extracted for 242 conventional dentures and 39 digital dentures. Objective treatment outcomes were obtained for each included denture: the number of patient appointments from preliminary impressions to denture placement, the number of postoperative visits, any complications noted, and any need for remakes. Fisher's Exact Test and Cochran-Mantel-Haenszel analysis were completed with statistical significance set at p < 0.05. Results: For the number of visits from preliminary impression to placement, 50% of conventionally fabricated dentures had 6 or more visits, while only 5% of digitally fabricated dentures had 6 or more visits. This difference for the number of patient visits was statistically significant (p < 0.05). Additionally, conventionally fabricated dentures required an average of 2-3 postoperative visits, whereas digitally fabricated dentures required 1-2 postoperative visits. This difference was also statistically significant (p < 0.05). For the number of dentures requiring remake, there was no statistical difference (p = 0.1904). Conclusions: When comparing conventionally fabricated and digitally fabricated dentures in the predoctoral clinic, the digitally fabricated dentures required fewer patient appointments from start to finish, and fewer postoperative appointments than conventionally fabricated dentures. Fewer visits may be an important consideration for patients, especially those with limited access to care.
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.
Digitally Planned and Fabricated Mandibular Fixed Complete Dentures. Part 2. Prosthodontic Phase
International Journal of Prosthodontics, 2015
Part 1 of this patient report described a prosthetically driven protocol that used computer-aided engineering for the fabrication of a mandibular conversion denture and maxillary provisional complete denture using the AvaDent Digital Denture system. The report demonstrated that this system combined with NobelClinician implant-planning software can be used to efficiently convert a digital denture into an immediately loaded provisional implant-supported fixed complete denture (hybrid prosthesis). Part 2 of the patient report describes the technique and steps involved in the fabrication of a digitally planned and fabricated mandibular fixed complete denture with incorporated titanium milled bar opposed by a definitive computer-aided design/computer-assisted manufacture-milled maxillary complete denture.
Digital workflow in complete dentures: a narrative review
Journal of Osseointegration, 2020
Aim The aim of the present study is to review the literature evaluating the main steps required in complete denture rehabilitation in case of edentulous jaws in the digital workflow. Methods This review was conducted using PubMed and Scopus databases. It focuses on the following clinical and laboratory steps: the impression, the registration of the centric relation, the try-in and the finalization. Results According to the reported data in literature, impression, try-in and finalization are feasible with a complete digital approach. Registration of the centric is possible only combining the digital with the traditional one. Digital impression is accurate, but shows some limitations in the peripheral areas. The printing process, because of accuracy and its cost, can be used for the try-in of the prototype. Milling machine is more accurate than 3D printing and offers a good level of retention and of satisfaction for the patient. Conclusions In relation to optical scanning, there are...
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.
Egyptian Dental Journal
Purpose: This study aimed to measure retention force and evaluate patient satisfaction level as treatment outcomes of indirect versus direct digitally constructed complete dentures (CDs) as compared to conventionally constructed CDs. Material and methods: Eight completely edentulous patients were enrolled in this study to receive maxillary and mandibular complete denture (CD) sets made by conventional method. They wore these CDs for three months constituting the first group (Group I) followed by two weeks as a 1 st wash out period. Then the patients received three dimensional (3D) printed computer aided design computer aided manufacturing CAD/CAM CD sets and wore them for another three months. These sets were made by indirect digital technique using extra-oral scan to capture patients' clinical data to be analogical-digital technique constituting the second group (Group II). Patients then left out these dentures for two weeks as a 2 nd washout period after which they received 3D printed CAD\CAM CD sets made digitally by direct intra-oral scanning impression (IOSI) in combination with 3D face scan to constitute the third group (Group III). They again wore these sets for another three months. Retention force was measured as well as the patient satisfaction level was evaluated for every group two times, one and three-month post-insertion of each CD set. Results: The results of this study showed that there were significant differences between CD sets of Groups II and III when compared to conventional CD sets. However, Group II had significantly higher values of retention force as well as the best significant patient satisfaction as compared to Group I and Group III that showed generally the least potential retention force and patient satisfaction (with exception of esthetic satisfaction that was significantly the best for Group III followed by Group II). Conclusion: Within the limitations of this study, we can conclude that: 3D printed CDs digitally made by indirect method had better retention force and patient satisfaction level compared to conventionally made CD. However, 3D printed digitally made by direct method expressed the least retention force and patient satisfaction level compared to the other two groups. The esthetic satisfaction level was the best for CD sets made digitally by direct method due to the use of 3D face scan.
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)
The Journal of Advanced Prosthodontics
PURPOSE. Digital technology has enabled improvements in the fitting accuracy of denture bases via milling techniques. The aim of this study was to evaluate the trueness and precision of digital and analog techniques for manufacturing complete dentures (CDs). MATERIALS AND METHODS. Sixty identical CDs were manufactured using different production protocols. Digital and analog technologies were compared using the reference geometric approach, and the Δ-error values of eight areas of interest (AOI) were calculated. For each AOI, a precise number of measurement points was selected according to sensitivity analyses to compare the Δ-error of trueness and precision between the original model and manufactured prosthesis. Three types of statistical analysis were performed: to calculate the intergroup cumulative difference among the three protocols, the intergroup among the AOIs, and the intragroup difference among AOIs. RESULTS. There was a statistically significant difference between the dentures made using the oversize process and injection molding process (P < .001), but no significant difference between the other two manufacturing methods (P = .1227). There was also a statistically significant difference between the dentures made using the monolithic process and the other two processes for all AOIs (P = .0061), but there was no significant difference between the other two processes (P = 1). Within each group, significant differences among the AOIs were observed. CONCLUSION. The monolithic process yielded better results, in terms of accuracy (trueness and precision), than the other groups, although all three processes led to dentures with Δ-error values well within the clinical tolerance limit. [