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Boontherawara P, Chaijareenont P, Angkasith P. Comparing the trueness of 3D printing and conventional casting for the fabrication of removable partial denture metal frameworks for patients with different palatal vault depths: An in vitro study. J Prosthet Dent 2024; 132:434.e1-434.e6. [PMID: 38845279 DOI: 10.1016/j.prosdent.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 08/04/2024]
Abstract
STATEMENT OF PROBLEM The success of a removable partial denture depends on its fit, and, with conventional casting, the framework is more distorted in patients with a deep palatal vault. Questions remain about whether the three-dimensional (3D) printing technique for fabricating a framework can improve the accuracy of fit for these patients. PURPOSE The purpose of this in vitro study was to compare the trueness of metal frameworks fabricated by selective laser melting, 3D printing pattern casting, and conventional casting for different palatal vault depths. MATERIAL AND METHODS A total of 30 partially edentulous maxillary casts were custom-made in 15 medium and 15 deep palatal vaults. All stone casts were scanned as reference models in digital files. For the medium palatal vault casts, Co-Cr frameworks of the conventional casting (CON) group (n=5) were fabricated with the lost wax technique. For the 3D printing pattern casting (PPC) group (n=5), wax patterns of the framework were printed, followed by metal casting. The frameworks created for the selective laser melting (SLM) group (n=5) were printed directly by using the SLM machine. The same procedures were followed for the deep palatal vault group. All the metal frameworks were scanned and superimposed with the reference casts by using the Geomagic Control X software program. Discrepancies were measured as mean ±standard deviation (trueness), and the data were statistically analyzed with a 2-way ANOVA test to evaluate the interaction of 2 independent factors (fabrication techniques and palatal vault depths) on a trueness outcome (α=.05). RESULTS The lowest mean ±standard deviation value was 0.092 ±0.023 mm, found from the SLM framework with deep palatal vault group, while the highest value was 0.194 ±0.017 mm, found from the CON framework with deep palatal vault group. Different fabrication techniques interacted with different palatal vault depths in terms of trueness (P<.05); however, no significant differences were observed in the medium palatal vault groups (P>.05). Additionally, color mapping demonstrated the gaps of metal frameworks among the 6 groups. CONCLUSIONS With the conventional casting technique, the accuracy of the metal framework was affected by the depth of the palate. For medium palatal vaults, all fabricated frameworks had clinically acceptable fit. For deep palatal vaults, the SLM frameworks showed the lowest discrepancy. As a result, the SLM technique is advised for fabricating a better-fitting metal framework for patients with a deep palatal vault.
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Affiliation(s)
- Passorn Boontherawara
- Graduate student, Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Pisaisit Chaijareenont
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Pattarika Angkasith
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
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Almufleh B, Arellanob A, Tamimi F. Patient-reported outcomes and framework fit accuracy of removable partial dentures fabricated using digital techniques: A systematic review and meta-analysis. J Prosthodont 2024; 33:626-636. [PMID: 37930081 DOI: 10.1111/jopr.13786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/26/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023] Open
Abstract
PURPOSE This review aimed to summarize the evidence on patient-reported outcomes and clinical performance of digitally fabricated removable partial dentures (RPDs) compared to traditionally fabricated dentures. METHODS Three databases were systematically searched (PubMed, CENTRAL, and Wiley online library) for clinical studies comparing digitally and conventionally fabricated RPDs regardless of data acquisition methods used for fabrication. The Cochrane Collaboration risk of bias assessment tool 2 and the Oxford Center for Evidence-based Medicine tool were used to assess risk of bias, and level of evidence, respectively. Descriptive narrative analysis was used to summarize data on patient-reported outcomes, as there were inadequate studies to pool data in a meta-analysis. A random-effects model was used to analyze the data of framework fit accuracy. RESULTS Ten randomized controlled trials were included in the systematic review, and 4 were included in the meta-analysis. Two studies showed that digitally fabricated RPDs are associated with higher patient satisfaction than conventionally fabricated RPDs (with a mean difference of 12.5 mm on a 100-satisfaction scale, p = .008). The pooled standardized mean difference for framework fit accuracy was 0.49 (p = 0.02) in favor of conventionally fabricated RPDs, which showed that conventionally fabricated RPDs have a quantitatively better fit compared to digitally fabricated RPDs. However, clinical evaluation studies showed that both frameworks have clinically acceptable fit. CONCLUSIONS Current evidence shows that digitally fabricated RPDs are associated with higher patient satisfaction compared to conventionally fabricated RPDs. However, the scarcity of literature here warrants the generalization of this conclusion. Both digitally and conventionally fabricated metal RPD frameworks showed acceptable fit clinically.
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Affiliation(s)
- Balqees Almufleh
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Alexia Arellanob
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Faleh Tamimi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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Yoon JM, Liu Y, Sun Y, Ye H, Zhou Y. Clinical evaluation of a one-piece polyetheretherketone removable partial denture fabricated using a novel digital workflow: A self-controlled clinical trial. J Prosthodont 2024. [PMID: 39008343 DOI: 10.1111/jopr.13907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/08/2024] [Indexed: 07/16/2024] Open
Abstract
PURPOSE To explore the clinical application of one-piece polyetheretherketone (PEEK) removable partial dentures (RPDs) fabricated using a novel digital workflow and to evaluate their weights and fits in vivo and patient satisfaction. MATERIALS AND METHODS Fifteen cases with posterior partially edentulous situations were selected, and each patient received two types of RPDs, including a novel digital workflow (test group) and a conventional workflow (control group). For the test group, one-piece RPDs were designed through three-dimensional (3D) methods by scanning stone casts and fabricated by milling PEEK discs. Each RPD was weighed. The gaps between the oral tissue and RPDs in each group were duplicated using a polyvinylsiloxane (PVS) replica and measured by 3D analysis. A visual analog scale (VAS) was used to evaluate the patient's satisfaction. Paired t-tests were used to compare the differences in the weight, the gaps of each RPD, and VAS values between the two groups. One-way analysis of variance tests was used to compare the differences in the gap among different components in each group. RESULTS The RPD in the test group weighed less than that in the control group (p < 0.01). No statistically significant differences in the gaps of denture bases and rests (p > 0.05) were found between the two groups, but the gaps of major connectors in the test group were significantly smaller than in the control group (p < 0.05). The VAS scores for comfortableness and masticatory efficiency were not significantly different between the two groups (p > 0.05) but the scores for the aesthetic appearance of the clasps in the test group were significantly higher than that in the control group (p < 0.05). CONCLUSIONS One-piece PEEK RPDs manufactured using a novel digital workflow weighed less than conventional RPDs and exhibited a clinically acceptable internal fit. Although the aesthetic appearance of the PEEK clasps was superior to the control, there is still room for improvement.
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Affiliation(s)
- Jung-Min Yoon
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yuchun Sun
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Hongqiang Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Pelletier S, Pelletier A, Al Dika G. Adaptation of removable partial denture rest seats in prostheses made with selective laser sintering or casting techniques: A randomized clinical trial. J Prosthet Dent 2024; 132:108-114. [PMID: 35786347 DOI: 10.1016/j.prosdent.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM New fabrication techniques have been developed for removable partial denture (RPD) frameworks although studies validating the clinical application of these techniques are scarce. PURPOSE The purpose of this clinical study was to compare the adaptation of RPD framework rests made with conventional casting or computer-aided design and computer-aided manufacturing (CAD-CAM) with selective laser sintering (SLS) at the clinical evaluation and 1 year after the delivery of the prostheses. MATERIAL AND METHODS This triple-blinded pilot study included 18 participants presenting with maxillary and/or mandibular partial edentulism, of which only 7 returned for the second measurement 1 year after prosthesis delivery. Participants were randomly assigned to 1 of 2 groups depending on whether the RPD framework was made with SLS or conventional lost-wax casting. The adaptation of the RPD at the rest seat area was evaluated by injecting a silicone material on the abutment tooth before seating. The silicone specimens were then sectioned transversely and measured with a scanning electron microscope. The statistical analysis was performed with a linear mixed-effect model with the intention to treat and with a 3-factor repeated measures ANOVA (α=.05). RESULTS At the metal framework evaluation (T0), the prostheses made with SLS showed a mean ±standard deviation adaptation of 398 ±45 μm, while those made with conventional casting presented a mean ±standard deviation adaptation of 176 ±41 μm (P=.009). One year after the delivery of the prostheses (T1), the adaptation of the frameworks made with conventional casting was still significantly better (88 ±6 μm versus 197 ±94 μm, P=.03). CONCLUSIONS Frameworks made with SLS showed worse clinical accuracy at the rest than frameworks produced with conventional casting.
