Intaglio surface trueness of dentures bases fabricated with 3D printing vs. conventional workflow: a clinical study.

The latest generation of intraoral scanners can record the prosthetic field with relative ease, high accuracy and comfort for the patient, and have enabled fully digital protocols for designing and manufacturing complete dentures. The present study aims to examine the intaglio surface trueness of 3D printed maxillary dentures produced by fully digital workflow in comparison with dentures produced by analogue clinical and laboratory prosthetic workflow. The edentulous maxillary arch of 15 patients was scanned with an intraoral scanner as well as the intaglio of the delivered conventional denture. The scan of the edentulous arch was imported into a dental design software to produce the denture base which was then 3D printed. The intaglio surface of the finished 3D printed denture bases was digitized and used to assess the trueness of the printed denture bases compared to the intaglio surface of the conventional dentures as well as performing a trueness comparison in relation to the scanned edentulous arches. The dataset (n = 30) was subjected to Kruskal-Wallis test analysis, the significance level being established at α = 0.05. The results of the study showed that the printed group displayed better trueness values with a median of 176.9 µm while the analogue group showed a median of 342 µm. Employing a fully digital workflow to produce 3D-printed denture bases yields a consistent and precise manufacturing method when accounting for the intaglio surface of the denture.

The effect of restorative material selection and cementation procedures on the durability of endocrowns in the anterior teeth: an in-vitro study.

OBJECTIVE: To investigate the fracture resistance and failure modalities of anterior endocrown restorations fabricated employing diverse ceramic materials, and bonded using various cementation methodologies. MATERIALS AND METHODS: Forty maxillary central incisors were divided into two main groups based on the ceramic materials used; GroupI (Zir): zirconia endocrwons (Zolid HT+, Ceramill, Amanngirrbach) and GroupII (E-Max): e-max endocrowns (IPS e.max CAD, Ivoclar Vivadent). Both groups were further split into two subgroups depending on the cementation protocols; subgroup IA "ZirMDP": endocowns cemented with MDP primer + MDP resin cement, subgroup IB (ZirNon-MDP): cemented with MDP primer + non-MDP resin cement, subgroup IIA (E-maxMDP): cemented with MDP primer + MDP resin cement, subgroup IIB (E-maxNon-MDP): cemented with MDP primer + non-MDP resin cement. (n = 10/subgroup). Endocrowns were manufactured using CAD/ CAM. Teeth were subjected to 10,000 thermal cycles. The fracture test was performed at 45o with a palatal force direction until the fracture occurred. Test results were recorded in Newton. The failure mode was examined using a stereomicroscope. A One-way ANOVA test was utilized to compare different groups regarding fracture strength values. Tukey`s Post Hoc was utilized for multiple comparisons. RESULTS: The comparative analysis of fracture strength across the diverse groups yielded non-significant differences, as indicated by a p-value exceeding 0.05. Nonetheless, an observable trend emerged regarding the mode of failure. Specifically, a statistically significant prevalence was noted in fractures localized within the endocrown/tooth complex below the cementoenamel junction (CEJ) across all groups, except for Group IIB, "E-max Non-MDP," where fractures within the endocrown/tooth complex occurred above the CEJ. CONCLUSIONS: Combining an MDP-based primer with an MDP-based resin cement did not result in a significant effect on the anterior endocrown fracture strength. CLINICAL RELEVANCE: Regardless of the presence of the MDP monomer in its composition, adhesive resin cement achieved highly successful fracture strength when used with MDP-based ceramic primers. Additionally, ceramic materials exhibiting elastic moduli surpassing those of dentin are discouraged due to their propensity to induce catastrophic fractures within the tooth structure.

Generalized Bézier-like model and its applications to curve and surface modeling.

