Complete Denture Fabrication Research Articles

Is the Number of Appointments for Complete Denture Fabrication Reduced with CAD-CAM? A Literature Review

One of the key arguments in favor of digitally produced complete dentures (CDs) is the requirement for less patient visits in comparison to the conventional workflow. However, it is not yet clear if this argument is accurate; nor, if indeed the insertion of the complete dentures is achieved in fewer appointments, how many are required. The purpose of this literature review was to investigate the reported number of required patient visits for the production of digitally fabricated CDs. An electronic search was performed in PubMed/MEDLINE using three groups of keywords: “complete dentures”, “CAD/CAM”, and “Appointments” with their alternative forms. Out of the initial 157 results, 36 articles were automatically selected utilizing exclusion keywords. After consensus between the two examiners, eight articles were finally analyzed and presented in a table. The majority (75%) of the reports came from institutions, and the average number of appointments up to complete denture insertion was 4.1, not always including try-in dentures. In this study, it can be concluded that, with a digital workflow, the insertion appointment is reached in fewer visits than the conventional five-visit procedure which is commonly taught in dental schools.

Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) Complete Dentures for Atrophic Alveolar Ridges: Workflow Combining Conventional and Novel Techniques.

Extreme residual ridge resorption is a challenging clinical situation for the fabrication of complete dental prostheses. Computer-aided design and computer-aided manufacturing (CAD/CAM) complete dentures have been shown to have superior fit and material strength to conventionally fabricated dentures, but no clinical protocols have been described for cases of extreme residual ridge resorption. This report describes a workflow combining conventional and novel techniques for CAD/CAM complete dentures fabrication for atrophic alveolar ridges and demonstrates that a CAD/CAM workflow is an effective tool for solving this complex situation.

Effects of repeated use of tungsten carbide burs on the surface roughness and contact angles of a CAD-CAM PMMA denture base resin

Statement of problemThe surface roughness (Ra) and wettability of complete denture base materials must meet certain clinical requirements. Although computer-aided design and computer-aided manufacturing (CAD-CAM) systems have recently become popular for the fabrication of complete dentures, the effects of the repeated usage of milling burs on the surface properties of CAD-CAM denture base acrylic resins have not yet been fully investigated. PurposeThe purpose of this in vitro study was to evaluate the effects of new and used burs on the Ra and contact angles (wettability) of a CAD-CAM polymethylmethacrylate (PMMA) denture base material. Material and methodsA total of 40 Ø2×10-mm disks were fabricated from 1 brand of CAD-CAM PMMA resin (Polident). Half of the specimens (group N) were milled with a new tungsten carbide bur set, while the other half (group U) was milled with a used tungsten carbide bur set. Moreover, half of the specimens (groups NT and UT) were subjected to thermocycling before Ra and contact angle testing. Ra was tested by using a profilometer, and the surfaces were also examined by scanning electron microscopy (SEM). The contact angle was measured by using the sessile drop method. Data were analyzed with the Kruskal-Wallis and Dunn Pairwise Comparison tests (α=.05). ResultsThe mean contact angle was highest for group U (80 degrees) and lowest for group UT (66 degrees) (P<.05). Ra values were highest for group N (1.3 μm) and lowest for group U (0.93 μm) (P<.05). ConclusionsSpecimens milled with new tungsten carbide burs had lower mean contact angles and higher Ra values than specimens milled with used burs. The contact angles of CAD-CAM PMMA resin specimens milled with used burs decreased significantly after thermocycling. Regardless of whether or not thermocycling was performed, contact angle values decreased as Ra values increased.

Fabrication of complete denture using 3D printing: a case report

Fabrication of complete denture using 3D printing: a case report

Effective utilization of digital technology in complete denture fabrication.

Although digital technology is commonly used in various forms of dental treatment, its application to fabrication of removable dentures is still associated with limitations or challenges, such as the recording of occlusal vertical dimensions and determination of the occlusal plane. Here, a simple and inexpensive technique for fabrication of removable complete dentures, partly aided by digital technology, is proposed.