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Affiliation(s)
- Samuel Pelletier
- Masters student in Dental Science, Department of General Dentistry, Faculty of Dental Medicine of Laval University, Québec, Canada; and Private practice, Montreal, Quebec, Canada.
| | - Annik Pelletier
- Professor, Department of Restorative Dentistry, Faculty of Dental Medicine of Laval University, Québec, Canada
| | - Ghassan Al Dika
- Professor, Department of Restorative Dentistry, Faculty of Dental Medicine of Laval University, Québec, Canada
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Kim S, Oh KC, Kim JH. Accuracy of Mandibular Removable Partial Denture Frameworks Fabricated by 3D Printing and Conventional Techniques. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3148. [PMID: 38998231 PMCID: PMC11242778 DOI: 10.3390/ma17133148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024]
Abstract
Herein, we used digital superimposition to evaluate the accuracy of metal frameworks for mandibular removable partial dentures fabricated using three techniques. Thirty master casts of a mandibular dentiform were categorized into three groups (n = 10) based on the framework manufacturing method: selective laser melting-based metal three-dimensional (3D) printing (SLM), digital light projection-based resin 3D printing and subsequent casting (RPC), and conventional casting (CON). The master casts were scanned twice, initially after preparation and subsequently after attaching silicone using the frameworks. These scan files were digitally superimposed to measure the silicone thickness. Statistical analysis was conducted using SPSS Statistics (Version 23.0, IBM Corp., Somers, NY, USA). One-way ANOVA and a post hoc Tukey's multiple comparison tests were performed to determine differences among the three groups (α = 0.05). The RPC group exhibited significantly higher overall and mean internal discrepancies at rest and tissue stops than the SLM and CON groups, which exhibited statistically insignificant differences. Thus, SLM fabrication resulted in comparable accuracy to that achieved by CON, whereas sequentially performing resin 3D printing and casting induced inferior accuracy. However, all frameworks across the three groups were clinically acceptable.
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Affiliation(s)
- Soonam Kim
- Department of Dentistry, Graduate School, Yonsei University, Seoul 03722, Republic of Korea;
| | - Kyung Chul Oh
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea;
| | - Jee-Hwan Kim
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea;
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Rokhshad R, Tehrani AM, Nahidi R, Zarbakhsh A. Fit of removable partial denture frameworks fabricated from 3D printed patterns versus the conventional method: An in vitro comparison. J Prosthet Dent 2024; 131:1144-1149. [PMID: 35597606 DOI: 10.1016/j.prosdent.2022.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM The conventional method of fabricating removable partial denture (RPD) patterns is a time-consuming, expensive, and complex process, and the success of the treatment depends on the fit of the framework. Questions still remain as to whether the 3D-printing method is an acceptable procedure compared with the conventional method. PURPOSE The purpose of this in vitro study was to compare the fit of RPDs cast from 3D printed frameworks and conventionally fabricated RPDs according to the gaps between the framework and the reference model. MATERIAL AND METHODS A metal reference model was made from a Kennedy class III modification 1 maxillary typodont. For the conventional group (n=9), impressions were made from the metal cast. Cobalt chromium frameworks were cast with the conventional method. For the digital group (n=9), the metal cast was scanned with a laboratory scanner, and the RPD was designed in the 3Shape platform. The standard tessellation language (STL) file of the design was downloaded to a 3D printer (Hunter DLP), and 9 resin frameworks were printed. These frameworks were invested and cast in the same dental laboratory as the first group. Gap measurement was assessed vertically with a superimposition software program (Geomagic Control X), and additional measurements were assessed under rests, reciprocal arms, and a 2.2-mm box under the major connector. The independent t test was used for determining the results and statistical analysis between groups. The paired t test was used for statistical analysis within groups (α=.05 for all tests). RESULTS No significant differences (P>.05) were observed in the mean ±standard deviation in overall fit according to the gaps in the conventional group (103 ±18 μm) and those in the digital group (109 ±21 μm). The biggest gap (poorest fit) was observed in the 2.2-mm box under the major connector (115 ±6 μm). CONCLUSIONS Both conventional and 3D-printing methods showed clinically acceptable fits. Further clinical studies with a larger sample size and long-term follow-up are needed.
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Affiliation(s)
- Rata Rokhshad
- Dentist, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; and Topic Group Dental Diagnostics and Digital Dentistry, ITU/WHO Focus Group AI on Health, Berlin, Germany
| | - Azita Mazaheri Tehrani
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Reza Nahidi
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Arash Zarbakhsh
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Limpiwatana S, Nagaviroj N. Intaglio Surface Adaptation of Removable Partial Denture Framework Fabricated by Various Data Acquisition Techniques and Fabrication Approaches. Eur J Dent 2024; 18:493-500. [PMID: 37729933 PMCID: PMC11132788 DOI: 10.1055/s-0043-1772245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES The aim of this study was to compare intaglio surface adaptation of the removable partial denture framework among various data acquisition techniques and fabrication approaches using three-dimensional comparison by metrology software. MATERIALS AND METHODS The partial edentulous typodont model with five digital superimposition landmarks was duplicated and scanned for the digital reference model. Three approaches were the conventional lost-wax (group I; LWT, n = 5), intraoral digital impressions combined with PolyJet printing and lost-wax (group II; IP-LWT, n = 5), and extraoral digital impressions combined with PolyJet printing and lost-wax (group III; EP-LWT, n = 5). Each framework was scanned and superimposed with the reference model. The misfits at 53 locations were measured. STATISTICAL ANALYSIS Data were statistically analyzed by one-way analysis of variance, followed by Tukey's honestly significant difference for pairwise comparisons (p < 0.05). RESULTS Significant differences were found between three approaches at the reciprocal arm, terminal part of the retentive arm, rest, and major connector (p < 0.05). In the LWT group, the reciprocal arm and palatal vault region of major connector had the lowest misfits, but the highest misfit was found in the midline region (p < 0.001). In the IP-LWT group revealed the most excessive contact at the terminal part of the retentive arm (-0.111 ± 0.038 mm, p = 0.031), with the highest misfit at the rest area (p < 0.001). CONCLUSION A difference in adaptation was found in several removable partial denture framework components among three approaches. The LWT group had a better adaptation than other groups. Nevertheless, a clinically acceptable adaptation was seen in all three approaches.
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Affiliation(s)
- Seehachart Limpiwatana
- Residency Training in Prosthodontics, Department of Prosthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Noppavan Nagaviroj
- Department of Prosthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Zhao K, Wu S, Qian C, Sun J. Suitability and Trueness of the Removable Partial Denture Framework Fabricating by Polyether Ether Ketone with CAD-CAM Technology. Polymers (Basel) 2024; 16:1119. [PMID: 38675038 PMCID: PMC11053645 DOI: 10.3390/polym16081119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 04/03/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
The object of the study was to evaluate the suitability and trueness of the removable partial denture (RPD) framework fabricated by polyether ether ketone (PEEK) with the CAD-CAM technology in vitro. Four different types of dentition defects were selected. In each type, five PEEK RPD frameworks were fabricated by the CAD-CAM technology, while five Co-Cr RPD frameworks were made by traditional casting. The suitability of the framework was evaluated by silicone rubber film slice measurement and the three-dimensional image overlay method. The trueness of the PEEK framework was detected by the three-dimensional image overlay method. Data were statistically analyzed with the use of an independent samples t-test (α = 0.05). The suitability values by silicone rubber film slice measurement of the PEEK group were lower than those of the Co-Cr group in four types, with the differences indicating statistical significance (p < 0.05) in type one, type two, and type four. The suitability values using the three-dimensional image overlay method showed no statistical differences (p > 0.05) between the two groups in four types. The trueness values of the PEEK group were within the allowable range of clinical error. The suitability and trueness of the PEEK RPD framework fabricated by CAD-CAM technology met the requirements of the clinical prosthesis.
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Affiliation(s)
- Kening Zhao
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; (K.Z.); (S.W.)
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Su Wu
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; (K.Z.); (S.W.)
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China
- Department of Dentistry, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Chao Qian
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; (K.Z.); (S.W.)
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China
| | - Jian Sun
- Department of Prosthodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; (K.Z.); (S.W.)
- College of Stomatology, Shanghai Jiao Tong University, Shanghai 200011, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai 200011, China
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Conceição P, Portugal J, Franco M, Alves NM, Marques D, Neves CB. Comparison between digital superimposition and microcomputed tomography methods of fit assessment of removable partial denture frameworks. J Prosthet Dent 2024; 131:479-486. [PMID: 36890000 DOI: 10.1016/j.prosdent.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 03/08/2023]
Abstract
STATEMENT OF PROBLEM The fit of removable partial denture frameworks should be assessed to optimize clinical adaptation. Potential discrepancies between framework and supporting structures are typically precisely measured with negative subtracts and high-resolution equipment. The growth of computer-aided engineering technology allows the development of new methods for the direct evaluation of discrepancies. However, how the methods compare is unclear. PURPOSE The purpose of this in vitro study was to compare 2 digital methods of fit assessment based on direct digital superimposition and microcomputed tomography indirect analysis. MATERIAL AND METHODS Twelve cobalt chromium removable partial denture frameworks were fabricated by conventional lost-wax casting or additive manufacturing techniques. The thickness of the gap between occlusal rests and respective definitive cast rest seats (n=34) was evaluated by using 2 different digital methods. Silicone elastomer impressions of the gaps were obtained, and microcomputed tomography measurements were used as controls for validation purposes. Digitization of the framework, the respective definitive cast, and the combination was followed by digital superimposition and direct measurements with the Geomagic Control X software program. Because normality and homogeneity of variance were not verified (Shapiro-Wilk and Levene tests, P<.05), the data were analyzed with Wilcoxon signed rank and Spearman correlation tests (α=.05). RESULTS The thicknesses measured by microcomputed tomography (median=242 μm) and digital superimposition (median=236 μm) did not reveal statistically significant differences (P=.180). A positive correlation (ρ=0.612) was detected between the 2 methods of assessing fit. CONCLUSIONS The frameworks presented median gap thicknesses under the limit of clinical acceptability without differences between the proposed methods. The digital superimposition method was determined to be as acceptable as the high-resolution microcomputed tomography method for assessing removable partial denture framework fit.