The subject matter of surfaces in computer aided geometric design (CAGD) is the depiction and design of surfaces in the computer graphics arena. Due to their geometric features, modeling of Bézier curves and surfaces with their shape parameters is the most well-liked topic of research in CAGD/computer-aided manufacturing (CAM). The primary challenges in industries such as automotive, shipbuilding, and aerospace are the design of complex surfaces. In order to address this issue, the continuity constraints between surfaces are utilized to generate complex surfaces. The parametric and geometric continuities are the two metrics commonly used for establishing connections among surfaces. This paper proposes continuity constraints between two generalized Bézier-like surfaces (gBS) with different shape parameters to address the issue of modeling and designing surfaces. Initially, the generalized form of C3 and G3 of generalized Bézier-like curves (gBC) are developed. To check the validity of these constraints, some numerical examples are also analyzed with graphical representations. Furthermore, for a continuous connection among these gBS, the necessary and sufficient G1 and G2 continuity constraints are also developed. It is shown through the use of several geometric designs of gBS that the recommended basis can resolve the shape and position adjustment problems associated with Bézier surfaces more effectively than any other basis. As a result, the proposed scheme not only incorporates all of the geometric features of curve design schemes but also improves upon their faults, which are typically encountered in engineering. Mainly, by changing the values of shape parameters, we can alter the shape of the curve by our choice which is not present in the standard Bézier model. This is the main drawback of traditional Bézier model.

Effect of surface treatment strategies on bond strength of additively and subtractively manufactured hybrid materials for permanent crowns.

OBJECTIVES: The purpose of this study is to evaluate the bond strength of different computer-aided design / computer-aided manufacturing (CAD/CAM) hybrid ceramic materials following different pretreatments. METHODS: A total of 306 CAD/CAM hybrid material specimens were manufactured, n = 102 for each material (VarseoSmile Crownplus [VSCP] by 3D-printing; Vita Enamic [VE] and Grandio Blocs [GB] by milling). Each material was randomly divided into six groups regarding different pretreatment strategies: control, silane, sandblasting (50 µm aluminum oxide particles), sandblasting + silane, etching (9% hydrofluorics acid), etching + silane. Subsequently, surface roughness (Ra) values, surface free energy (SFE) were measured. Each specimen was bonded with a dual-cured adhesive composite. Half of the specimens were subjected to thermocycling (5000 cycles, 5-55 °C). The shear bond strength (SBS) test was performed. Data were analyzed by using a two-way analysis of variance, independent t-test, and Mann-Whitney-U-test (α = 0.05). RESULTS: Material type (p = 0.001), pretreatment strategy (p < 0.001), and the interaction (p < 0.001) all had significant effects on Ra value. However, only etching on VSCP and VE surface increased SFE value significantly. Regarding SBS value, no significant difference was found among the three materials (p = 0.937), while the pretreatment strategy significantly influenced SBS (p < 0.05). Etching on VSCP specimens showed the lowest mean value among all groups, while sandblasting and silane result in higher SBS for all test materials. CONCLUSIONS: The bond strength of CAD/CAM hybrid ceramic materials for milling and 3D-printing was comparable. Sandblasting and silane coupling were suitable for both millable and printable materials, while hydrofluoric etching should not be recommended for CAD/CAM hybrid ceramic materials. CLINICAL RELEVANCE: Since comparable evidence between 3D-printable and millable CAD/CAM dental hybrid materials is scarce, the present study gives clear guidance for pretreatment planning on different materials.

Assessing the suitability of fused deposition modeling to produce acrylic removable denture bases.

OBJECTIVE: To study the feasibility of using poly methyl methacrylate (PMMA) filament and fused deposition modeling (FDM) to manufacture denture bases via the development of a study that considers both conventional and additive-based manufacturing techniques. MATERIALS AND METHODS: Five sample groups were compared: heat and cold cured acrylic resins, CAD/CAM milled PMMA, 3D-printed PMMA (via FDM), and 3D-printed methacrylate resin (via stereolithography, SLA). All groups were subjected to mechanical testing (flexural strength, impact strength, and hardness), water sorption and solubility tests, a tooth bonding test, microbiological assessment, and accuracy of fit measurements. The performance of sample groups was referred to ISO 20795-1 and ISO/TS 19736. The data was analyzed using one-way ANOVA. RESULTS: Samples manufactured using FDM performed within ISO specifications for mechanical testing, water sorption, and solubility tests. However, the FDM group failed to achieve the ISO requirements for the tooth bonding test. FDM samples presented a rough surface finish which could ultimately encourage an undesirable high level of microbial adhesion. For accuracy of fit, FDM samples showed a lower degree of accuracy than existing materials. CONCLUSIONS: Although FDM samples were a cost-effective option and were able to be quickly manufactured in a reproducible manner, the results demonstrated that current recommended testing regimes for conventionally manufactured denture-based polymers are not directly applicable to additive-manufactured denture base polymers. Therefore, new standards should be developed to ensure the correct implementation of additive manufacturing techniques within denture-based fabrication workflow.

