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BMC Oral Health Nov 2020The purpose of this paper is to review the available literature on three-dimensionally printed complete dentures in terms of novel biomaterials, fabrication techniques... (Review)
Review
BACKGROUND
The purpose of this paper is to review the available literature on three-dimensionally printed complete dentures in terms of novel biomaterials, fabrication techniques and workflow, clinical performance and patient satisfaction.
METHODS
The methodology included applying a search strategy, defining inclusion and exclusion criteria, selecting studies and forming tables to summarize the results. Searches of PubMed, Scopus, and Embase databases were performed independently by two reviewers to gather literature published between 2010 and 2020.
RESULTS
A total of 126 titles were obtained from the electronic database, and the application of exclusion criteria resulted in the identification of 21 articles pertaining to printed technology for complete dentures. Current innovations and developments in digital dentistry have successfully led to the fabrication of removable dental prostheses using CAD/CAM technologies. Milled dentures have been studied more than 3D printed ones in the currently available literature. The limited number of clinical studies, mainly case reports, suggest current indications of 3D printing in denture fabrication process to be custom tray, record bases, trial, interim or immediate dentures but not definitive prostheses fabrication. Limitations include poor esthetics and retention, inability to balance occlusion and low printer resolution.
CONCLUSIONS
Initial studies on digital dentures have shown promising short-term clinical performance, positive patient-related results and reasonable cost-effectiveness. 3D printing has potential to modernize and streamline the denture fabrication techniques, materials and workflows. However, more research is required on the existing and developing materials and printers to allow for advancement and increase its application in removable prosthodontics.
Topics: Computer-Aided Design; Denture, Complete; Esthetics, Dental; Humans; Printing, Three-Dimensional; Workflow
PubMed: 33246466
DOI: 10.1186/s12903-020-01328-8 -
Primary Dental Journal Sep 2020Improvements in oral health including increased retention of natural teeth have given rise to a partially dentate older population. Replacement of missing natural teeth...
Improvements in oral health including increased retention of natural teeth have given rise to a partially dentate older population. Replacement of missing natural teeth is important to improve function, aesthetics and quality of life for this patient group. A variety of options are available to replace missing teeth in partially dentate older adults, including fixed, removable and implant retained prostheses. This article will discuss the provision of removable partial dentures including treatment planning and denture design. When planning removable partial dentures, careful attention must be paid to stabilising the patient prior to delivering any prosthesis. Partial dentures should be designed to minimise the potential for plaque accumulation with carefully designed metal based frameworks. Acrylic resin can also be utilised with attention to detail to minimise the risk of damage to delicate supporting tissues. Removable dentures have the advantage that they can be readily added to in the event of further tooth loss which may be particularly relevant for older adults. Partial dentures which optimise support, retention and stability can function very successfully and significantly improve patients' oral health related quality of life.
Topics: Aged; Denture, Partial; Denture, Partial, Removable; Humans; Mouth, Edentulous; Quality of Life; Tooth Loss
PubMed: 32940586
DOI: 10.1177/2050168420943435 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Feb 2021Digital technologies use high-precision three-dimensional scanning, intelligence-aided design software, and multi-axis numerical control milling or 3D printing, which... (Review)
Review
Digital technologies use high-precision three-dimensional scanning, intelligence-aided design software, and multi-axis numerical control milling or 3D printing, which can produce restorations with reliable precision and suitable function. However, the development of digital technologies in the field of complete denture restoration has been slow due to the complexity of prosthesis. This review article introduces the current research status and clinical applications of digital complete dentures in prosthodontic clinics and dental laboratories to provide beneficial references to prosthodontists and dental technicians.