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Affiliation(s)
- Pedro Conceição
- Invited Assistant Professor, Department of Dental Biomaterials, Biomedical and Oral Sciences Research Unit (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Jaime Portugal
- Full Professor and Head, Department of Dental Biomaterials, Biomedical and Oral Sciences Research Unit (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Margarida Franco
- Laboratory Responsible, Material Characterization Laboratory, Centre for Rapid and Sustainable Product Development (CDRSP), Polytechnic Institute of Leiria (IPL), Marinha Grande, Portugal
| | - Nuno M Alves
- Coordinator Professor and Director, Department of Biomechanics, Centre for Rapid and Sustainable Product Development (CDRSP), Polytechnic Institute of Leiria (IPL), Marinha Grande, Portugal
| | - Duarte Marques
- Associate Professor with Habilitation, Department of Oral Rehabilitation, Biomedical and Oral Sciences Research Unit (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal
| | - Cristina B Neves
- Assistant Professor with Habilitation, Department of Oral Rehabilitation, Biomedical and Oral Sciences Research Unit (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal.
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Qiu J, Liu W, Wu D, Qiao F, Sui L. Fit accuracy in the rest region of RPDs fabricated by digital technologies and conventional lost-wax casting: a systematic review and meta-analysis. BMC Oral Health 2023; 23:667. [PMID: 37715159 PMCID: PMC10504730 DOI: 10.1186/s12903-023-03348-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 08/24/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Digital technologies have recently been introduced into the fabrication of removable partial dentures (RPDs). However, it is still unclear whether the digitally fabricated RPDs fit better than conventionally cast ones in the rest region. The aim of this study was to evaluate the fit accuracy in the rest region of RPDs fabricated by digital technologies and compare it to those made by conventional lost-wax (CLW) technique. METHODS A comprehensive search was conducted in Cochrane Library, PubMed, EMbase, Web of Science and SpringerLink. Studies published up to August 2022 were collected. Two authors analyzed the studies independently and assessed the risk of bias on the modified methodological index for non-randomized studies (MINORS) scale. The mean values of gap distance between rests and corresponding rest seats of each study were extracted as outcome. A random-effects model at a significance level of P < 0.05 was used in the global comparison and subgroup analysis was carried out. RESULTS Overall, 11 articles out of 1214 complied with the inclusion criteria and were selected, including 2 randomized controlled trials (RCTs), 1 non-randomized clinical trial and 8 in vitro studies. Quantitative data from Meta-analysis revealed that fit accuracy in the rest region of RPDs fabricated with CLW showed no statistically significant difference with digital techniques (SMD = 0.33, 95%CI (-0.18, 0.83), P = 0.21). Subgroup analysis revealed a significantly better fit accuracy of CLW-fabricated RPDs in the rest region than either additive manufacturing (AM) groups or indirect groups (P = 0.03, P = 0.00), in which wax or resin patterns are milled or printed before conventional casting. While milled RPDs fit significantly better than cast ones in the rest region (P = 0.00). With digital relief and heat treatment, hybrid manufactured (HM) clasps obtained better fit accuracy in the rest region (P < 0.05). In addition, finishing and polishing procedure had no significant influence in the fit accuracy in all groups (P = 0.83). CONCLUSIONS RPDs fabricated by digital technologies exhibit comparable fit accuracy in rest region with those made by CLW. Digital technologies may be a promising alternative to CLW for the fabrication of RPDs and additional studies are recommended to provide stronger evidence. TRIAL REGISTRATION CRD42020201313.
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Affiliation(s)
- Jiachao Qiu
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Qixiangtai Road No.12, Tianjin, 300070, P.R. China
| | - Wei Liu
- Department of Stomatology, North Sichuan Medical College, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, People's Republic of China
| | - Danfeng Wu
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Qixiangtai Road No.12, Tianjin, 300070, P.R. China
| | - Feng Qiao
- Department of Oral and Maxillofacial Surgery, Tianjin Medical University School and Hospital of Stomatology, Qixiangtai Road No.12, Tianjin, 300070, P.R. China
| | - Lei Sui
- Department of Prosthodontics, Tianjin Medical University School and Hospital of Stomatology, Qixiangtai Road No.12, Tianjin, 300070, P.R. China.
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Antohe ME, Dascălu CG, Forna DA, Hitruc EG, Cimpoeșu N, Forna NC. Research on the Quality of Partially Removable Skeletal Prostheses Made Using Classical Versus Modern Sintering Techniques. Biomedicines 2023; 11:2397. [PMID: 37760838 PMCID: PMC10525243 DOI: 10.3390/biomedicines11092397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023] Open
Abstract
Conventional partially removable skeletal dentures are one of the most common therapeutic solutions offered to edentulous patients worldwide. The present study aims to compare the skeleton of removable dentures realized via classical techniques to that realized via modern techniques, represented by the laser sintering technique, with the comparative aspects being realized through the evaluation of atomic force microscopy (AFM). A total of 20 metal frameworks made of Co-Cr were sectioned, representing the infrastructure of partially removable skeletal dentures, developed using the classical technique versus the laser sintering technique. The infrastructures of partially removable skeletal dentures were designed for both the maxilla and the mandible, with the design of each type of denture being identical, and were developed using both techniques. The roughness values are different depending on the technological method used; for the conventional casting technique, we have higher roughness for the component elements of the partially removable skeletal denture that have more stretch, e.g., the major connector, and for the 3D laser sintering technique, lower roughness is obtained for the component elements that have a lower stretch, e.g., the clasp arms, the minor connector, or the junction between the saddles and the major connector. The clinical implications of the presence of roughness at the level of the active arms or at the level of the connector saddle junction are represented by the risk of fracture, which confers real discomfort to the patient.
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Affiliation(s)
- Magda-Ecaterina Antohe
- 3rd Dental Medicine Department, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.-E.A.); (N.C.F.)
| | - Cristina Gena Dascălu
- Department of Medical Informatics, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania
| | - Doriana Agop Forna
- 1st Dental Medicine Department, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania
| | - Elena Gabriela Hitruc
- “Petru Poni” Institute of Macromolecular Chemistry, Aleea Grigore Ghica-Vodă, 41A, 700487 Iasi, Romania;
| | - Nicanor Cimpoeșu
- Faculty of Materials Science and Engineering, “Gheorghe Asachi” Technical University, Bulevardul Profesor Dimitrie Mangeron 67, 700050 Iasi, Romania;
| | - Norina Consuela Forna
- 3rd Dental Medicine Department, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.-E.A.); (N.C.F.)
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Rokhshad R, Mazaheri Tehrani A, Zarbakhsh A, Revilla-León M. Influence of fabrication method on the manufacturing accuracy and internal discrepancy of removable partial dentures: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00256-1. [PMID: 37474386 DOI: 10.1016/j.prosdent.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/06/2023] [Accepted: 04/06/2023] [Indexed: 07/22/2023]
Abstract
STATEMENT OF PROBLEM Removable partial dentures (RPDs) can be fabricated with conventional casting procedures or computer-aided design and computer-aided manufacturing (CAD-CAM) technologies; however, the manufacturing accuracy and internal discrepancy differences among these manufacturing methods remain uncertain. PURPOSE The purpose of this systematic review and meta-analysis was to assess the influence of the fabricating method (casting, milling, or additive manufacturing) on the accuracy and internal discrepancy of RPDs. MATERIAL AND METHODS An electronic search of the literature was performed in 6 databases: PubMed/Medline, Embase, Web of Science, Scopus, Cochrane, and Google Scholar. The studies that assessed the accuracy and internal discrepancy of RPDs fabricated from casting, milling, and additive manufacturing were included. Studies reporting gaps (mean) and standard deviations were included in the meta-analysis. Publication bias was identified using funnel plot asymmetry and the Egger test. RESULTS A total of 25 articles were included. The internal discrepancy of the additively manufactured RPDs ranged from 14.4 to 511 μm and from 7 to 419 μm in conventionally fabricated RPDs. For the milling method, 20 to 66 μm horizontal and 17 to 59 μm vertical discrepancies were reported. The Egger tests indicated no publication bias among the studies that were included in the meta-analysis. Four included studies resulted in more than the acceptable clinical gap (311 μm) for the CAD-CAM method. Independently of the manufacturing method, the greatest internal discrepancies reported were observed under the major connectors. RPDs fabricated by using CAD-CAM techniques required fewer clinical appointments, the RPD design was easier to reproduce, and laboratory time was less than with conventional procedures. However, the reviewed studies described several disadvantages, including limited RPD design programs, difficulties in defining the occlusal plane, expensive materials, and increased laboratory cost. CONCLUSIONS Additive and subtractive technologies provide accurate methods for RPD fabrication; however, all challenges, including limited design software programs have not yet been overcome, and casting is still needed when the framework pattern is milled or printed.