3D Printing of Complete Dentures: A Narrative Review.

To explore the applications of 3D printing for the fabrication of complete dentures, a literature search was conducted using PubMed to identify articles related to the topic of 3D-printed complete dentures. A search was conducted that included the following keywords: digital complete denture workflow, printed complete denture, additive manufacturing complete denture, digital complete denture, CAD/CAM complete denture. Articles published before 2016 were excluded to increase the relevancy of reporting results. Determining how 3D-printed dentures compare to conventional and milled dentures is important to better understand how they can be used clinically. Material strength, color stability, and denture base adaptation are discussed. Currently, the area of greatest innovation is with printing resins and improving physical and esthetic properties. As with every innovation, multiple generations of materials are created before the gold standard is achieved. While the ideal printed denture material does not currently exist, based on the published research, printed dentures have material strength that meets ISO standards, with denture base adaptation similar to conventionally processed dentures. Clinically, it is likely that printed dentures will have more challenges with fractures, color stability, and staining. However, printed dentures offer many benefits, and the current limitations will be addressed as new materials are developed. We are currently at the beginning of what is an exciting future for printed dentures.

Manufacturing Accuracy, Intaglio Surface Adaptation, and Survival of Additively and Subtractively Manufactured Definitive Resin Crowns After Cyclic Loading: An In Vitro Study.

PURPOSE: To assess the manufacturing accuracy, intaglio surface adaptation, and survival of resin-based CAD/CAM definitive crowns created via additive manufacturing (AM) or subtractive manufacturing (SM). MATERIALS AND METHODS: A maxillary right first molar crown was digitally designed and manufactured using AM hybrid resin composite (VarseoSmile Crown Plus, Bego [AM-HRC]), AM glass filler-reinforced resin composite (Crowntec, Saremco Dental [AM-RC]), and SM polymer-infiltrated ceramic (Vita Enamic, VITA Zahnfabrik [SM-PICN]). Manufacturing accuracy (trueness and precision) was assessed by computing the root mean square (RMS) error (in µm; n = 15 per material). Intaglio surface adaptation was assessed by calculating the average gap distance (µm). Ten crowns from each group were cemented on fiberglass-reinforced epoxy resin dies and cyclically loaded to simulate 5 years of functional loading. One-way ANOVA, post hoc Bonferroni comparison tests, and Levene's test were used to analyze the data (α = .05). RESULTS: AM-RC had higher overall trueness than AM-HRC and SM-PICN (P ≤ .05), whereas the trueness of AM-RC on the external surface was similar to that of SM-PICN (P = .99) and higher than AM-HRC (P = .001). SM-PICN had lower precision than AM-RC and AM-HRC overall and at internal occlusal surfaces (P ≤ .05). Overall intaglio surface adaptation was similar between all groups (P = .531). However, for the axial intaglio surface, AM-RC and AM-HRC had higher adaptation than SM-PICN (P ≤ .05). All tested crowns survived the cyclic loading simulation of 5 years clinical use. CONCLUSIONS: AM-RC showed high manufacturing accuracy and adaptation. The tested resin-based CAD/CAM materials demonstrated clinically acceptable manufacturing accuracy and simulated medium-term durability, justifying the initiation of clinical investigations to determine their potential implementation in daily clinical practice.

Working Models in the Digital Workflow: Are They Reliable?