Flexural Strength of CAD/CAM Denture Base Materials: Systematic Review and Meta-analysis of In-vitro Studies.

ABSTRACTIntroduction:Digital complete dentures fabrication techniques are expanding. This study aimed to review flexural strength (FS) of milled and 3D-printed denture base materials to answer the study question: is FS of computer-aided designing/computer-aided manufacturing (CAD/CAM) denture base comparable to conventional heat-polymerized materials?Materials and Methods:Search was done within different databases for articles published between January 2010 and June 2021 using specific keywords. Articles of in-vitro studies in English language with methods following International Standards Organization standardization/ADA specifications for flexural testing of conventional and CAD/CAM (milled or printed) polymethyl methacrylate (PMMA) materials were included.Results:Out of the 61 studies, 9 were processed for data extraction and only 7 underwent meta-analysis. Two, six, and one study showed high, moderate, and low risk of bias, respectively. Random-effects model was used for analysis and resulted in the average FS of 120.61 MPa [95% confidence interval (CI): 109.81−131.41] and 92.16 MPa (CI: 75.12−109.19) for CAD/CAM milled and heat-polymerized PMMA, respectively.Conclusion:Subtractive CAD/CAM technique of denture fabrication showed satisfactory FS values, whereas additive CAD/CAM method was comparable to conventional heat-polymerized technique with lower value, requiring further investigations and improvement. The clinical use of milled denture bases is an acceptable substitution to heat-polymerized PMMA, making the denture fabrication an easier and faster process.

Maxillary complete denture fabrication cases with posterior palatal seal considering palatal form and tissue displacement

Maxillary complete denture fabrication cases with posterior palatal seal considering palatal form and tissue displacement

Current educational concepts and techniques related to impression making of removable complete dentures.

The purpose of the present study is to gain an understanding of the current state of pre-clinical education for procedures of impression making. In 2019, a survey questionnaire was emailed to the senior professors and department heads of 29 Japanese dental colleges. The response rate was 100%. This cross-sectional survey clarified the impression making for removable complete denture fabrication in Japanese dental schools' education.

A study comparing patient satisfaction and retention of CAD/CAM milled complete dentures and 3D printed CAD/CAM complete dentures versus conventional complete dentures: a randomized clinical trial

Objective: To compare the three different methods of complete denture fabrication assessing patient satisfactionand retention after insertion for six months’ follow-up period. Material and Methods: The study was conductedin the Prosthodontic Department where a total of forty-eight patients were recruited from the outpatient clinicsfulfilling the inclusion criteria. This study was designed as a randomized controlled clinical trial. All patientsfollowed the steps of complete denture construction till jaw relation record. Then, all eligible patients wererandomized to intervention and control groups. For intervention groups digital scanning, designing, manufacturingof complete dentures was done; 3D printing for first and milling for second intervention. For the comparatorgroup, complete dentures were manufactured the conventional way. After 2 weeks of delivery of the dentures,patients received a patient satisfaction questionnaire, retention was measured by retention force gauge. Bothreadings were also recorded after 3 months and at 6 months. The mean and standard deviation values werecalculated for each group in each test. The significance level was set at P &lt; 0.05. Results: No statistical differencewas found in terms of patient satisfaction and retention between the three groups at different time intervals.Conclusion: The manufacturing technique seemed to have no influence on patient satisfaction and retentionwith milled showing the least results.KEYWORDSComputer-aided design; Denture, Complete; Denture retention; Patient satisfaction; Printing, Three-dimensional

Fabrication of complete denture by stereolithography-based 3D printing: a case report

Fabrication of complete denture by stereolithography-based 3D printing: a case report

Steps in digital denture fabrication

Fabricating a complete denture in a conventional manner may be complicated and difficult. The purpose of this presentation is to describe the benefits of a fully digital workflow and fabrication procedure of complete dentures based on digital impressions of edentulous jaws. The digital data for the workflow were acquired using an intraoral scanner and were then used to design the denture base and teeth. The resulting data were exported to a 3D printer or a milling machine for denture fabrication. The high accuracy of digitalized dental fabrication has been proved by several studies compared to conventional methods .CAD/CAM fabrication of complete dentures based on digital impressions of edentulous jaws obtained using an intraoral scanner. By this method the occurrence of human processing errors, inaccuracies, and multiple clinical appointments can be avoided.