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Affiliation(s)
- Rata Rokhshad
- Researcher, Topic Group Dental Diagnostics and Digital Dentistry, ITU/WHO Focus Group AI on Health, Berlin, Germany; and Researcher, Department of Medicine, Section of Endocrinology, Boston University Medical Center, Boston, Mass
| | - Azita Mazaheri Tehrani
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Arash Zarbakhsh
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; and Adjunct Professor, Department of Prosthodontics, Tufts University, Boston, Mass
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13
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Adil H, Ahmed N, Heboyan A. Prosthetic rehabilitation of a patient with hemimandibulectomy by a double occlusal table prosthesis. SAGE Open Med Case Rep 2023; 11:2050313X231181976. [PMID: 37342420 PMCID: PMC10278425 DOI: 10.1177/2050313x231181976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/29/2023] [Indexed: 06/22/2023] Open
Abstract
The objective of prosthetic rehabilitation of patients with hemimandibulectomy is to regain the masticatory function, comfort, esthetics, and self-esteem. This article presents a plan for the management of hemimandibulectomy with a removable maxillary double occlusal table prosthesis. A male patient, aged 43 years, was referred to Prosthodontic Out Patient Department with complaints of compromised aesthetics, difficulty in speaking, and lack of ability to chew. The patient underwent surgery 3 years ago in which hemimandibulectomy was performed due to oral squamous cell carcinoma. The patient had a Cantor and Curtis Type II defect. The mandible was resected distally from canine region on the right side of the arch. A prosthodontic device was planned with a double occlusal table, also known as twin occlusion prosthesis. The rehabilitation of hemimandibulectomy patients with a double occlusal table is of considerable importance. This report describes a simple prosthetic device that will help patients in regaining their functional and psychological well-being.
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Affiliation(s)
- Huda Adil
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
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Ciocca L, Maltauro M, Pierantozzi E, Breschi L, Montanari A, Anderlucci L, Meneghello R. Evaluation of trueness and precision of removable partial denture metal frameworks manufactured with digital technology and different materials. J Adv Prosthodont 2023; 15:55-62. [PMID: 37153006 PMCID: PMC10154145 DOI: 10.4047/jap.2023.15.2.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/19/2023] [Accepted: 01/31/2023] [Indexed: 05/09/2023] Open
Abstract
PURPOSE The aim of this study is to evaluate the accuracy of removable partial denture (RPD) frameworks produced using different digital protocols. MATERIALS AND METHODS 80 frameworks for RPDs were produced using CAD-CAM technology and divided into four groups of twenty (n = 20): Group 1, Titanium frameworks manufactured by digital metal laser sintering (DMLS); Group 2, Co-Cr frameworks manufactured by DMLS; Group 3, Polyamide PA12 castable resin manufactured by multi-jet fusion (MJF); and Group 4, Metal (Co-Cr) casting by using lost-wax technique. After the digital acquisition, eight specific areas were selected in order to measure the Δ-error value at the intaglio surface of RPD. The minimum value required for point sampling density (0.4 mm) was derived from the sensitivity analysis. The obtained Δ-error mean value was used for comparisons: 1. between different manufacturing processes; 2. between different manufacturing techniques in the same area of interest (AOI); and 3. between different AOI of the same group. RESULTS The Δ-error mean value of each group ranged between -0.002 (Ti) and 0.041 (Co-Cr) mm. The Pearson's Chi-squared test revealed significant differences considering all groups paired two by two, except for group 3 and 4. The multiple comparison test documented a significant difference for each AOI among group 1, 3, and 4. The multiple comparison test showed significant differences among almost all different AOIs of each group. CONCLUSION All Δ-mean error values of all digital protocols for manufacturing RPD frameworks optimally fit within the clinical tolerance limit of trueness and precision.
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Affiliation(s)
- Leonardo Ciocca
- Oral and Maxillo-Facial Prosthodontics, Section of Prosthodontics, Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Mattia Maltauro
- Department of Management and Engineering, University of Padova, Vicenza, Italy
| | - Elena Pierantozzi
- Oral and Maxillo-Facial Prosthodontics, Section of Prosthodontics, Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Lorenzo Breschi
- Oral and Maxillo-Facial Prosthodontics, Section of Prosthodontics, Department of Biomedical and Neuromotor Science, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Angela Montanari
- Department of Statistical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Laura Anderlucci
- Department of Statistical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Roberto Meneghello
- Department of Management and Engineering, University of Padova, Vicenza, Italy
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Souza Curinga MR, Claudino Ribeiro AK, de Moraes SLD, do Egito Vasconcelos BC, da Fonte Porto Carreiro A, Pellizzer EP. Mechanical properties and accuracy of removable partial denture frameworks fabricated by digital and conventional techniques: A systematic review. J Prosthet Dent 2023:S0022-3913(23)00075-6. [PMID: 36870892 DOI: 10.1016/j.prosdent.2023.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 03/06/2023]
Abstract
STATEMENT OF PROBLEM Providing a removable partial denture (RPD) can be a complex, time-consuming, and error-prone procedure. Computer-aided design and computer-aided manufacturing (CAD-CAM) techniques have shown promising clinical outcomes; however, the influence of manufacturing techniques on the properties of RPD components is unclear. PURPOSE The purpose of this systematic review was to determine the accuracy and mechanical properties of RPD components fabricated with conventional and digital methods. MATERIAL AND METHODS This study followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) and was registered on the international prospective register of systematic reviews (PROSPERO) database (CRD42022353993). An electronic search was conducted on PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library in August 2022. Only in vitro studies comparing the digital with the lost-wax casting technique were included. The quality of the studies was assessed by using the methodological index for nonrandomized studies (MINORS) scale. RESULTS Of the 17 selected studies, 5 evaluated the accuracy of RPD components as well as the mechanical properties, 5 studies evaluated only the component accuracy, and another 7 evaluated only the mechanical properties. The accuracy was similar regardless of the technique, with discrepancies within clinically acceptable values (50 to 426.3 μm). The surface roughness was higher for 3D-printed clasps and lower for milled clasps (P<.05). The metal alloy significantly influenced the porosity, with the highest number of pores obtained by casting for Ti clasps and by rapid prototyping for Co-Cr clasps. CONCLUSIONS In vitro studies showed that the digital technique provided similar accuracy to that of the conventional technique within a clinically acceptable range. The manufacturing technique influenced the mechanical properties of RPD components.
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Affiliation(s)
| | | | - Sandra Lúcia Dantas de Moraes
- Associate Professor, Division of Oral Rehabilitation, Faculty of Dentistry, University of Pernambuco (UPE), Recife, PE, Brazil
| | | | | | - Eduardo Piza Pellizzer
- Full Professor, Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Araçatuba, SP, Brazil
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16
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Hwang S, An S, Robles U, Rumpf RC. Process parameter optimization for removable partial denture frameworks manufactured by selective laser melting. J Prosthet Dent 2023; 129:191-198. [PMID: 34119322 DOI: 10.1016/j.prosdent.2021.04.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 01/18/2023]
Abstract
STATEMENT OF PROBLEM Selective laser melting (SLM), an additive manufacturing technology, is expected to replace the traditional lost-wax casting process used in producing removable partial denture (RPD) frameworks. However, studies comparing the accuracy of RPD frameworks and the effects of process parameters are lacking. PURPOSE The purpose of this in vitro study was to optimize SLM process parameters and use a quantitative analysis method to improve the accuracy of 3D-printed RPD frameworks. MATERIAL AND METHODS The orientation and support structure of Kennedy Class II RPDs were designed in various ways by using 2 different software programs, CAMbridge and Magics. The optimum melt-pool parameters, including laser power, scan speed, hatch distance, and layer thickness, were determined empirically before manufacturing 12 RPD frameworks with 4 different process designs by using SLM (n=3). The accuracy of the RPD frameworks was determined by 3D scanning and comparing the 3D scan data with the original standard tessellation language (STL) RPD design with the best-fit algorithm of the Geomagic software program. RESULTS Optimum melt-pool parameters were found with the function of density, surface roughness, and productivity (P=180 W, v=1200 mm/s, h=60 μm, t=30 μm). RPD frameworks fabricated by the optimized process parameters (167 ±105 μm) showed significantly better (P<.05) mean ±standard deviation accuracy than the 3 other groups of RPD frameworks manufactured by using the nonoptimized process parameters (180 ±121 μm to 222 ±136 μm). The best accuracy was found with the transverse orientation and interconnected support structure. CONCLUSIONS With the optimized design of process parameters, clinically acceptable RPD frameworks were produced. The accuracy of RPD frameworks fabricated by using SLM varied according to the design of the process parameters, indicating that SLM technology can replace the traditional lost-wax casting process.