Topics: Computer-Aided Design; Denture, Complete; Printing, Three-Dimensional
PubMed: 33723930
DOI: 10.7518/hxkq.2021.01.001 -
BioMed Research International 2021The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures... (Review)
Review
The present study was aimed at reviewing the studies that used finite element analysis (FEA) to estimate the biomechanical stress arising in removable partial dentures (RPDs) and how to optimize it. A literature survey was conducted for the English full-text articles, which used only FEA to estimate the stress developed in RPDs from Jan 2000 to May 2021. In RPDs, the retaining and supporting structures are subjected to dynamic loads during insertion and removal of the prosthesis as well as during function. The majority of stresses in free-end saddle (FES) RPDs are concentrated in the shoulder of the clasp, the horizontal curvature of the gingival approaching clasp, and the part of the major connector next to terminal abutments. Clasps fabricated from flexible materials were beneficial to eliminate the stress in the abutment, while rigid materials were preferred for major connectors to eliminate the displacement of the prosthesis. In implant-assisted RPD, the implant receive the majority of the load, thereby reducing the stress on the abutment and reducing the displacement of the prosthesis. The amount of stress in the implant decreases with zero or minimal angulation, using long and wide implants, and when the implants are placed in the first molar area.
Topics: Algorithms; Biomechanical Phenomena; Dental Abutments; Dental Implants; Denture Design; Denture, Partial, Removable; Finite Element Analysis; Humans; Stress, Mechanical
PubMed: 34485518
DOI: 10.1155/2021/5699962 -
Journal of Oral Science Oct 2021The recent literature on maxillary implant overdenture (IOD) was reviewed in order to clarify its predictability and establish treatment guidelines. Electronic searches... (Review)
Review
The recent literature on maxillary implant overdenture (IOD) was reviewed in order to clarify its predictability and establish treatment guidelines. Electronic searches were performed using PubMed, and articles about maxillary IOD written after 1990 were reviewed, focusing on the following items: I. implant survival rate, II. maxillary IOD survival rate, III. number of implants, IV. attachment type, V. follow-up period, VI. implant system, and VII. opposing dentition. The review revealed an implant survival rate of 61-100% and an overdenture survival rate of 72.4-100%. The attachments used included bars, balls, locators, and telescope crowns. The minimum and maximum observation periods were 12 months and 120 months, respectively, and the number of implants used for supporting IOD ranged from 2 to 8. At present, there is no strong evidence to indicate that maxillary IOD is clearly superior for all the items examined. However, the existing data indicate that maxillary IOD has almost the same therapeutic effect as fixed implant superstructures, and is a treatment option that can be actively adopted for patients in whom fixed superstructures cannot be applied for various reasons.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture Retention; Denture, Overlay; Humans; Maxilla
PubMed: 34408111
DOI: 10.2334/josnusd.21-0087 -
Journal of Prosthodontic Research Jan 2022This study comprehensively reviewed the current status of the digital workflow of removable partial dentures (RPDs) and summarized information about the fabrication...
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.
CONCLUSION
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.
Topics: Computer-Aided Design; Denture Bases; Denture, Partial, Removable; Humans; Tooth, Artificial; Workflow
PubMed: 33504722
DOI: 10.2186/jpr.JPR_D_20_00117 -
Journal of Dentistry Oct 2021This review compared Computer-aided designand Computer-aided manufactured (CAD-CAM) and conventionally constructed removable complete dentures (CDs). (Meta-Analysis)
Meta-Analysis Review
CAD-CAM removable complete dentures: A systematic review and meta-analysis of trueness of fit, biocompatibility, mechanical properties, surface characteristics, color stability, time-cost analysis, clinical and patient-reported outcomes.
OBJECTIVES
This review compared Computer-aided designand Computer-aided manufactured (CAD-CAM) and conventionally constructed removable complete dentures (CDs).
DATA
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.
SOURCES
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.
STUDY SELECTION
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 .
RESULTS
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.
CONCLUSIONS
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.
CLINICAL SIGNIFICANCE
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.
Topics: Aged; Computer-Aided Design; Costs and Cost Analysis; Denture, Complete; Esthetics, Dental; Humans; Patient Reported Outcome Measures; Reproducibility of Results; Surface Properties
PubMed: 34400250
DOI: 10.1016/j.jdent.2021.103777 -
International Journal of Implant... Nov 2021Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy... (Review)
Review
BACKGROUND
Implant-assisted removable partial dentures (IARPDs) have recently become popular, but little information is available on the treatment outcomes based on the Kennedy classification and attachment types.
OBJECTIVE
The objective of this review was to evaluate the treatment outcomes of IARPD delivered for distal extension edentulous areas based on the differences in the Kennedy classification and attachment type.
