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Wang X, Ma D, Zhong S, Ye Q, Zhao Y, Ren N, Bai S. A digital workflow for designing and manufacturing metal frameworks and removable partial dentures: A novel dental technique. J Prosthodont 2024. [PMID: 38566576 DOI: 10.1111/jopr.13845] [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: 11/18/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
The purpose of this technical report is to demonstrate a fully digital workflow for designing and fabricating metal frameworks and removable partial dentures. After obtaining a digital cast of the dental arch with bilateral distal extension defect, computer-aided design software and 3D printing technology are used for the design and fabrication of the removable partial denture frameworks, denture teeth, and denture bases, instead of the traditional workflow. The assembly of the three components is facilitated through a meticulously structured framework. The technology, which prints metal frameworks, denture bases, and denture teeth through different processes with different materials, achieves full 3D printing technology for making removable partial dentures.
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Affiliation(s)
- Xin Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Dan Ma
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Sheng Zhong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Qingyuan Ye
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Yimin Zhao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Nan Ren
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Shizhu Bai
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, PR China
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Chebib N, Imamura Y, El Osta N, Srinivasan M, Müller F, Maniewicz S. Fit and retention of complete denture bases: Part II - conventional impressions versus digital scans: A clinical controlled crossover study. J Prosthet Dent 2024; 131:618-625. [PMID: 36055812 DOI: 10.1016/j.prosdent.2022.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/15/2022] [Accepted: 07/15/2022] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM Although the intraoral scanning of edentulous ridges is feasible, clinical evidence that the resulting denture retention is equivalent to that achieved with conventional impressions is lacking. PURPOSE The purpose of this clinical study was to determine the retention of complete denture bases fabricated from digital intraoral scans versus conventional impressions by using border molding and posterior palatal seal compression. MATERIAL AND METHODS Twenty volunteers with an edentulous maxilla were recruited. An intraoral scan of the maxilla and a conventionally border-molded impression with a custom tray were made. The conventional impression was poured; the definitive cast was scanned. Three-dimensionally (3D) printed (PB1) and milled bases (MB1) were fabricated based on the scan of the definitive cast. Based on the intraoral scan, a 3D printed (PB2) and a milled base (MB2) were fabricated. On each base, a platform with a hook consisting of a central notch orienting the force against the post dam (PD) and 2 lateral notches orienting the forces against the left (LT) and right (RT) tuberosities was set in the center of the outer surface of the base. A traction dynamometer was inserted in the hook and oriented into the corresponding notch by applying force until dislodgement. All bases were subsequently stored in artificial saliva for 2 weeks and scanned. Retention testing was repeated by using the same procedure. To evaluate trueness and to visualize the differences on a color map, the scan of the definitive cast and the intraoral scans were matched and compared in 3 dimensions. The Wilcoxon tests were used to compare the retention of the different bases (95% confidence interval, α=.05). RESULTS Nineteen participants with a mean ±standard deviation age of 64.1 ±14.7 years completed the 4 study sessions. The retention of printed bases (PD: 16.08 ±15.28 N; LT: 14.98 ±14.72 N; RT: 11.28 ±9.57 N) and milled bases (PD:14.52 ±17.07 N; RT: 11.99 ±12.10 N; LT: 13.55 ±15.53 N) fabricated from conventional impressions presented significantly higher retentive forces than those printed (PD: 6.21 ±4.72 N; RT:5.12 ±2.78 N; LT: 4.45 ±2.77 N) and milled (PD: 6.58 ±4.92 N; RT: 4.65 ±2.63 N; LT: 5.02 ±3.58 N) from the intraoral scans (P<.05). The differences were significant in all directions of dislodgement, as well as after storage in artificial saliva for 2 weeks. Comparison of the 3D distances between the intraoral scan and the definitive cast revealed a mean deviation of 0.45 ±0.11 mm. CONCLUSIONS Conventional impressions of the edentulous maxilla, including the clinical steps of border molding and posterior palatal seal compression, provide better retention than digital intraoral scans with both milled and 3D printed denture bases.