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Affiliation(s)
- Seyeon Hwang
- Team Manager, ICT Business Division, Dentium Co, Ltd, Suwon, Gyeonggi-do, Republic of Korea.
| | - Sangsup An
- Director, ICT Business Division, Dentium Co, Ltd, Suwon, Gyeonggi-do, Republic of Korea
| | - Ubaldo Robles
- Principal Research Engineer, Department of Electrical and Computer Engineering, The University of Texas at El Paso, El Paso, Texas
| | - Raymond C Rumpf
- Full Professor, Department of Electrical and Computer Engineering, The University of Texas at El Paso, El Paso, Texas
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17
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Al Hamad KQ, Al-Rashdan BA, Ayyad JQ, Al Omrani LM, Sharoh AM, Al Nimri AM, Al-Kaff FT. Additive Manufacturing of Dental Ceramics: A Systematic Review and Meta-Analysis. J Prosthodont 2022; 31:e67-e86. [PMID: 35675133 DOI: 10.1111/jopr.13553] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/29/2022] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the effect of using additive manufacturing (AM) for dental ceramic fabrication in comparison with subtractive manufacturing (SM), and to evaluate the effect of the type of AM technology on dental ceramic fabrication. MATERIALS AND METHODS A search was conducted electronically in MEDLINE (via PubMed), EBSCOhost, Scopus, and Cochran Library databases, and also by other methods (table of contents screening, backward and forward citations, and grey literature search) up to February 12, 2022, to identify records evaluating additive manufacturing of ceramics for dental purposes in comparison with subtractive manufacturing. A minimum of 2 review authors conducted tstudy selection, quality assessment, and data extraction. Quality assessment was performed with Joanna Briggs Institute tool, and the quantitative synthesis was performed with the Comprehensive Meta-Analysis program (CMA, Biostat Inc). Hedges's g for effect size was calculated, with 0.2 as small, 0.5 as medium, and 0.8 as large. Heterogeneity was assessed with I2 and prediction interval (PI) statistics. Publication bias was investigated with funnel plots and grey literature search. Certainty of evidence was assessed with the Grading of Recommendations: Assessment, Development, and Evaluation (GRADE) tool. RESULTS A total of 28 studies were included for the qualitative and quantitative synthesis; 11 in vitro studies on accuracy, 1 in vivo study on color, and 16 in vitro studies on physical and mechanical properties. Meta-analysis showed overall higher accuracy for SM compared with AM, with medium effect size (0.679, CI: 0.173 to 1.185, p = 0.009) and also for marginal (g = 1.05, CI: 0.344 to 1.760, p = 0.004), occlusal (g = 2.24, CI: 0.718 to 3.766, p = 0.004), and total (g = 4.544, CI: -0.234 to 9.323, p = 0.062) with large effect size; whereas AM had higher accuracy than SM with small effect size for the external (g = -0.238, CI: -1.215 to 0.739), p = 0.633), and internal (g = -0.403, CI: -1.273 to 0.467, p = 0.364) surfaces. For technology, self-glazed zirconia protocol had the smallest effect size (g = -0.049, CI: -0.878 to 0.78, p = 0.907), followed by stereolithography (g = 0.305, CI: -0.289 to 0.9, p = 0.314), and digital light processing (g = 1.819, CI: 0.662 to 2.976, p = 0.002) technologies. Flexural strength was higher for ceramics made by SM in comparison to AM with large effect size (g = -2.868, CI: -4.371 to -1.365, p < 0.001). Only 1 study reported on color, favoring ceramics made through combined AM and SM. CONCLUSIONS Subtractive manufacturing had better overall accuracy, particularly for the marginal and occlusal areas, higher flexural strength, and more favorable hardness, fracture toughness, porosity, fatigue, and volumetric shrinkage; whereas AM had more favorable elastic modulus and wettability. Both methods had favorable biocompatibility. All studies on accuracy and mechanical properties were in vitro, with high heterogeneity and low to very low certainty of evidence. There is a lack of studies on color match and esthetics.
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Affiliation(s)
- Khaled Q Al Hamad
- Department of Prosthodontics, Jordan University of Science & Technology, Irbid, Jordan
| | | | - Jad Q Ayyad
- Department of Prosthodontics, Jordan University of Science & Technology, Irbid, Jordan
| | - Leen M Al Omrani
- Department of Prosthodontics, Jordan University of Science & Technology, Irbid, Jordan
| | - Ayat M Sharoh
- Department of Prosthodontics, Jordan University of Science & Technology, Irbid, Jordan
| | - Adnan M Al Nimri
- Department of Prosthodontics, Jordan University of Science & Technology, Irbid, Jordan
| | - Fatma T Al-Kaff
- Department of Prosthodontics, Jordan University of Science & Technology, Irbid, Jordan
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Alabdullah SA, Hannam AG, Wyatt CC, McCullagh AP, Aleksejuniene J, Mostafa NZ. Comparison of digital and conventional methods of fit evaluation of partial removable dental prosthesis frameworks fabricated by selective laser melting. J Prosthet Dent 2022; 127:478.e1-478.e10. [DOI: 10.1016/j.prosdent.2021.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
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Yoon JM, Liu Y, Liu Y, Sun Y, Ye H, Zhou Y. The accuracy of a novel 3D digital evaluation method of intraoral fitness for removable partial dentures. Comput Biol Med 2022; 144:105348. [DOI: 10.1016/j.compbiomed.2022.105348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/27/2022]
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Oh KC, Yun BS, Kim JH. Accuracy of metal 3D printed frameworks for removable partial dentures evaluated by digital superimposition. Dent Mater 2021; 38:309-317. [PMID: 34969522 DOI: 10.1016/j.dental.2021.12.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 11/30/2021] [Accepted: 12/08/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To evaluate the accuracy of metal 3D printed frameworks (MEP group) for removable partial dentures (RPDs) by digital superimposition, in comparison to that of frameworks produced by the conventional (CON group) and resin printing/casting (RPC group) workflows. METHODS A partially edentulous maxillary dentiform was prepared with rest seats and guiding planes on the right canine, left first premolar, and left second molar. Thirty master casts were prepared via repeated impressions of the dentiform. Frameworks were fabricated by three different workflows (n = 10 for each group). The internal discrepancies of the frameworks were assessed at 12 points by digital scanning with an optical triangulation principle-based tabletop scanner and superimposition using a reference best-fit alignment method. First, the master cast was scanned alone. Subsequently, a thin silicone material was applied to the framework and fitted onto the master cast, after which the framework was removed. Finally, the master cast with the silicone material attached was rescanned. The data from the two scans were matched, with the reference being the area not occupied by the silicone. RESULTS For the CON, MEP, and RPC groups, respectively, the mean overall internal discrepancies (279.72 µm, 241.02 µm, and 331.70 µm), and the mean internal discrepancies on palate areas (292.92 µm, 250.72 µm, and 355.84 µm) and rest seat areas (240.12 µm, 211.91 µm, and 259.26 µm) did not significantly differ among the three fabrication methods (p = 0.558, 0.542, and 0.774). SIGNIFICANCE The reference best-fit alignment of scan datasets is a useful approach to evaluate the internal discrepancy of frameworks. Metal 3D printing produces RPD frameworks that are comparable to conventional frameworks and meet clinical standards.
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Affiliation(s)
- Kyung Chul Oh
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Republic of Korea.
| | - Byoung Soo Yun
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Republic of Korea.
| | - Jee-Hwan Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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21
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MAI HAIYEN, MAI HANGNGA, KIM HOJIN, LEE JAESIK, LEE DUHYEONG. ACCURACY OF REMOVABLE PARTIAL DENTURE METAL FRAMEWORKS FABRICATED BY COMPUTER-AIDED DESIGN/ COMPUTER-AIDED MANUFACTURING METHOD: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2021; 22:101681. [DOI: 10.1016/j.jebdp.2021.101681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/07/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
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22
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Asakura M, Ueno A, Hayashi T, Kawai T. Accuracy of a titanium maxillary complete denture baseplate fabricated by using the electron beam melting technique: An in vitro study. J Prosthet Dent 2021; 126:710.e1-710.e7. [PMID: 34561095 DOI: 10.1016/j.prosdent.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Electron beam melting (EBM) is a promising additive manufacturing technique for fabricating denture baseplates; however, studies evaluating its accuracy are sparse. PURPOSE The purpose of this in vitro study was to compare the fit accuracy of titanium maxillary complete denture baseplates fabricated by using the EBM technique with those fabricated by using the conventional casting technique and to evaluate the dimensional accuracy of the EBM baseplate by using a 3-dimensional inspection software program. MATERIAL AND METHODS Definitive casts of an edentulous maxilla were prepared. After the casts were optically scanned, computer-aided designs for the EBM baseplate were created by using a software program for standard tessellation language file editing. The EBM baseplates were fabricated with an EBM machine by using a Grade II titanium powder as the raw material. The cast baseplates were fabricated with a lost-wax casting technique by using refractory casts duplicated from the definitive casts. After fitting the EBM and cast baseplates to their corresponding definitive cast, they were embedded in a Type IV stone. The embedded baseplates on the casts were sectioned at 3 regions: posterior palatal seal, molar, and premolar. The maximum gaps between the baseplate and definitive cast were measured in these 3 regions. The virtual casts obtained by scanning the EBM baseplate were superimposed on the computer-aided design to evaluate the dimensional accuracy. Distribution color maps were then generated, and the mean absolute deviations and root mean square deviations were calculated. One-way analysis of variance and t tests were used for statistical analysis (α=.05). RESULTS No significant differences in the maximum gaps among the 3 regions were found in the cast or EBM baseplate groups (P>.05). The EBM baseplate group showed significantly lower values than the cast baseplate group in all regions (premolar: P=.008; molar: P=.003; posterior palatal seal: P=.004). The mean maximum gap for the 3 regions in the cast baseplates was 168.0 μm and that in the EBM baseplates was 60.7 μm. The distribution color map of the EBM baseplate showed a favorable dimensional accuracy. The mean absolute deviation value was 19.7 μm, and the root mean square deviation value was 25.1 μm. CONCLUSIONS The EBM baseplates had a significantly higher fit accuracy than the cast baseplates. Thus, the fit accuracy of the EBM technique is suitable for fabricating metal baseplates.
