Evaluation of Denture Base Adaptation Fabricated Using Conventional, Subtractive, and Additive Technologies: A Volumetric Micro-Computed Tomography Analysis.

Abstract

An in vitro study to compare the adaptation of denture bases fabricated with 4 different techniques using volumetric 3-dimentional (3D) analysis. Edentulous maxillary and mandibular casts were scanned, and standardized denture bases were designed using CAD design software. The same standard tessellation language (STL) data were used to produce the denture bases with 4 different fabrication methods: compression molding (CM), injection molding (IM), PMMA milling (PM), and 3D printing (3D) (n = 11/group). Milled wax denture bases were used to fabricate CM and IM groups. Denture bases placed on edentulous casts were scanned using micro-computed tomography (micro-CT). Volumetric gap between denture base and cast was calculated from 6 locations for maxilla (anterior ridge crest, posterior ridge crest, labial vestibule, buccal vestibule, palate, and posterior palatal seal) and 3 locations for mandible (intermolar, molar, and retromolar) in addition to overall gap measurements for edentulous arches. The data were analyzed with factorial analysis of variance (ANOVA), 1-way ANOVA, and post-hoc Duncan tests. Reproducibility of fabrication methods with regard to each location was assessed using Z test (α = 0.05). In the maxilla, the highest and lowest palatal gap measurements were recorded for CM (898.44 ± 87.73 mm3 ) and PM (357.16 ± 57.68 mm3 ) (p = 0.05). The highest gap measurements for CM and 3D were at palate and, for IM and PM were at posterior ridge crest. In mandible, the volumetric gap measurements for CM were the highest and for PM were the lowest irrespective of location (p = 0.05). PM group showed the best reproducibility and adaptation with the lowest overall mean gaps for both edentulous arches (p = 0.05). Denture bases milled from PMMA blocks showed better adaptation than 3D printed, or wax milled and conventionally fabricated denture bases for both maxillary and mandibular arches. PMMA milling is a reproducible technique that enables the construction of accurate dentures. Clinicians should be cautious about the palatal gap when the compression molding technique is used. Micro-CT is a valid technique for evaluating the denture base adaptation.