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Affiliation(s)
- Najla Chebib
- Research and Teaching Fellow, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.
| | - Yoshiki Imamura
- Research and Teaching Fellow, Division of Fixed Prosthodontics, School of Dentistry, Meikai University, Saitama, Japan; Research and Teaching Fellow, Department of Geriatric Dentistry, School of Dentistry, Showa University, Tokyo, Japan
| | - Nada El Osta
- Professor, Department of Prosthodontics and Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon; Lecturer, Center for Research in Clinical Odontology, University of Clermont Auvergne, Clermont-Ferrand, France
| | - Murali Srinivasan
- Professor, Clinic of General-, Special care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Research and Teaching Fellow, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Frauke Müller
- Professor, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland; Professor, Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Thônex, Switzerland
| | - Sabrina Maniewicz
- Research and Teaching Fellow, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Ma D, Wang X, Zhang T, Bai S. A digital and cast-free workflow for fabricating a definitive hollow obturator prosthesis for a maxillectomy defect: A dental technique. J Prosthet Dent 2023:S0022-3913(23)00759-X. [PMID: 38123417 DOI: 10.1016/j.prosdent.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 12/23/2023]
Abstract
This article presents a novel digital and cast-free workflow for fabricating a definitive hollow obturator prosthesis. A digital altered cast is made after the framework-fitting appointment to maximize support. The framework, hollow obturator base, and teeth are digitally designed, additively manufactured, and then assembled precisely without a cast. This method simplifies the laboratory process, reduces human errors, and provides a prosthesis with high accuracy and good fit.
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Affiliation(s)
- Dan Ma
- Graduate student, Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, PR China
| | - Xin Wang
- Graduate student, Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, PR China
| | - Tingmin Zhang
- Graduate student, Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, PR China
| | - Shizhu Bai
- Associate Professor, Digital Center, School of Stomatology, The Fourth Military Medical University, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an, Shaanxi, PR China.
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Akiyama Y, Kanazawa M, Iwaki M, Hada T, Soeda Y, Otake R, Kashiwazaki K, Komagamine Y, Murakami N, Takaichi A, Wakabayashi N, Minakuchi S. Fabrication of milled removable partial dentures using a custom plate with prefabricated artificial teeth. J Prosthodont Res 2023; 67:647-651. [PMID: 36725080 DOI: 10.2186/jpr.jpr_d_22_00100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Although digital removable partial dentures have been previously described, there have been no reports on how to fabricate them in one piece. This study proposes a new method for fabricating patient-specific digital removable partial dentures using a custom plate. METHODS First, a gypsum model was scanned using a laboratory scanner and a removable partial denture was designed using computer-aided design (CAD) software based on standard tessellation language data. The metal clasp was fabricated from Ti-6Al-4V using a 3D printer. For custom plate fabrication, a resin plate frame was designed using computer-aided design (CAD) software and fabricated using a 3D printer. An artificial tooth and metal clasp were fixed on the base surface of the frame, an auto-polymerizing resin was poured into the frame for the denture base, and the artificial tooth and metal clasp were packed to form a custom plate. The plate was cut using a milling machine. Subsequently, the support attached to the denture was removed and polished for complete fabrication of the denture. CONCLUSIONS Our novel removable partial denture fabrication method is more efficient than the conventional method. The obtained removable partial dentures demonstrated satisfactory accuracy.
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Affiliation(s)
- Yo Akiyama
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Manabu Kanazawa
- Digital Dentistry,Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Maiko Iwaki
- Digital Dentistry,Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Tamaki Hada
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yumika Soeda
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Ryosuke Otake
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kenta Kashiwazaki
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Natsuko Murakami
- Advanced prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Atsushi Takaichi
- Advanced prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Noriyuki Wakabayashi
- Advanced prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Song S, Ren N, Li F, Bai S. Fully digital workflow for duplicating clasp-retained removable partial dentures using three-dimensional printing: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00485-7. [PMID: 37604754 DOI: 10.1016/j.prosdent.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/09/2023] [Accepted: 07/11/2023] [Indexed: 08/23/2023]
Abstract
This clinical report describes a fully digital workflow for replicating removable partial dentures (RPDs). The artificial teeth and denture base of existing dentures were duplicated and applied to new dentures with a redesigned framework. After the components of RPDs had been separated from the scan data of the existing dentures, they were fabricated using 3-dimensional printing and assembled to create a new denture.
