CAD-CAM complete removable dental prostheses: a double-blind, randomized, crossover clinical trial evaluating milled and 3D-printed dentures.

Abstract

OBJECTIVE\nThis double-blind, randomized, crossover, clinical trial aimed to evaluate and compare the differences between milled and 3D-printed complete removable dental prostheses (CRDPs).\n\n\nMETHODS\nFifteen edentulous patients (men: n=10, women: n=5; age: 66.7±8.0 years) rehabilitated with conventional CRDPs were recruited for this trial. Participants were randomized to first receiving either the milled or 3D-printed CAD-CAM manufactured CRDPs to cross over after 6-weeks to the other set. Both, clinicians and participants were blinded to the group allocation. Outcomes included patient s denture satisfaction (PDS), and oral-health related quality of life (OHIP-EDENT), willingness-to-pay analysis, final choice (FC) of CRDPs, clinician s denture quality evaluation (CDQE), chewing efficiency (CE), maximum-voluntary-bite-force (MBF), and prosthodontic maintenance needs. The outcomes were measured at with old CRDPs, at 1 and 6 weeks after new CRDP insertion; following crossover with the second set of CRDPs, they followed the identical protocol. Generalized linear regression for repeated measures was used for statistical analysis with ⍺=0.05.\n\n\nRESULTS\nAll participants completed the trial. 3D-printed CRDPs required more maintenance visits, adjustment time (p=0.0003), and adjustment costs (p=0.021). Patients were willing-to-pay an average 606.67 Swiss Francs more than the actual cost for the milled CRDPs. There were no differences in the PDS, OHIP, FC, CDQE, CE, and MBF between the two CRDPs groups.\n\n\nCONCLUSIONS\nThe findings of this double-blind randomized crossover clinical trial confirm that both, milled and 3D-printed CRDPs are valid treatment modalities for edentulous patients, with the latter performing inferior with regards to prosthodontic aftercare, cost and patients willingness-to-pay.\n\n\nCLINICAL RELEVANCE\nThe findings of this trial provide evidence to help the clinician in choosing the adequate type of CAD-CAM manufacturing process for fabricating CRDPs.