DIGITAL OCCLUSAL ANALYSIS AND ORAL HEALTH-RELATED QUALITY OF LIFE OF PATIENTS WITH 3D PRINTED COMPLETE DENTURES VERSUS CONVENTIONAL DENTURES

Background: 3D printed complete dentures fabrication with computer-aided designing and computer-aided manufacturing (CAD/CAM) techniques is becoming popular nowadays. However, studies that analyzed the occlusal forces distribution using recent digital methods as T-scan III and further evaluated the dentures effect on patient`s life quality were lacking. Objectives: Evaluation of the occlusal forces distribution using T-scan III, and evaluation of the oral health-related quality of life (OHRQoL) using Oral Health Impact Profile for Edentulous Patients (OHIP-EDEN) questionnaire for 3D printed complete dentures and comparing it with conventional denture fabrication techniques. Methods: Twenty completely edentulous patients were selected and divided randomly into two equal groups according to manufacturing technique group I (patients who received conventional complete dentures), and group II (patients who received 3D printed complete dentures). For all patients, occlusal force analysis (percentage of applied occlusal force on both sides) was performed using the T-Scan III (digital occlusal analysis system). Also, OHRQoL was assessed using (OHIP-EDENT) questionnaire. Results: In the digital occlusal analysis, comparison between right and left sides regarding occlusal forces distribution revealed a significant difference in group I (conventional denture), while in group II (3D printed denture), it revealed an insignificant difference. Regarding, OHIP-EDENT patients in group I (conventional denture) revealed higher scores than group II (3D printed dentures). Also, the correlation between occlusal forces &amp; (OHIP-EDENT) scores revealed a strong negative significant correlation. Conclusions: The 3D printed complete dentures fabricated using CAD/CAM technology proved to be more superior over conventional methods in terms of digital occlusal force analysis and Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT). However, further studies are required on more patients to decide the exact superiority of one technique over the other after long-term follow-up periods.

Correlation of Salivary Cortisol Levels with Anxiety in Type II Diabetes Mellitus Patients before and after Complete Denture Rehabilitation - An in vivo Study

Background: Complete edentulism constitutes health care burden, resulting in alterations in physical, psychological and emotional behavior. Also, a reduction in quality of life is expressed by patients, raising their levels of stress and anxiety. Stressful situations cause increased blood pressure and heart rate resulting in the secretion of cortisol hormone, which stimulates gluconeogenesis and glycogenolysis causing hyperglycemia, which may favor the occurrence of Diabetes. As the diabetic’s population is rapidly rising, Prosthodontists are certain to see a greater number of diabetic edentulous patients. Thus, there is a need to assess the relationship of complete denture rehabilitation with the generic health of edentulous patients which can be done by checking the stress levels, and their effects on systemic health.&#x0D; Objectives: To determine anxiety levels and Salivary Cortisol levels in Type II Diabetes Mellitus patients and compare and correlate them before and after rehabilitation with Complete Dentures.&#x0D; Methodology: It will be a cross-sectional study, carried out on edentulous diabetic patients aged 50-70 years visiting the Department of Prosthodontics of Sharad Pawar Dental College and Hospital. With consent for participation, Glycated Hemoglobin and anxiety levels will be determined, along with fabrication of complete dentures. Patients will be assessed at two stages; before and 1 month after complete denture rehabilitation.&#x0D; Results: The research has been approved by the Institutional Ethical Committee. The results expected are the significant reduction in anxiety levels after Complete Denture Rehabilitation and thus, a definitive correlation between anxiety and salivary cortisol levels.&#x0D; Conclusion: Adaptation of patients to their new set of Complete dentures can be improved by their clinicians by acquisition of the knowledge of relationship of the general health of the patient and correlating it to the dental rehabilitation.

