This review compared Computer-aided designand Computer-aided manufactured (CAD-CAM) and conventionally constructed removable complete dentures (CDs). Seventy-three studies reporting on CAD-CAM (milled/3D-printed) CDs were included in this review. The most recent literature search was performed on 15/03/2021. Two investigators searched electronic databases [PubMed (MEDLINE), Embase, CENTRAL], online search engines (Google) and research portals. Hand searches were performed to identify literature not available online. Studies on CAD-CAM CDs were included if they reported on trueness of fit, biocompatibility, mechanical, surface, chemical, color , microbiological properties, time-cost analysis, and clinical outcomes. Inter-investigator reliability was assessed using kappa scores. Meta-analyses were performed on the extracted data . The kappa score ranged between 0.897-1.000. Meta-analyses revealed that 3D-printed CDs were more true than conventional CDs (p = 0.039). Milled CDs had a higher flexural-strength than conventional and 3D-printed CDs (p < 0.0001). Milled CDs had a higher flexural-modulus than 3D-printed CDs (p < 0.0001). Milled CDs had a higher yield-strength than injection-molded (p = 0.004), and 3D-printed CDs (p = 0.001). Milled CDs had superior toughness (p < 0.0001) and surface roughness characteristics (p < 0.0001) than other CDs . Rapidly-prototyped CDs displayed poor color-stability compared to other CDs (p = 0.029). CAD-CAM CDs d displayed better retention than conventional CDs (p = 0.015). Conventional CDs had a higher strain at yield point than milled CDs (p < 0.0001), and had superior esthetics than 3D-printed (p < 0.0001). Fabrication of CAD-CAM CDs required less chairside time (p = 0.037) and lower overall costs (p < 0.0001) than conventional CDs. This systematic review concludes that CAD-CAM CDs offer a number of improved mechanical/surface properties and are not inferior when compared to conventional CDs. CAD-CAM CDs should be considered for completely edentulous patients whenever possible, since this technique offers numerous advantages including better retention, mechanical and surface properties but most importantly preserves a digital record. This can be a great advantage for older adults with limited access to dental care.

This study evaluated the biocompatibility, mechanical properties, and surface roughness of CAD-CAM milled and rapidly-prototyped/3D-printed resins used for manufacturing complete dentures. Six groups of resin specimens were prepared, milled-base (MB), milled-tooth shade (MT), printed-tooth shade (PT), printed-base with manufacturer-recommended 3D-printer (PB1), printed-base with third-party 3D-printer (PB2), printed-base in a vertical orientation (PB2V). Human epithelial (A-431) and gingival (HGF-1) cells were cultured and tested for biocompatibility using Resazurin assays. Three-point bending and nanoindentation tests measured the mechanical properties of the resin groups. Surface roughness was evaluated using a high-resolution laser profilometer. ANOVA and post-hoc tests were used for statistical analyses (α = 0.05). There were no significant differences in biocompatibility between any of the investigated groups. MB revealed a higher ultimate strength (p = 0.008), elastic modulus (p = 0.002), and toughness (p = 0.014) than PB1. MT had significantly higher elastic modulus than PT (p < 0.001). Rapidly-prototyped resin samples with a manufacturer-recommended 3D-printer (PB1) demonstrated higher ultimate strength (p = 0.008), elastic modulus (p < 0.001), hardness (p < 0.001) and a reduced surface roughness (p < 0.05) when compared with rapidly-prototyped groups using a third-party 3D-printer (PB2). Rapidly-prototyped samples manufactured with a vertical printing orientation (PB2V) revealed a significantly lower elastic modulus than samples groups manufactured using horizontal printing orientation (PB2) (p = 0.011). Within the limits of this present study, CAD-CAM milled and rapidly-prototyped complete denture resins performed similarly in terms of biocompatibility and surface roughness. However, the milled denture resins were superior to the rapidly-prototyped denture resins with regard to their mechanical properties. Printing orientation and type of 3D-printer can affect the resin strength and surface roughness.

Objectives: The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient‐reported outcomes (dPROs), (b) improvement in orofacial function, and (c) preservation of orofacial tissues in partially and fully edentulous patients following provision of implant‐retained/supported dental prostheses were addressed.Materials and Methods: Three systematic reviews formed the basis for discussion. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary of the 7th ITI Consensus Conference, taking place in 2023 in Lisbon, Portugal.Results: Edentulous patients wearing complete dentures (CD) experience substantial improvements in overall dPROs and orofacial function following treatment with either complete implant‐supported fixed dental prostheses (CIFDP) or implant overdentures (IODs). With respect to dPROs, mandibular IODs retained by two implants are superior to IODs retained by one implant. However, increasing the number of implants beyond two, does not further improve dPROs. In fully edentulous patients, rehabilitation with CIFDP or IOD is recommended to benefit the preservation of alveolar bone and masseter muscle thickness.Conclusions: Completely edentulous patients benefit substantially when at least the mandible is restored using an CIFDP or an IOD compared to CD. In fully edentulous patients, implant prostheses are the best option for tooth replacement. The availability of this treatment modality should be actively promoted in all edentulous communities, including those with limited access and means.