PURPOSE: This position paper summarizes all relevant aspects of the use of working models derived from digital data in digital and hybrid workflows, aiming to (1) provide the reader with a comprehensive review of the types of models that currently can be produced from a digital file created by an intraoral scanner (IOS); (2) critically analyze issues that may undermine or compromise their reliability when requested for the fabrication of both tooth-borne and implant-supported fixed dental prostheses (FDPs); and (3) indicate the procedures to be implemented in order to overcome these issues and produce satisfactory restorations. MATERIALS AND METHODS: By way of a thorough literature review, the authors highlight the critical issues of milled and 3D-printed models, solid and alveolar, explaining the differences in terms of accuracy and reliability. RESULTS AND CONCLUSIONS: By describing the peculiarities of models with prepared natural teeth and those incorporating metal implant analogs, the clinical indications for their use are given while proposing the strategies that can be adopted to avoid errors during fabrication or to overcome inaccuracies.

Complete Digital Workflow for Fabricating an Occlusal Device Using Artificial Intelligence- Powered Design Software and Additive Manufacturing: A Dental Method.

Artificial intelligence (AI) has been expanding into areas that were thought to be reserved for human experts and has a tremendous potential to improve patient care and revolutionize the healthcare field. Recently launched AI-powered dental design solutions enable automated occlusal device design. This article describes a dental method for the complete digital workflow for occlusal device fabrication using two different AIpowered design software programs (Medit Splints and 3Shape Automate) and additive manufacturing. Additionally, the benefits and drawbacks of this workflow were reviewed and compared to conventional workflows.

Additive Manufacturing Technologies: Where Did We Start and Where Have We Landed? A Narrative Review.

Additive manufacturing (AM), also known as 3D printing, is gaining burgeoning interest among various dental disciplines. The import of this technology stems not only from its ability to fabricate different parts but from the solutions it provides for the customization and production of complex designs that other methods cannot offer-all to the end of enhancing clinical treatment alternatives. There is a wide range of AM machinery and materials available to choose from, and the goal of this review is to provide readers and clinicians with a decision tool for selecting the appropriate technology for a given application and to successfully integrate AM into the digital workflow.

Positional Trueness with Different Titanium Base Bonding Techniques for Single Implant Crowns: In Vitro Evaluation of Model-Free Workflow Versus Additively Manufactured Models.

OBJECTIVES: To compare the positional trueness of implant-crown bonding to titanium bases (Ti-bases) using different bonding protocols. MATERIALS AND METHODS: A nonprecious alloy model with a single implant at the mandibular right first molar site was digitized, then a single implant crown was designed. The crown was milled, adhesively cemented on a Ti-base, and screw-retained on the implant in the master model to obtain a reference scan. Forty PMMA implant crowns were subtractively manufactured and allocated to one of four study groups (n = 10 crowns per group) based on the bonding protocol on Ti-bases: Group 1 = modelfree bonding; Group 2 = bonding on the master model (control); Group 3 = bonding on a model from an industrial-grade 3D printer (Prodways); Group 4 = bonding on a model from a conventional 3D printer (Asiga). To assess the positional trueness of crowns, the scans of crowns when on the model were superimposed over the reference scan. Median distance and angular deviations were analyzed using Kruskal-Wallis and Mann- Whitney tests (α = .05). Mesial and distal contacts of crowns were assessed by two independent clinicians. RESULTS: The control group (Group 2) resulted in the smallest distance deviations (0.30 ± 0.03 mm) compared to model-free (0.35 ± 0.02 mm; P = .002; Group 1) and conventional 3D printer (0.37 ± 0.01 mm; P = .001; Group 4) workflows. Buccolingual (P = .002) and mesiodistal (P = .01) angular deviations were higher in the conventional 3D printer group than in the control group (P = .002). Proximal contact assessments did not show any differences among groups. CONCLUSIONS: While bonding crowns to Ti-bases on a master model created with an industrial-grade 3D printer resulted in the highest positional trueness, model-free workflows had a similar positional trueness to those manufactured with a conventional 3D printer.

Maximum Fracture Load of Interim Crowns Fabricated by Additive and Subtractive Techniques.