Rehabilitation and Esthetic Enhancement of Edentulous Patient with Hollow Cheeks Using Innovative Detachable Cheek Plumper: Case Report

Complete edentulism for longer period of time and aging causes flaccid of facial musculature which leads to sunken cheeks and unpleasing appearance of face. In order to get a supplemental support for the drooping cheek muscles, fabrication of conventional complete denture with adjunct detachable cheek plumpers are simple, acceptable non-invasive and economical. Despite the discussion of various attachment used for cheek plumper in literature each have their own disadvantages. The present clinical report demonstrated the use of chairside available lingual sheath and stainless steel wire for the attachment of cheek plumpers to the maxillary complete denture.

Workflow for complete dentures fabrication in three appointments: A dental technique

This technical report describes a novel workflow for complete denture fabrication designed to abbreviate the necessary steps for dental prostheses delivery by using a 3-appointment protocol in which preliminary impressions are made in the first session together with the registration of maxillary lip support, occlusal plane, and reference lines for tooth arrangement. A trial denture is fabricated with conventional or computer-aided design and computer-aided manufacturing procedures and is evaluated in the second appointment for esthetics, the definitive impression, and the maxillomandibular relationship record to provide precise references for definitive denture fabrication.

MICROBIOLOGICAL ASSESSMENT OF CAD/CAM FABRICATED DENTURES &amp; ITS CORRELATION WITH SURFACE PROPERTIES: A RANDOMIZED CLINICAL TRIAL

Background: Computer-aided design and computer-aided manufacturing (CAD-CAM) techniques have lately become a popular treatment option for complete dentures fabrication. The two principal CAD-CAM techniques milling and 3D printing used in complete dentures construction have been approved and documented in showing clinically good results. Surface characteristics of dentures fabricated by these new techniques have a great effect on microbiological adherence to denture fitting surfaces. Aim: As other clinical trials and/or in-vitro studies evaluating the microbiological effect and its correlation with the surface roughness of the two advanced manufacturing techniques and comparing it with the conventional technique are lacking. Thus, this study aimed to further assess the microbiological and surface properties of different widely used denture base materials. Methodology: Thirty-six completely edentulous patients were selected and divided randomly into three groups Group I patients received conventional complete denture, Group II patients received CAD/CAM milled complete dentures and Group III patients received 3D printed complete dentures. All denture`s surface roughness were evaluated, also all patients were recalled after 3, 9 &amp; 12 months respectively to evaluate the microbiological adherence. Results: Microbiological count significantly increased (P &lt; 0.05) after 12 months in all groups, after 12 months there was a significant difference (P &lt; 0.05) between three groups as group II (Milled) was significantly the lowest, then the group I (conventional), while group III (3D printed) was significantly the highest. Regarding surface roughness of group II (milled) was significantly the lowest, while group III (3D printed) was significantly the highest. Finally, there was a strong positive significant correlation between microbiological adherence and surface roughness in all groups as (r &gt; 0.5). Conclusion: Group II (Milled) appeared to be the best regarding microbiological adherence and surface roughness followed by the group I (conventional) and finally group III (3D printed). Furthermore, it was evident that surface roughness has a great effect on microbiological adherence regardless of the fabrication technique utilized.