The study aimed to quantitatively evaluate the elution of methylmethacrylate from CAD-CAM manufactured removable complete dentures (RCDs) using high performance liquid chromatography (HPLC). Thirty-two RCDs were manufactured following either the CNC-milling (Milled: n=8) or the 3D-printing (n=24) protocols. The 3D-printed dentures were further categorized into three groups based on their post-production rinsing cycles [Extended wash cycle (EWC), Standard wash cycle (SWC), and SWC with an additional Durécon coating (SWC2)]. HPLC was used to evaluate the methylmethacrylate concentrations (MMCs) eluted from the dentures in each group for different time periods (1, 2, 4, 8, and 24 hours). Mean and standard deviations were calculated for the MMCs; data was verified for normal distribution, ANOVA and post hoc tests were applied for statistical analyses (⍺=0.05). The HPLC revealed that all the denture groups recorded some amounts of MMCs, with significant differences [F (3, 31) = 23.646, p<0.0001]. The milled denture group had the highest MMCs at 24 hours when compared to the EWC (p<0.0001), SWC (p=0.001), and SWC2 (p<0.0001) denture groups. SWC had a higher MMC than EWC (p=0.032) and SWC2 (p=0.015). No differences were found in MMCs when comparing EWC and SWC2 (p=0.989). Methylmethacrylate concentrations were significantly lower in 3D-printed RCDs than in milled RCDs when using the resins employed in this study. Furthermore, the MMCs can be further decreased in 3D-printed RCDs when coated with an additional thin protective layer (Durécon) by following the manufacturer-recommended rinsing protocol or when an extended isopropanol wash cycle is adopted.

Objectives: This review evaluated the effects of rehabilitation with implant‐supported prostheses on the oral function of completely edentulous adults.Materials and Methods: Systematic literature searches were performed to identify records reporting on oral function in completely edentulous adults rehabilitated with implant‐supported prostheses. Meta‐analyses were performed on various outcomes including bite force, masticatory performance, muscle activity, mandibular movement/chewing pattern, and salivary flow.Results: 5507 records were identified. Thirty studies qualified for data extraction and analysis. The kappa (𝛋) for the search and identification strategy ranged between 0.50 and 1.00. Meta‐analysis was performed grouping the studies by outcomes and split by time points of 6–12 months, 12–36 months, and >36 months after implant therapy. The meta‐analyses revealed a significant improvement in oral function of completely edentulous adults after rehabilitation with implant‐supported prostheses at 6–12 months (Z = −4.895, p < .001; 95% CI: −0.703, −0.301; τ² = .609; Q = 114.953, df = 17, p < .001; I² = 85.2%), at 12–36 months (Z = −4.886, p < .001; 95% CI: −0.580, −0.248; τ² = .908; Q = 280.611, df = 35, p < .001; I² = 87.5%) and at more than 36 months (Z = −9.108, p < .001; 95% CI: −1.472, −0.951; τ² = .019; Q = 7.918, df = 7, p = .340; I² = 11.6%). The included studies demonstrated a low to moderate risk of bias.Conclusions: This systematic review concluded that the oral function of completely edentate adults significantly improved with implant‐supported/retained prostheses, even when only one jaw received implant therapy. Therefore, implant therapy should be promoted for edentulous adults to alleviate the shortcomings of conventional complete removable dental prostheses.

The aim of this study was to compare the shear bond strength of relined CAD-CAM complete removable dental prosthesis (CRDP) resins with conventional heat-polymerized polymethylmethacrylate (PMMA) resin. A total of 96 resin specimens in identical dimensions of 10 mm × 10 mm × 11 mm were fabricated for four study groups [#1- Conventional heat-polymerized group: n=24 (ProBase); #2- Milled#1: n=24 (Ivobase); #3- Milled#2: n=24 (Ivotion); #4- 3D-printed: n=24, (NextDent Denture 3D+)]. Twelve specimens in each group were sectioned in the middle to produce a 3 mm defect and then were relined using a conventional denture relining material. All specimens underwent thermocycling (5-55°C) for 10,000 cycles. The shear bond tests were carried out in a universal testing machine. One-way ANOVA and Tukey's test were used for statistical analysis (p<0.05). The two-parameter Weibull distribution values were calculated. Relined 3D-printed specimens had a significantly lower shear bond strength when compared with conventional (p=0.0003) and milled groups (Milled#1: p=0.0004; Milled#2: p<0.0001). There were no differences in the shear bond strengths between the milled and conventional groups. Weibull distribution presented the highest shape value for the non-relined Milled#1 (22.83) group and the lowest values for the 3D-printed relined group (4.001). The findings of this study conclude that the shear bond strength of the conventionally-relined 3D-printed resins used for fabricating CRDPs was inferior to the shear bond strength of conventionally-relined resins employed for manufacturing CRDPs using CAD-CAM milling and conventional heat-polymerization techniques. When considering 3D-printing for the fabrication of CRDPs, it is recommended to employ it in clinical situations where a frequent need for denture relining is not expected.