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Affiliation(s)
- Masaki Asakura
- Assistant Professor, Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, Nagoya, Japan
| | - Atsuko Ueno
- Assistant Professor, Department of Gerodontology and Home Care Dentistry, Aichi Gakuin University School of Dentistry, Nagoya, Japan
| | - Tatsuhide Hayashi
- Associate Professor, Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, Nagoya, Japan.
| | - Tatsushi Kawai
- Professor, Department of Dental Materials Science, Aichi Gakuin University School of Dentistry, Nagoya, Japan
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23
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Fit Accuracy of Removable Partial Denture Frameworks Fabricated with CAD/CAM, Rapid Prototyping, and Conventional Techniques: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2021; 2021:3194433. [PMID: 34532499 PMCID: PMC8440078 DOI: 10.1155/2021/3194433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/20/2021] [Accepted: 08/16/2021] [Indexed: 11/18/2022]
Abstract
Objective Analyzing and comparing the fit and accuracy of removable partial denture (RPDs) frameworks fabricated with CAD/CAM and rapid prototyping methods with conventional techniques. Materials and Methods The present systematic review was carried out according to PRISMA guidelines. The search was carried out on PubMed/MEDLINE, Cochrane collaboration, Science direct, and Scopus scientific engines using selected MeSH keywords. The articles fulfilling the predefined selection criteria based on the fit and accuracy of removable partial denture (RPD) frameworks constructed from digital workflow (CAD/CAM; rapid prototyping) and conventional techniques were included. Results Nine full-text articles comprising 6 in vitro and 3 in vivo studies were included in this review. The digital RPDs were fabricated in all articles by CAD/CAM selective laser sintering and selective laser melting techniques. The articles that have used CAD/CAM and rapid prototyping technique demonstrated better fit and accuracy as compared to the RPDs fabricated through conventional techniques. The least gaps between the framework and cast (41.677 ± 15.546 μm) were found in RPDs constructed through digital CAD/CAM systems. Conclusion A better accuracy was achieved using CAD/CAM and rapid prototyping techniques. The RPD frameworks fabricated by CAD/CAM and rapid prototyping techniques had clinically acceptable fit, superior precision, and better accuracy than conventionally fabricated RPD frameworks.
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Gentz FI, Brooks DI, Liacouras PC, Petrich A, Hamlin CM, Ellert DO, Ye L. Retentive Forces of Removable Partial Denture Clasp Assemblies Made from Polyaryletherketone and Cobalt-Chromium: A Comparative Study. J Prosthodont 2021; 31:299-304. [PMID: 34081360 DOI: 10.1111/jopr.13398] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To compare retentive forces of removable partial denture clasps traditionally fabricated with cobalt-chromium (CoCr) material and two computer-aided design and computer-aided manufactured (CAD/CAM) thermoplastic polymers. MATERIALS AND METHODS Forty-eight clasp assemblies (16 CoCr, 16 polyetheretherketone (PEEK) and 16 polyetherketoneketone (PEKK) thermoplastic polymer) were fabricated for 48 mandibular tooth analogs. Individual clasps were inserted and removed on the tooth analogs utilizing a chewing simulator for 15,000 cycles to simulate 10 years of use. Retentive forces were measured utilizing a mechanical load tester at baseline and intervals of 1500 cycles. Data were analyzed with one-way Analysis of Variance, Tukey post-hoc, and paired T tests. RESULTS Mean retentive forces between all groups were significantly different (p < 0.001). Retentive forces of CoCr clasps were significantly higher than both polymers (p < 0.001). The mean retentive forces for PEEK were not significantly different from PEKK (p = 0.23). A significant increase in retentive forces was observed for all three clasps after the first period of cycling, followed by continual decrease for the remaining cycles. At the endpoint of 15,000 cycles, no clasp assemblies showed lower retentive forces than at initial baseline. CONCLUSION Thermoplastic polymer clasps demonstrated lower retentive forces compared to CoCr clasps. All three groups displayed a similar pattern of initial increase, followed by a gradual decrease, of retentive force. Despite this observation, the clasps maintained similar or higher retentive forces than measured at baseline. This resistance to fatigue and ability to fabricate with CAD/CAM technologies provides support for clinical use of these high-performance polymer (HPP) materials.
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Affiliation(s)
- Frank I Gentz
- Prosthodontics Department, Naval Postgraduate Dental School, Naval Medical Leader & Professional Development Command; Postgraduate Dental College, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Daniel I Brooks
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, MD
| | - Peter C Liacouras
- 3D Medical Applications Center, Department of Radiology, Walter Reed National Military Medical Center, Bethesda, MD.,Naval Postgraduate Dental School, Bethesda, MD
| | - Anton Petrich
- Prosthodontics Department, Naval Postgraduate Dental School, Naval Medical Leader & Professional Development Command; Postgraduate Dental College, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Christopher M Hamlin
- Prosthodontics Department, Naval Postgraduate Dental School, Naval Medical Leader & Professional Development Command; Postgraduate Dental College, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Daniel O Ellert
- Prosthodontics Department, Naval Postgraduate Dental School, Naval Medical Leader & Professional Development Command; Postgraduate Dental College, Uniformed Services University of Health Sciences, Bethesda, MD
| | - Ling Ye
- Research Department, Naval Postgraduate Dental School, Naval Medical Leader & Professional Development Command; Postgraduate Dental College, Uniformed Services University of Health Sciences, Bethesda, MD
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尹 祯, 王 子, 陈 俊, 孙 玉, 刘 云, 叶 红, 周 永. [Evaluation of methods for fitness of removable partial denture]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:406-412. [PMID: 33879919 PMCID: PMC8072425 DOI: 10.19723/j.issn.1671-167x.2021.02.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To compare the differences and indications of three evaluation methods for fitness evaluation of removable partial denture (RPD). METHODS A RPD was fabricated and seated on the stone cast of a partially edentulous mandible, and the spaces between RPD and stone cast were recorded with polyvinyl siloxane (PVS) impression material forming PVS replicas. Using cross sectional measurement, the average thicknesses of PVS replicas were measured under stereomicroscope with different numbers of selected measuring points in the denture base, major connector, occlusal rest of the RPD, and the average thicknesses of the PVS replicas measured with different numbers of measuring points were compared using one-way analysis of variance (ANOVA) and independent sample t test. Three kinds of method, including cross sectional measurement, three-dimensional analysis on the stone cast, and three-dimensional analysis on the polyether cast, were applied to measure the average thicknesses of the PVS replicas, and the average thicknesses of the PVS replicas measured by these three evaluation methods were compared with ANOVA. RESULTS For cross sectional measurement, statistically significant differences were found in the average thicknesses of the PVS replicas in the denture base and the major connector among the different numbers of measuring points (P < 0.05), but no differences were found in the average thicknesses of the PVS replicas in the occlusal rest (P>0.05). There were significant differences among the average thicknesses of the PVS replicas measured by these three evaluation methods in each component of the RPD (P < 0.01). The average thickness measured by three-dimensional analysis on the stone cast and three-dimensional analysis on polyether cast were smaller than that measured by cross sectional measurement (P < 0.05). And there were no differences between the average thicknesses of PVS replicas measured by three-dimensional analysis on stone cast and three-dimensional analysis on polyether cast (P>0.05). CONCLUSION For cross sectional measurement, the average thickness of the PVS replicas was influenced by the number of measuring points, and the measurement accuracy of cross sectional measurement was not reliable enough. Three-dimensional analysis on stone cast which is suitable for evaluation in vitro and three-dimensional analysis on polyether cast which is suitable for evaluation in vivo can evaluate the fitness of RPD more comprehensively and effectively than that of cross sectional measurement.
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Affiliation(s)
- 祯敏 尹
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 子轩 王
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 俊锴 陈
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 玉春 孙
- 北京大学口腔医学院·口腔医院,口腔医学数字化研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 云松 刘
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 红强 叶
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 永胜 周
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Baig MR, Omar R. Association of fit of partial denture metal framework with various framework design features using alginate as a final impression material: A prospective clinical study. J Dent 2021; 107:103608. [PMID: 33609613 DOI: 10.1016/j.jdent.2021.103608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/30/2020] [Accepted: 02/12/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To assess the fit of PRDP frameworks fabricated using alginate as a final impression material in metal stock trays, in terms of number of fabricated frameworks needed until realization of clinically adequate fit. Also, any association of framework fit achieved with its design features, namely major connector design, and numbers of guide plates and occlusal/incisal rests was investigated. METHODS 147 partially dentate patients were provided with Co-Cr PRDPs, in single or both arches, by undergraduate dental students. Final impressions were made with alginate in metal stock trays. At metal framework try-in, clinical examinations were carried out by two prosthodontists and relevant information noted with regard to proper fit. The relationship between three PRDP design features and number of frameworks that needed to be made in each case to achieve satisfactory fit was determined using factorial analysis of variance (ANOVA) (α = 0.05). RESULTS 86% (148) of the 173 frameworks fabricated were found to be clinically satisfactory at the first try-in visit (with or without any chairside adjustment). The remaining 14% (25) required new impressions for re-fabrication and passed at the second attempt. None of the examined design features were significantly associated with the number of construction attempts needed, for all 173 arches, or when maxillary and mandibular arches were considered independently (p > 0.05). CONCLUSIONS PRDP design features were not associated with the level of accuracy of fit achieved. CLINICAL SIGNIFICANCE Alginate in metal stock trays seems to be acceptable for final impressions of all types of Co-Cr PRDP designs with just 1 in 7 castings not fitting after chairside adjustment.