MATERIALS AND METHODS
English-language clinical studies on IARPD published between January 1980 and February 2020 were collected from MEDLINE (via PubMed), the Cochrane Library (via the Cochrane Central Register of Controlled Trials), Scopus online database, and manual searching. Two reviewers selected the articles based on pre-determined inclusion and exclusion criteria, followed by data extraction and analysis.
RESULTS
Eighty-one studies were selected after evaluating the titles and abstracts of 2410 papers. Nineteen studies were finally included after the perusal of the full text. Fourteen studies focused on Class I, 4 studies investigated both Class I and II, and only 1 study was conducted on Kennedy's class II. Eight types of attachments were reported. The ball attachment was the most frequently used attachment, which was employed in 8 of the included studies. The implant survival rate ranged from 91 to 100%. The reported marginal bone loss ranged from 0.3 mm to 2.30 mm. The patient satisfaction was higher with IARPD than with conventional RPDs or that before treatment. The results of prosthetic complications were heterogeneous and inconclusive.
CONCLUSION
IARPD exhibited favorable clinical outcomes when used as a replacement for distal extension edentulous areas. The comparison between the clinical outcomes of Kennedy's class I and II was inconclusive owing to the lack of studies focusing on Kennedy Class II alone. The stud attachment was the most commonly used type in IARPDs. Overall, the different attachment systems did not influence the implant survival rate and patient satisfaction. Further high-quality studies are needed to investigate the attachment systems used in IARPD.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Patient Satisfaction; Treatment Outcome
PubMed: 34773513
DOI: 10.1186/s40729-021-00394-z -
Clinical and Experimental Dental... Feb 2022The purpose of this systematic review and meta-analysis was to compare implant-supported removable partial dentures (ISRPDs) with distal extension removable partial... (Meta-Analysis)
Meta-Analysis Review
Implant-supported removable partial dentures compared to conventional dentures: A systematic review and meta-analysis of quality of life, patient satisfaction, and biomechanical complications.
OBJECTIVES
The purpose of this systematic review and meta-analysis was to compare implant-supported removable partial dentures (ISRPDs) with distal extension removable partial dentures (DERPDs) in terms of patient-reported outcome measures (PROMs: patients' quality of life and satisfaction) and to determine mechanical and biological complications associated with ISRPDs.
MATERIAL AND METHODS
An electronic search was performed on four databases to identify studies treating Kennedy class I or II edentulous patients and which compared ISRPDs with DERPDs in terms of PROMS and studies, which evaluated mechanical and biological complications associated ISRPDs. Two authors independently extracted data on quality of life, patient satisfaction, and biomechanical complications from these studies. The risk of bias was assessed for each study, and for PROMs, the authors performed a meta-analysis by using a random-effects model.
RESULTS
Thirteen articles were included based on the selection criteria. The difference in mean scores for quality of life (30.5 ± 1.8; 95% confidence interval [CI], 24.9-36.1) and patient satisfaction (-20.8 ± 0.2; 95% CI, -23.7 to -17.8) between treatments with conventional and implant-supported removable dentures was statistically significant (p < .05). Implant-supported removable dentures improved patients' overall quality of life and satisfaction. Some mechanical and biological complications, such as clasp adjustment, abutment or implant loosening, marginal bone resorption, and peri-implant mucositis, were noted in ISRPDs during patient follow-up. Studies assessing PROMs were very heterogeneous (I = 65%, p = .85; I = 75%, p = .88).
CONCLUSIONS
ISRPDs significantly improved quality of life and patient satisfaction. Some mechanical and biological complications have been associated with ISRPDs treatment, requiring regular monitoring of patients to avoid the occurrence of these complications.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Partial, Removable; Humans; Patient Satisfaction; Quality of Life
PubMed: 35014207
DOI: 10.1002/cre2.521 -
BioMed Research International 2021Analyzing and comparing the fit and accuracy of removable partial denture (RPDs) frameworks fabricated with CAD/CAM and rapid prototyping methods with conventional...
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 m) 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.
Topics: Computer-Aided Design; Denture Design; Denture, Partial; Denture, Partial, Removable; Humans; Lasers; Workflow
PubMed: 34532499
DOI: 10.1155/2021/3194433