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Affiliation(s)
- Shiwei Song
- Researcher, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China; Researcher, School of Stomatology, Shanxi Medical University, 56 Xinjian South Road, Taiyuan, Shanxi, PR China
| | - Nan Ren
- Researcher, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
| | - Fenglan Li
- Professor, Department of Prosthodontics, Fifth Hospital of Shanxi Medical University, Taiyuan, Shanxi, PR China.
| | - Shizhu Bai
- Associate Professor, State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, PR China
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Cameron AB, Evans JL, Robb ND. A technical and clinical digital approach to the altered cast technique with an intraoral scanner and polyvinyl siloxane impression material. J Prosthet Dent 2022:S0022-3913(22)00357-2. [PMID: 35850875 DOI: 10.1016/j.prosdent.2022.05.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 11/19/2022]
Abstract
This technique digitalizes the clinical and laboratory steps of fabricating removable partial dentures (RPDs) with the altered cast technique. An intraoral scanner was used to capture the mandibular Kennedy class II partially edentulous arch. An RPD framework was fabricated digitally and then combined with a custom tray with a wax occlusal rim. A conventional polyvinyl siloxane altered cast impression was made and then digitalized both intraorally and extraorally, followed by a digital interocclusal record. The resulting scan was modified to produce an additively manufactured cast. The teeth and gingival components were then designed and fabricated with a combination of additive and subtractive manufacturing, followed by the conventional acrylic resin pour technique. The definitive prosthesis was completed with minimal conventional techniques and without the use of gypsum, prefabricated teeth, or a physical articulator. The technique reduces the number of appointments and achieves the functional extension of the prosthesis through border molding, which is not possible with intraoral scanning.
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Affiliation(s)
- Andrew B Cameron
- Lecturer, School of Medicine and Dentistry, Griffith University, Gold Coast, Australia.
| | - Jane L Evans
- Professor, School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
| | - Nigel D Robb
- Professor, School of Medicine and Dentistry, Griffith University, Gold Coast, Australia
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Piao XY, Jeon J, Shim JS, Park JM. A Digital Workflow for the Fabrication of a Milled Removable Partial Denture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148540. [PMID: 35886391 PMCID: PMC9324999 DOI: 10.3390/ijerph19148540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022]
Abstract
Complete dentures fabricated with the additive or subtractive method have been widely used and proven to be clinically acceptable. However, fabrication of removable partial dentures (RPDs) using computer-aided design and computer-aided manufacturing is limited by its technique sensitivity as the pink resin, which encases part of metal framework, cannot be fabricated digitally. This article introduces a digital workflow to fabricate an RPD with the subtractive method. A complex structure of the offset metal framework and denture base with teeth sockets was milled with this technique. Artificial teeth were milled with a resin disk according to the computer-aided design data, resulting in the customized occlusal surface. This digital technique can be an alternative to the analog fabrication method as the RPD was fabricated digitally, keeping the original structures and reducing resin shrinkage on the intaglio surface.
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Affiliation(s)
- Xing-Yu Piao
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Korea; (X.-Y.P.); (J.-S.S.)
| | - Jeongho Jeon
- Central Dental Laboratory, College of Dentistry, Yonsei University, Seoul 03722, Korea;
| | - June-Sung Shim
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Korea; (X.-Y.P.); (J.-S.S.)
| | - Ji-Man Park
- Department of Prosthodontics & Dental Research Institute, Seoul National University, Seoul 03080, Korea
- Correspondence:
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Muralidharan C, Schneider RL, Kotowske S. CAD-CAM denture teeth made on cast metal removable partial denture frameworks. J Prosthet Dent 2022:S0022-3913(22)00325-0. [PMID: 35773021 DOI: 10.1016/j.prosdent.2022.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 11/23/2022]
Abstract
Once the fit of the cast metal framework on a removable partial denture (RPD) has been verified, the manufacturer's prefabricated denture teeth are typically secured on the cast metal framework to prepare for a wax evaluation. Although prefabricated denture teeth are available in different tooth forms and sizes, they require modification to fit an edentulous space. In arches with severe space discrepancy, it may be inefficient and time-consuming to make modifications to prefabricated denture teeth. The technique described uses digital technology to fabricate custom denture teeth on a cast metal framework and establish harmonious occlusion. An edentulous space with more than a single tooth replacement is designed as a splinted fixed partial denture with a connector. The designed teeth are milled in the double-cross-linked polymer to prepare for a wax evaluation, and once verified, the RPD is processed by using heat polymerization. Modifications are made to the milled denture teeth after wax elimination to reduce the likelihood of acrylic resin bond failure.
