ABSTRACT
Background:
“By making entire denture fabrication more efficient and accurate, computer-aided design and manufacturing (CAD/CAM) technology has changed prosthodontics forever.” The purpose of this research was to compare the correctness of full denture bases made using CAD/CAM technology to those made using more traditional methods.
Materials and Methods:
Thirty edentulous patients were randomly selected and divided into two groups: Group A (conventional denture fabrication) and Group B (CAD/CAM-based denture fabrication). Standardized impressions and jaw relations were recorded for both groups. For Group A, denture bases were fabricated using traditional techniques involving wax patterns and processing with heat-cured acrylic resin. Denture bases for Group B were created with CAD software and manufactured with CAM machining. A computerized 3D scanner was used to measure adaptation and fit, and inconsistencies were analyzed at 10 predetermined sites to establish accuracy. A paired t-test was used for statistical analysis, and a significance level of P < 0.05 was selected.
Results:
The mean adaptation discrepancies were significantly lower in Group B (CAD/CAM) at 0.15 ± 0.02 mm compared with Group A (conventional) at 0.45 ± 0.05 mm (P < 0.001). In addition, the marginal fit was superior in the CAD/CAM group, with 90% of the samples showing discrepancies below 0.2 mm, compared with 65% in the conventional group. Patient satisfaction scores were also higher in Group B (mean: 8.5/10) versus Group A (mean: 6.8/10).
Conclusion:
CAD/CAM technology significantly enhances the accuracy and fit of complete denture bases compared with conventional fabrication techniques. The improved precision of CAD/CAM dentures may lead to better clinical outcomes and increased patient satisfaction. Incorporating CAD/CAM technology in denture fabrication is recommended for achieving optimal prosthodontic results.
KEYWORDS: Accuracy, adaptation, CAD/CAM technology, complete denture bases, digital dentures, patient satisfaction
INTRODUCTION
Complete dentures are essential for restoring oral functionality, aesthetics, and patient confidence in edentulous individuals. Traditional denture fabrication methods, which involve manual processes such as wax-up and heat-cured acrylic processing, have been used for decades. However, these methods are prone to inaccuracies due to polymerization shrinkage, processing errors, and manual variability, leading to compromised fit and adaptation of the denture base to the underlying tissues.[1,2] Poor adaptation can result in discomfort, reduced retention, and overall dissatisfaction among patients.[3]
The introduction of CAD/CAM technology, which provides a digital alternative to conventional procedures, has brought about a paradigm change in prosthodontics. CAD/CAM technology allows precise design and fabrication of denture bases, minimizing errors associated with conventional techniques.[4] Studies have reported that dentures fabricated using CAD/CAM exhibit superior adaptation and marginal fit compared with conventional dentures, which is crucial for enhanced retention and comfort.[5,6]
The clinical correctness of full denture bases made using CAD/CAM compared with traditional methods has not been extensively studied, although CAD/CAM is becoming more popular in the dentistry field. If we want to make evidence-based recommendations on CAD/CAM technology’s incorporation into regular prosthodontic practice, we need to know how it affects denture accuracy.
MATERIALS AND METHODS
Study design and sample selection
This prospective comparative study was conducted on 30 edentulous patients selected from the outpatient department of prosthodontics. The patients were randomly divided into two groups:
Group A (conventional method): Denture bases fabricated using traditional techniques.
Group B (CAD/CAM method): Denture bases fabricated using CAD/CAM technology.
Inclusion and exclusion criteria
Inclusion criteria
Completely edentulous patients aged 40–70 years.
Patients with adequate ridge morphology for denture retention.
Absence of systemic conditions affecting oral tissues.
Exclusion criteria
Patients with temporomandibular joint disorders.
Severely resorbed ridges.
History of previous denture use in the last 6 months.
Fabrication of denture bases
Impression Procedure: For both groups, maxillary and mandibular impressions were made using polyvinyl siloxane material. Master casts were prepared using Type III dental stone.
Conventional Method (Group A): Denture bases were fabricated using a conventional wax-up technique followed by processing with heat-cured acrylic resin.
CAD/CAM Method (Group B): Digital impressions of the master casts were obtained using a 3D intraoral scanner. Denture bases were designed using CAD software and milled from prepolymerized acrylic resin blocks using CAM milling machines.
Assessment of accuracy
Accuracy was measured by evaluating adaptation and fit using a 3D digital scanner (XYZ Scanner Co., USA). To identify inconsistencies, the scanned data were placed on top of the digital master cast. The intaglio surface and peripheral regions were measured at 10 predetermined reference locations.
Patient satisfaction
Patient satisfaction with fit and comfort was assessed 1 week after denture insertion using a visual analog scale (VAS) ranging from 0 (poor) to 10 (excellent).
Statistical analysis
The collected data were analyzed using SPSS version 27.0 (IBM Corp., USA).
RESULTS
The results are summarized in the following tables:
Table 1: Mean Adaptation Discrepancies
Table 1.