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Affiliation(s)
- Mirza Rustum Baig
- Department of Restorative Sciences (Prosthodontics), Faculty of Dentistry, Kuwait University, Kuwait.
| | - Ridwaan Omar
- Department of Restorative Sciences (Prosthodontics), Faculty of Dentistry, Kuwait University, Kuwait
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Pordeus MD, Santiago Junior JF, Venante HS, Bringel da Costa RM, Chappuis Chocano AP, Porto VC. Computer-aided technology for fabricating removable partial denture frameworks: A systematic review and meta-analysis. J Prosthet Dent 2021; 128:331-340. [PMID: 33581866 DOI: 10.1016/j.prosdent.2020.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM A consensus that establishes the indications and clinical performance of removable partial denture (RPD) frameworks designed and manufactured with computer-aided design and computer-aided manufacturing (CAD-CAM) systems is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the currently published literature investigating different CAD-CAM methods and techniques for RPD manufacturing and their clinical performance. MATERIAL AND METHODS A comprehensive search of studies published up to September 2019 was performed in PubMed/MEDLINE, Web of Science, Cochrane Library, and SciELO databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA Statement) criteria and was registered and approved in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020152197). The population, intervention, comparison, outcome (PICO) question was "Do the CAD-CAM frameworks have similar performances to those fabricated by conventional techniques?" The meta-analysis included clinical and in vitro studies based on the effect size and test of Null (2-Tail) with 95% confidence interval (CI). Clinical and in vitro studies were selected and analyzed separately. RESULTS A total of 15 articles out of 358 were selected. For clinical studies, quantitative analysis with a sample of 25 participants showed a mean discrepancy between occlusal rests and rest seats of 184.91 μm (95% CI: 152.6 μm-217.15 μm) and heterogeneity (I2) of 0%. Clinical data considered that frameworks were acceptable for continuity of treatment. The predominant materials were cobalt-chromium (Co-Cr) and polyetheretherketone (PEEK), and studies using Co-Cr reported that the structure required adjustments. In addition, it has been reported that the indirect technique was time-consuming and selective laser melting (SLM) can be costly. PEEK structures have been more widely accepted because of improved esthetics. Quantitative data from the in vitro studies revealed that the additive manufacturing technique (2.006 mm: 95% CI: -2.021 mm to 6.032 mm) was not significantly different from the indirect technique (0.026 mm; P=.455; random: I2: 98.402%). CONCLUSIONS Clinical studies and in vitro research on CAD-CAM planning and manufacturing of removable prosthesis frameworks are still sparse. However, preliminary data indicate a similar fit and esthetic improvement when compared with the conventional technique.
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Affiliation(s)
- Mariana Domingues Pordeus
- MSc student, Dental School of Bauru, FOB-USP - University of São Paulo, Octávio Pinheiro Brisolla, Jardim Brasil, Bauru, São Paulo, Brazil
| | | | - Helena Sandrini Venante
- PhD student, Dental School of Bauru, FOB-USP - University of São Paulo, Bauru, São Paulo, Brazil.
| | | | | | - Vinicius Carvalho Porto
- Associate Professor, Dental School of BauruFOB-USP - University of São Paulo, Bauru, São Paulo, Brazil
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Fueki K, Inamochi Y, Wada J, Arai Y, Takaichi A, Murakami N, Ueno T, Wakabayashi N. A systematic review of digital removable partial dentures. Part I: Clinical evidence, digital impression, and maxillomandibular relationship record. J Prosthodont Res 2021; 66:40-52. [PMID: 33504721 DOI: 10.2186/jpr.jpr_d_20_00116] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study comprehensively reviewed the current status of digital workflows in fabricating removable partial dentures (RPDs) using evidence from clinical trials and case reports. STUDY SELECTION We performed a systematic review of the literature on the materials and fabrication of RPDs using digital technologies published in online databases from 1980 to 2020. We selected eligible articles from the search results, retrieved information on digital RPDs from these, and conducted a qualitative analysis. We report evidence from clinical papers and case reports, digital impression-taking methods, and maxillomandibular relationship (MMR) records. RESULTS A case report electronically published in 2019 introduced a clasp-retained RPD fabricated via a full-digital workflow without a gypsum definitive cast. Computer-aided design and computer-aided manufacturing of double-crown-retained RPDs with nonmetal materials were described in some case reports. Intraoral scanners were used to obtain digital impressions and MMR records in the fabrication of digital RPDs, which have potential advantages for reducing the number of clinical appointments and simplifying laboratory procedures. Evidence from clinical trials is scarce; a randomized controlled trial reported higher patient satisfaction with digital clasp-retained RPDs than with conventional RPDs. CONCLUSIONS Full-digital RPDs can be fabricated without a gypsum definitive cast. However, the indication for full-digital RPDs is limited to cases with Kennedy Class III/IV partially edentulous arches with several missing teeth. Challenges in digital impression-taking and MMR recording remain to be solved to extend these indications. More evidence from clinical trials is required to evaluate the efficacy and usefulness of digital R PDs.
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Affiliation(s)
- Kenji Fueki
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Yuka Inamochi
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Junichiro Wada
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Yuki Arai
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Atsushi Takaichi
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Natsuko Murakami
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Takeshi Ueno
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Noriyuki Wakabayashi
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
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Takaichi A, Fueki K, Murakami N, Ueno T, Inamochi Y, Wada J, Arai Y, Wakabayashi N. A systematic review of digital removable partial dentures. Part II: CAD/CAM framework, artificial teeth, and denture base. J Prosthodont Res 2021; 66:53-67. [PMID: 33504722 DOI: 10.2186/jpr.jpr_d_20_00117] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study comprehensively reviewed the current status of the digital workflow of removable partial dentures (RPDs) and summarized information about the fabrication methods and material properties of the dental framework, artificial teeth, and denture base. STUDY SELECTION We performed a systematic review of the literature published in online databases from January 1980 to April 2020 regarding RPD fabrication and materials used in the related digital technology. We selected eligible articles, retrieved information regarding digital RPDs, and conducted qualitative/quantitative analyses. In this paper, the computer-aided design/computer-aided manufacturing (CAD/CAM) framework, artificial teeth, and denture base materials are reported. RESULTS A variety of materials, such as cobalt-chromium alloy, titanium, zirconia, and polyether ether ketone, are used for dental CAD/CAM frameworks. The mechanical strength of the metal materials used for the CAD/CAM framework was superior to that of the cast framework. However, the fitness and surface roughness of the framework and clasp fabricated using a selective laser melting (SLM) method were not superior to those obtained via cast fabrication. Most material properties and the surface roughness of poly methyl methacrylate (PMMA) discs used for digital RPDs were superior to those of heat-cured PMMA. CONCLUSIONS The use of a CAD/CAM framework and PMMA disc for digital RPDs offers numerous advantages over conventional RPDs. However, technical challenges regarding the accuracy and durability of adhesion between the framework and denture base remain to be solved. In digital fabrication, human technical factors influence the quality of the framework.
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Affiliation(s)
- Atsushi Takaichi
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Kenji Fueki
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Natsuko Murakami
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Takeshi Ueno
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Yuka Inamochi
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Junichiro Wada
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Yuki Arai
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
| | - Noriyuki Wakabayashi
- Department of Removable Partial Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo
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Al Mortadi N, Alzoubi KH, Williams R. A Scoping Review on the Accuracy of Fit of Removable Partial Dentures in a Developing Digital Context. Clin Cosmet Investig Dent 2020; 12:551-562. [PMID: 33244275 PMCID: PMC7683352 DOI: 10.2147/ccide.s282300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/20/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of this paper is to evaluate studies on the quality of fit of alloy removable-partial-dentures (RPDs) produced by computer-aided design/computer-aided manufacturing (CAD/CAM) and rapid prototyping (RP) technology. This paper offers a comprehensive scoping review of various methods of assessing the quality of fit of RPDs in the context of a developing digital approach to manufacturing and assessment. Methodology/Approach A search was made using MEDLINE/PubMed, Scopus, and Science Direct to identify the studies of the accuracy of fit of RPDs. Findings Optical and physical examination of dentures “in situ” on the model or in the patient’s oral cavity were the most commonly used methods for the assessment of fit of RPDs. Eighteen of the included studies assessed the internal fit between RPDs and oral tissues or models using either polyvinyl silicone materials as filler, calipers, photographs, and microscopes or a combination of these. Two studies used visual assessment. Most studies reported that the fit of RPDs ranged from satisfactory to excellent. However, many of these assessments seemed somewhat subjective and flawed with regard to assessing indentations of the framework into a model or distortion. Two papers used a new method of computer-based superimposition which included a color map of discrepancies to assess the fit of the machine-produced RPDs offering possibilities to quantify the assessment of fit, perhaps leading to a more objective assessment. Despite the limited number of clinical trials, the available evidence was thought to reinforce the claim that the fit of RPDs fabricated digitally was acceptable. Conclusion The recent introduction of color maps to compare the differences between the fitting surface and the model is promising. However, a new method for displaying discrepancies shown by color maps is introduced, which could lead to a more quantitative assessment.