PURPOSE: To evaluate fracture load values of five types of interim CAD/CAM crowns with and without thermocycling. MATERIALS AND METHODS: A complete coverage crown was designed on a mandibular first molar with a uniform 1.5-mm axial and occlusal reduction, and the STL file was exported to manufacture 100 crowns using five materials (20 crowns per material): ZCAD Temp Esthetic (SM-ZCAD; Harvest Dental); Telio CAD (SM-TCAD); P pro Crown and Bridge (AM-PPRO); E-Dent 400 C&B MHF (AM-EDENT); and DENTCA Crown & Bridge (AM-DENTCA). Each group was then divided into two subgroups: before and after thermocycling (10 cornws per subgroup). The STL file of the mandibular first molar die was used to manufacture 100 resin dies. Each die was assigned to one interim crown. Interim crowns were then luted to their assigned die using a temporary luting agent. The fracture strength of crowns was then assessed using a universal testing machine at a crosshead speed of 2 mm/minute. Two-way ANOVA followed by Tukey multiple comparations post-hoc tests were used to assess the effect of material choice and thermocycling process on the fracture strength of interim crowns (α = .05). RESULTS: Material choice and the thermocycling process exerted a significant (P < .001) impact on the fracture strength of interim crowns. However, the interaction between these two factors did not yield a statistically significant effect (P = .176). CONCLUSIONS: Within the limitations of this study, the type of interim materials and thermocycling process have a significant impact on the fracture strength of interim crowns.

Replacement of unsatisfactory ceramic veneers with the aid of a digital workflow.

This case report focuses on the replacement of ceramic laminate veneers with suboptimal marginal fit and design, employing a digital workflow and CAD-CAM technology. The patient, a woman in her 30s, expressed concerns about the appearance and hygiene challenges of her existing veneers. A comprehensive assessment, including clinical examination, facial photographs and intraoral scanning, was conducted. Utilising CAD software, facial photographs and 3D models merged to create a digital wax-up, crucial in designing suitable veneers and addressing issues like overcontouring and a poor emergence profile. Following the removal of old veneers, a mock-up was performed and approved. Preparations ensured space for restorations with well-defined margins. The final restorations, milled with Leucite-reinforced vitreous ceramic, were cemented. At the 1 year follow-up, improved aesthetics, gingival health and functional restorations were observed. This report highlights the efficacy of digital workflows in achieving consistent and aesthetically pleasing outcomes in ceramic laminate veneer replacement.

Maxillomandibular relationship record methods for computer-engineered complete dentures: a scoping review.

OBJECTIVES: The purpose of this scoping review was to identify different methods employed for recording the maxillomandibular relationship (MMR) for computer-aided designed and manufactured (CAD-CAM) complete dentures (CDs). MATERIALS AND METHODS: This scoping review followed the PRISMA-ScR guidelines and was developed according to Arksey and O'Malley and The Joanna Briggs Institute protocol. The methods were registered on the Open Science Framework (< osf.io/rf4xm> ). The focus question was: "What are the different techniques for recording the maxillomandibular relationship in the digital workflow used in CECDs?" Two investigators searched 3 online databases [MEDLINE (PubMed), Scopus, and Science Direct] independently. The inclusion criteria were clinical studies and reviews that assessed techniques for recording MMR using digital workflow for manufacturing of CECDs. A descriptive analysis was performed considering the study design, manufacturing system, clinical steps, and tools for the determination of MMR, and the difficulty level of procedures. RESULTS: 4779 articles were identified in the electronic search and 10 studies were included for data analysis. The review identified 4 commercially available CAD-CAM denture systems and 3 innovative methods suitable for abbreviating the number of appointments (2 to 4 visits). The trial denture is inherent to the procedure for the Baltic System and 3 innovative techniques. Three techniques (2 innovative and WholeYouNexteeth) demonstrated lower difficulty levels for performing the clinical procedures, regardless of the professional skills. CONCLUSIONS: The commercially available and innovative techniques for the recording of MMR may provide predictability of the treatment. The techniques are effective, however, rely on the learning curve and the patient's clinical condition. CLINICAL RELEVANCE: Recording of the maxillomandibular relationship is paramount for the manufacturing and functionality of complete dentures. Clinicians should be aware of the different tools and techniques described for registering the jaw relationship.