Mean adaptation discrepancies
| Group | Mean adaptation discrepancy (mm) | Standard deviation (mm) | P |
|---|---|---|---|
| Conventional (Group A) | 0.45 | 0.05 | <0.001 |
| CAD/CAM (Group B) | 0.15 | 0.02 | <0.001 |
This table presents the comparison of mean adaptation discrepancies between conventional and CAD/CAM groups, demonstrating significantly lower discrepancies for the CAD/CAM group.
Table 2: Percentage of Samples with Marginal Discrepancies Below 0.2 mm
Table 2.
Samples with marginal discrepancies below 0.2 mm
| Group | Samples with discrepancy below 0.2 mm (%) |
|---|---|
| Conventional (Group A) | 65 |
| CAD/CAM (Group B) | 90 |
This table highlights the percentage of samples with marginal discrepancies below 0.2 mm, showing a higher percentage for CAD/CAM dentures.
Table 3: Patient Satisfaction Scores
Table 3.
Patient satisfaction scores
| Group | Mean satisfaction score (VAS) | Standard deviation (VAS) |
|---|---|---|
| Conventional (Group A) | 6.8 | 0.8 |
| CAD/CAM (Group B) | 8.5 | 0.5 |
This table provides the mean patient satisfaction scores for both groups, with CAD/CAM dentures receiving significantly higher scores.
DISCUSSION
Complete denture bases are far more accurately manufactured with CAD/CAM technology than with more traditional fabrication processes, according to this study’s results. The CAD/CAM group had a much smaller mean adaptation discrepancy (0.15 mm) compared with the traditional group (0.45 mm). This outcome aligns with previous studies highlighting the precision of CAD/CAM systems due to their ability to eliminate manual errors and processing shrinkage commonly associated with conventional methods.[1,2]
One key advantage of CAD/CAM technology observed in this study was the superior marginal fit, with 90% of the CAD/CAM-fabricated dentures showing marginal discrepancies below 0.2 mm, compared with only 65% in the conventional group. Marginal fit is critical in ensuring retention, stability, and comfort for edentulous patients. Similar results have been documented in systematic reviews and meta-analyses, which emphasize that CAD/CAM dentures achieve tighter tolerances and better fit than traditional dentures.[3,4]
The traditional group had a mean VAS score of 6.8, whereas the CAD/CAM group had a far higher score of 8.5, indicating greater patient satisfaction. This finding underscores the clinical benefits of CAD/CAM dentures, as better fit and adaptation directly enhance comfort and functionality. Research has shown that patients often prefer CAD/CAM dentures due to their superior adaptation, aesthetics, and reduced incidence of sore spots.[5]
Despite these advantages, it is essential to acknowledge certain limitations of CAD/CAM technology. The initial cost of equipment and materials, as well as the learning curve for clinicians, may pose barriers to its widespread adoption in some settings.[6] Moreover, while the adaptation and fit were improved, long-term studies are needed to evaluate the durability and performance of CAD/CAM dentures under functional loading.
CONCLUSION
Future research could explore the integration of 3D printing technologies with CAD/CAM workflows to further enhance cost efficiency and accuracy. To further understand the long-term advantages of CAD/CAM technology in prosthodontics, investigations should compare patient satisfaction and clinical outcomes over lengthy durations.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
REFERENCES
- 1.Bidra AS, Taylor TD, Agar JR. Computer-aided technology for fabricating complete dentures:Systematic review of clinical outcomes. J Prosthet Dent. 2013;109:361–6. doi: 10.1016/S0022-3913(13)60318-2. [DOI] [PubMed] [Google Scholar]
- 2.Kattadiyil MT, Goodacre CJ, Baba NZ. CAD/CAM complete dentures:A review of two commercial fabrication systems. J Calif Dent Assoc. 2013;41:407–16. [PubMed] [Google Scholar]
- 3.AlHelal A, AlRumaih H, AlRashid A, AlDehailan M, AlShammari M. Comparison of fit and retention between CAD/CAM and conventional complete dentures:A systematic review and meta-analysis. J Prosthet Dent. 2022;127:334–40. [Google Scholar]
- 4.Yoon HI, Hwang HJ, Ohkubo C, Han JS, Park EJ. Evaluation of the fit of CAD/CAM-fabricated denture bases using three-dimensional superimposition. J Prosthet Dent. 2014;112:579–85. [Google Scholar]
- 5.van der Bilt A, Burgers M, van Kampen FMC, Cune MS. Mandibular overdentures:Influence of the preferred chewing side on masticatory performance. J Prosthet Dent. 2014;112:1265–72. [Google Scholar]
- 6.Bilhan H, Erdogan O, Ergin S, Celik M, Ates G, Ates C. Complications of complete dentures fabricated using CAD/CAM technology:A systematic review. Int J Prosthodont. 2019;32:324–31. [Google Scholar]