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Affiliation(s)
- Noor Al Mortadi
- Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Robert Williams
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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Tasaka A, Okano H, Shimizu T, Kato Y, Higuchi S, Yamashita S. Influence of reinforcement bar on accuracy of removable partial denture framework fabricated by casting with a 3D-printed pattern and selective laser sintering. J Prosthodont Res 2020; 65:213-218. [PMID: 32938855 DOI: 10.2186/jpr.jpor_2020_10] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this study was to investigate the accuracy of removable partial denture frameworks fabricated by 3D-printed pattern casting (AM-Cast) and selective laser sintering (SLS) under different co nditions with a reinforcement bar. METHODS A partially edentulous model was scanned with a dental laboratory scanner, and CAD software was used to design the framework. Reinforcement bars (n=0-2) were set on the lingual side of the framework. 3D scanning of the fabricated frameworks by AM-Cast and SLS was performed, and the obtained data were overlapped with the design data. The differences in shape among setting conditions of the bar were statistically compared using the Bonferroni method after the Kruskal-Wallis test. RESULTS The ranges in differences of the AM-Cast-0, AM-Cast-1, and AM-Cast-2 were -0.167 to 0.128 mm, -0.101 to 0.105 mm, and -0.185 to 0.015 mm, respectively. The ranges of SLS-0, SLS-1, and SLS-2 were -0.166 to 0.035 mm, -0.182 to 0.049 mm, and -0.138 to 0.038 mm, respectively. Large discrepancies were observed at the joining area of the lingual bar on the right side of the AM-Cast. A significant difference was found between the AM-Cast-0 and AM-Cast-1, and between the AM-Cast-0 and AM-Cast-2. CONCLUSIONS The setting conditions of the reinforcement bar affected the accuracy of the lingual bar in the AM-Cast; however, no effect was observed on the displacement of the central area of the lingual bar in SLS. Setting a single reinforcing bar on the retentive latticework contributed to improving the accuracy of the lingual bar in the AM-Cast but not the displacement of the central area of the lingual bar in SLS.
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Affiliation(s)
- Akinori Tasaka
- Department of Removable Partial Prosthodontics, Tokyo Dental College, Tokyo.,Oral Health Science Center, Tokyo Dental College, Tokyo
| | - Haruna Okano
- Department of Removable Partial Prosthodontics, Tokyo Dental College, Tokyo
| | - Takahiro Shimizu
- Department of Removable Partial Prosthodontics, Tokyo Dental College, Tokyo
| | - Yoshimitsu Kato
- Department of Removable Partial Prosthodontics, Tokyo Dental College, Tokyo
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Oh KC, Jeon J, Kim JH. Fabrication of a removable partial denture combining conventional and digital techniques. J Prosthet Dent 2020; 125:588-591. [PMID: 32331784 DOI: 10.1016/j.prosdent.2020.01.046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 01/28/2020] [Accepted: 01/28/2020] [Indexed: 11/26/2022]
Abstract
This article describes a combined conventional and digital workflow for fabricating removable partial dentures (RPDs). After scanning the dental cast and RPD framework assembly, artificial teeth and denture base regions were designed using computer-aided design software. The artificial teeth and denture base assembly was milled as a single structure by using a wax disk and then placed on the RPD framework. The artificial teeth were additionally milled from a polymethyl methacrylate disk. Conventional procedures were followed for denture investment until the wax elimination procedure, after which the assembly was replaced with the artificial teeth in the cope of the flasks, and the denture resin material was injected to process the RPD. This technique enabled the RPD to be fabricated in the same form as the design state.
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Affiliation(s)
- Kyung Chul Oh
- Clinical Assistant Professor, Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jeongho Jeon
- Certified Dental Technician, Central Dental Laboratory, Yonsei University Dental Hospital, Seoul, Republic of Korea
| | - Jee-Hwan Kim
- Associate Professor, Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Tasaka A, Shimizu T, Kato Y, Okano H, Ida Y, Higuchi S, Yamashita S. Accuracy of removable partial denture framework fabricated by casting with a 3D printed pattern and selective laser sintering. J Prosthodont Res 2020; 64:224-230. [DOI: 10.1016/j.jpor.2019.07.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/18/2019] [Accepted: 07/22/2019] [Indexed: 11/30/2022]
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Tasaka A, Uekubo Y, Mitsui T, Kasahara T, Takanashi T, Homma S, Matsunaga S, Abe S, Yoshinari M, Yajima Y, Sakurai K, Yamashita S. Applying intraoral scanner to residual ridge in edentulous regions: in vitro evaluation of inter-operator validity to confirm trueness. BMC Oral Health 2019; 19:264. [PMID: 31791324 PMCID: PMC6889518 DOI: 10.1186/s12903-019-0918-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/20/2019] [Indexed: 11/17/2022] Open
Abstract
Background The purpose of this study was to investigate the trueness of intraoral scanning of residual ridge in edentulous regions during in vitro evaluation of inter-operator validity. Methods Both edentulous maxillary and partially edentulous mandibular models were selected as a simulation model. As reference data, scanning of two models was performed using a dental laboratory scanner (D900, 3Shape A/S). Five dentists used an intraoral scanner (TRIOS 2, 3Shape A/S) five times to capture intraoral scanner data, and the “zig-zag” scanning technique was used. They did not have experience with using intraoral scanners in clinical treatment. The intraoral scanner data was overlapped with the reference data (Dental System, 3Shape A/S). Regarding differences that occurred between the reference and intraoral scanner data, the vertical maximum distance of the difference and the integral value obtained by integrating the total distance were analyzed. Results In terms of the maximum distances of the difference on the maxillary model, the means of five operators were as follows: premolar region, 0.30 mm; molar region, 0.18 mm; and midline region, 0.18 mm. The integral values were as follows: premolar region, 4.17 mm2; molar region, 6.82 mm2; and midline region, 4.70 mm2. Significant inter-operator differences were observed with regard to the integral values of the distance in the premolar and midline regions and with regard to the maximum distance in the premolar region, respectively. The maximum distances of the difference in the free end saddles on mandibular model were as follows: right side, 0.05 mm; and left side, 0.08 mm. The areas were as follows: right side, 0.78 mm2; and left side, 1.60 mm2. No significant inter-operator differences were observed in either region. Conclusions The present study demonstrated satisfactory trueness of intraoral scanning of the residual ridge in edentulous regions during in vitro evaluation of inter-operator validity.
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Affiliation(s)
- Akinori Tasaka
- Department of Removable Partial Prosthodontics, Tokyo Dental College, 2-9-18 Kandamisakicho Chiyoda-ku, Tokyo, 101-0061, Japan. .,Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.
| | - Yuuki Uekubo
- Department of Removable Partial Prosthodontics, Tokyo Dental College, 2-9-18 Kandamisakicho Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Tomoharu Mitsui
- Department of Removable Partial Prosthodontics, Tokyo Dental College, 2-9-18 Kandamisakicho Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Takao Kasahara
- Department of Prosthodontics, Matsumoto Dental University, Shiojiri, Japan
| | - Takuya Takanashi
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
| | - Shinya Homma
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
| | - Satoru Matsunaga
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.,Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | - Shinichi Abe
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | - Masao Yoshinari
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Yasutomo Yajima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
| | - Kaoru Sakurai
- Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan
| | - Shuichiro Yamashita
- Department of Removable Partial Prosthodontics, Tokyo Dental College, 2-9-18 Kandamisakicho Chiyoda-ku, Tokyo, 101-0061, Japan
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Negm EE, Aboutaleb FA, Alam‐Eldein AM. Virtual Evaluation of the Accuracy of Fit and Trueness in Maxillary Poly(etheretherketone) Removable Partial Denture Frameworks Fabricated by Direct and Indirect CAD/CAM Techniques. J Prosthodont 2019; 28:804-810. [DOI: 10.1111/jopr.13075] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Enas Elhamy Negm
- Department of Removable ProsthodonticsFaculty of Dentistry Tanta University Tanta Egypt
| | - Faten Ahmed Aboutaleb
- Department of Removable ProsthodonticsFaculty of Dentistry Tanta University Tanta Egypt
| | - Ahmed M. Alam‐Eldein
- Department of Removable ProsthodonticsFaculty of Dentistry Tanta University Tanta Egypt
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Arafa KAO. Assessment of the fit of removable partial denture fabricated by computer-aided designing/computer aided manufacturing technology. Saudi Med J 2018; 39:17-22. [PMID: 29332104 PMCID: PMC5885115 DOI: 10.15537/smj.2018.1.20796] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To assess the level of evidence that supports the quality of fit for removable partial denture (RPD) fabricated by computer-aided designing/computer aided manufacturing (CAD/CAM) and rapid prototyping (RP) technology. Methods: An electronic search was performed in Google Scholar, PubMed, and Cochrane library search engines, using Boolean operators. All articles published in English and published in the period from 1950 until April 2017 were eligible to be included in this review. The total number of articles contained the search terms in any part of the article (including titles, abstracts, or article texts) were screened, which resulted in 214 articles. After exclusion of irrelevant and duplicated articles, 12 papers were included in this systematic review. Results: All the included studies were case reports, except one study, which was a case series that recruited 10 study participants. The visual and tactile examination in the cast or clinically in the patient’s mouth was the most-used method for assessment of the fit of RPDs. From all included studies, only one has assessed the internal fit between RPDs and oral tissues using silicone registration material. The vast majority of included studies found that the fit of RPDs ranged from satisfactory to excellent fit. Conclusion: Despite the lack of clinical trials that provide strong evidence, the available evidence supported the claim of good fit of RPDs fabricated by new technologies using CAD/CAM.
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Affiliation(s)
- Khalid A O Arafa
- Dental Health Department, Faculty of Applied Medical Sciences, Albaha University, Albaha, Kingdom of Saudi Arabia. E-mail.
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