DIGITAL TECHNOLOGY IN COMPLETE DENTURE PROSTHODONTICS: A REVIEW OF LITERATURE

Background: Computer-aided design and computer-aided manufacturing (CAD/CAM) technology has expanded to embrace implant, maxillofacial and removable prosthodontics including the fabrication of complete dentures. However, despite that the implementation of computer-aided technology with edentulous patients seemed to improve and simplify complete denture treatment as it significantly reduced the number of patient visits, yet still a limited number of reports described its use for complete denture fabrication
Objective: This literature review will cast light on digital technology and its implementation in complete denture prosthodontics including its advantages, limitations, techniques and will present the articles that reported or investigated this topic and their outcomes including clinical or patient-based outcomes
Materials and methods: An independent electronic search of the English language literature was conducted by 2 investigators (authors), in bibliographic database MEDLINE, EMBASE, the Cochrane Library and Google up to March 2017 using certain key words. The electronic search was conducted in 3 stages in a systematic order. Stage 1, involved acquiring a record of titles from the electronic databases, which was then independently analysed by each investigator to extract relevant titles based on the predetermined inclusion criteria. The investigators independently applied the exclusion criteria, and any inconsistency was resolved by discussion. In uncertainty situations, the disputed article was included in the second (abstract) stage for contemplation. Stage 2 involved screening the abstracts of all selected titles by both investigators separately. Once more, any disagreement between the investigators was discussed, and, in uncertain situations, the abstract was included in the third and last stage of full-text analysis. At stage 3, all full text articles that were included were studied by the two investigators. This was followed by applying the final exclusion criteria and reviewing the final list of articles thoroughly and in depth to extract all relevant qualitative and quantitative data.
Results: The review included a total of 20 articles. 2 studies described techniques for digital arrangement of denture teeth, 13 studies described techniques for digital fabrication of digital complete dentures either using rapid prototyping technology or computerized numerical control milling. The other 5 articles were clinical studies that assessed the clinical and patient-based outcomes of digitally-fabricated dentures.
Conclusions: Digitally fabricated dentures can be an effective and time-efficient option for completely edentulous patients with favourable clinical and patient-centered outcomes. They are preferred by clinicians and patients as they significantly reduced clinical time and number of appointments, improved retention as well as digital archivability and hence reproducibility. However, dental literature lacks short-term and long term prospective clinical studies in this field to be able to reach definitive conclusions.