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Affiliation(s)
- Chandni Muralidharan
- Student, Dental Laboratory Technology, Kirkwood Community College, Cedar Rapids, Iowa
| | - Robert L Schneider
- Professor Emeritus, University of Iowa Hospital and Clinics, Hospital Dentistry Institute, Iowa City, Iowa.
| | - Sandra Kotowske
- Professor, Director of Removable Prosthodontics, Dental Laboratory Technology, Kirkwood Community College, Cedar Rapids, Iowa
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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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AlRumaih HS. Clinical Applications of Intraoral Scanning in Removable Prosthodontics: A Literature Review. J Prosthodont 2021; 30:747-762. [PMID: 34043266 DOI: 10.1111/jopr.13395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This review aimed to identify the reported intraoral scanning applications in fabricating different types of removable prostheses in the field of prosthodontics. METHODS A comprehensive electronic search was performed using the PubMed and MEDLINE databases. This review included in vitro studies and clinical reports published between January 2013 and March 2021. The main keywords were as follows: intraoral scanning, digital impression, computerized digital impression, removable prosthesis, chairside computer-aided design/computer-assisted manufacturing, digital complete denture, digital immediate complete denture, digital interim complete denture, digital removable partial denture, digital removable overdenture, digital obturator, digital occlusal splints, and digital maxillofacial prostheses. RESULTS In total, 33 papers (22 clinical reports, 8 papers focused on dental techniques, and 3 clinical studies) were included in the final analysis. CONCLUSIONS The efficiency of using intraoral scanning in the field of removable prosthodontics was documented. However, there is a need for more clinical studies to identify intraoral scanning-usage protocols and to yield reliable and valid data.
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Affiliation(s)
- Hamad S AlRumaih
- Substitutive Dental Science Department, College of Dentistry, Imam Abdulrahman Bin Fasial University, Dammam, Saudi Arabia
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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: 30] [Impact Index Per Article: 10.0] [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 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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Accuracy of intraoral scanning in completely and partially edentulous maxillary and mandibular jaws: an in vitro analysis. Clin Oral Investig 2020; 25:1839-1847. [PMID: 32812098 PMCID: PMC7966190 DOI: 10.1007/s00784-020-03486-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 07/30/2020] [Indexed: 10/28/2022]
Abstract
OBJECTIVES New generation intraoral scanners are promoted to be suitable for digital scans of long-span edentulous spaces and completely edentulous arches; however, the evidence is lacking. The current study evaluated the accuracy of intraoral scanning (IOS) in partially and completely edentulous arch models and analyzed the influence of operator experience on accuracy. MATERIALS AND METHODS Four different resin models (completely and partially edentulous maxilla and mandible) were scanned, using a new generation IOS device (n = 20 each). Ten scans of each model were performed by an IOS-experienced and an inexperienced operator. An industrial high-precision scanner was employed to obtain reference scans. IOS files of each model-operator combination, their respective reference scan files (n = 10 each; total = 80), as well as the IOS files from each model generated by the same operator, were superimposed (n = 45; total = 360) to calculate trueness and precision. An ANOVA for mixed models and post hoc t tests for mixed models were used to assess group-wise differences (α = 0.05). RESULTS The median overall trueness and precision were 24.2 μm (IQR 20.7-27.4 μm) and 18.3 μm (IQR 14.4-22.1 μm), respectively. The scans of the inexperienced operator had significantly higher trueness in the edentulous mandibular model (p = 0.0001) and higher precision in the edentulous maxillary model (p = 0.0004). CONCLUSION The accuracy of IOS for partially and completely edentulous arches in in vitro settings was high. Experience with IOS had small influence on the accuracy of the scans. CLINICAL RELEVANCE IOS with the tested new generation intraoral scanner may be suitable for the fabrication of removable dentures regardless of clinician's experience in IOS.
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