Comprehensive Prosthodontic Treatment of an Elderly Patient with Compromised Ridges: A Clinical Case Report

Introduction: The objective of a complete denture prosthesis is restoring aesthetics, comfort, and function by the replacement of missing dental and alveolar structures employing a stable prosthesis. Case Report: Many conditions can complicate the treatment plan and fabrication of a complete denture prosthesis. Complete denture fabrication in clinically compromised conditions is a challenging task for the dentist. In this clinical report, we present comprehensive management of a patient with denture-induced hyperplasia, flabby ridge, and severely resorbed edentulous ridge. The three-part strategy for management of the above-mentioned challenges can provide high-quality complete dentures, based on recognized prosthodontic principles. This first part will discuss the management of denture induced hyperplasia by elimination of the inflammation and excision of the lesion. Part two will cover management of the flabby ridge using a modified window technique for the impression of maxillary flabby tissues for an improved and controlled application of the impression material that is usually obtainable in dental practice. Part three highlights the rehabilitation procedure of the resorbed mandibular ridge using a functional impression technique with minimum soft tissue displacement and neutral zone arrangement of teeth to improve stability of the denture. Conclusion: rehabilitation of a patient with denture induced hyperplasia, flabby ridge, and severely resorbed edentulous ridges was successful.

Performance of complete dentures fabricated with the simplified and the traditional technique: A randomized clinical trial

Statement of problemThe simplified technique has been recommended for the fabrication of removable complete dentures. However, a consensus regarding the performance of the simplified and the traditional techniques is lacking. PurposeThe purpose of this randomized clinical trial was to compare the performance of prostheses fabricated with the simplified and the traditional techniques. Material and methodsSixty participants were recruited and randomized into 2 groups: traditional technique (control group) and simplified technique (experimental group). The assessments were performed before treatment (baseline) and 2 and 4 months after adaptation to the new complete dentures. The variables evaluated were satisfaction, oral health-related quality of life (OHRQoL) by using the Brazilian version of the OHIP-EDENT, the quality of the prostheses, and, for the functional assessment, the masticatory performance and swallowing threshold. The data were analyzed by the Fisher exact test, the Mann-Whitney test, and the generalized equations estimating (GEE) method. ResultsAt baseline, the mean ±standard deviation quality of the prostheses was 5.3 ±2.3 for the traditional technique and 4.9 ±2.3 for the simplified technique, and at 4 months, it was 9.3 ±0.9 and 9.1 ±0.9, respectively. For masticatory performance, the mean ±standard deviation X50 at baseline was 5.7 ±1.4 for the traditional technique and 5.7 ±0.9 for the simplified technique, and at 4 months, it was 3.8 ±1.2 and 3.7 ±0.9, respectively. The mean ±standard deviation OHRQoL at baseline was 14.1 ±8.6 for the traditional technique and 12.5 ±9.4 for the simplified technique, and at 4 months, it was 3.2 ±4.3 and 2.6 ±5.1, respectively. The mean ±standard deviation satisfaction at baseline was 9.5 ±3.9 for the traditional technique and 9.3 ±4.2 for the simplified technique; after 4 months, it was 14.8 ±2.0 for both techniques. There was a significant improvement (P<.05) for all variables in the study when comparing them at the baseline to those at the evaluation after provision of new complete dentures. There was no significant difference in all analyzed variables (P>.05) between the 2 techniques for prosthesis fabrication. ConclusionsThe simplified technique appears to be a suitable alternative to the traditional technique for the fabrication of complete dentures, with similar performance.

Use of Facebow in Fabrication of Complete Denture among Saudi Prosthodontist

Use of Facebow in Fabrication of Complete Denture among Saudi Prosthodontist

Neutral zone technique: An aid of the prosthodontist- A case series

The area where the outward forces from the tongue and the inward forces from the lips and cheeks are nullified during the functional movements is referred to as the neutral zone. Therefore, the incorporation of neutral cone technique serves as an alternative approach in the fabrication of lower complete dentures specifically in ridges which are highly atrophic. The technique aims to construct a denture that is shaped by muscle function and is in harmony with the surrounding oral structures. It is rarely used because of the extra clinical step involved and some clinicians may find the detection of neutral zone difficult. This article describes a technique for improving the stability of mandibular complete denture for patients who have a resorbed mandibular residual ridge.This neutral zone impression technique is a useful technique when providing mandibular complete denture. It’s use can overcome some of the denture stability difficulties caused in some patients with a more powerful oral musculature, or in patients who have poor or altered neuromuscular control.