Transferring emergence profile and position of interim restorative implant fixture. A novel digital technique.

The present technical article describes a protocol to digitally reproduce the emergence profile of an interim implant prosthesis (IP) and to transfer its macrogeometry into the definitive restoration. The purpose of this protocol was to minimize alterations in the gingival architecture developed during the interim restorative phase of a single implant that could potentially jeopardize its esthetic outcome. The process included obtaining an intraoral scan with the interim IP in situ, a duplicate of this intraoral scan that was used to capture the exact position of the implant, and an extraoral scan of the prosthesis. These data could then be imported into IOS software to create a model where the patients' soft tissue was incorporated with precision, allowing for the fabrication of a definitive crown with an optimal soft tissue adaptation. As there are few articles in the scientific literature that have reported a consistent method to replicate the emergence profile of an interim IP, the present technical article aims to highlight the potential of utilizing the emergence profile of an interim IP created by IOS software.

Advanced digital planning approach using a 3D-printed mock-up. A case report.

OBJECTIVE: A diagnostic mock-up is a key tool that allows a preview of the outcome of an esthetic restoration. With recent developments in CAD/CAM technology, it is important to understand the pros and cons of chairside digital dentistry and the restorative materials used. The aim of the present case report is to describe in detail the use of a 3D-printed mock-up fabricated from a polymer-based material for an esthetic treatment plan within a fully digital workflow. CASE REPORT: A 45-year-old female patient presented at the clinic concerned about her esthetic appearance and the color of her anterior incisors. After a conclusive diagnosis, a restoration was planned using ceramic veneers from maxillary premolar to premolar. For a preview visualization of the outcome, an intraoral scanner was used to obtain 3D images and to allow the design of a digital smile. The template STL file was exported to a 3D printer and a 0.6-mm mock-up in A3-shade 3D resin was produced after 25 min. The mock-up was tested through a try-in and approved by the patient. As a result, the printed mock-up was considered predictable and reliable for the final restoration. CONCLUSIONS: The ease, speed, and reduced costs derived from the digital workflow, in conjunction with the accuracy of the mock-up, made the procedure highly efficient and recommendable.

Bone reconstruction using CAD/CAM technology in head and neck surgical oncology. A narrative review of state of the art and aesthetic-functional outcomes.

Bone defects following resections for head and neck tumours can cause significant functional and aesthetic defects. The choice of the optimal reconstructive method depends on several factors such as the size of the defect, location of the tumour, patient's health and surgeon's experience. The reconstructive gold standard is today represented by revascularised osteo-myocutaneous or osteomuscular flaps with osteosynthesis using titanium plates. Commonly used donor sites are the fibula, iliac crest, and lateral scapula/scapular angle. In recent years, computer-aided design (CAD)/computer assisted manufacturing (CAM) systems have revolutionised the reconstructive field, with the introduction of stereolithographic models, followed by virtual planning software and 3D printing of plates and prostheses. This technology has demonstrated excellent reliability in terms of accuracy, precision and predictability, leading to better operative outcomes, reduced surgical times and decreased complication rates. Among the disadvantages are high costs, implementation times and poor planning adaptability. These problems are finding a partial solution in the development of "in house" laboratories for planning and 3D printing. Strong indications for the use of CAD/CAM technologies today are the reconstruction of total or subtotal mandibular or maxillary defects and secondary bone reconstructions.

Evaluation of the effect of different core substrates on the accuracy of intraoral scanners.

BACKGROUND: The aim of this study was to determine if different types of core substrates have any effect on the trueness and precision of digital intraoral impressions. MATERIAL AND METHODS: A customized typodont with four similar cores of natural dentine, composite, metal (Ni-Cr), and zirconia in the position of premolars was fabricated. The study model was scanned five times with two types of intraoral scanners (Carestream 3600 and 3Shape Trios 3), and a reference standard scan was obtained using a laboratory scanner (3shape D1000). A metrology software (Geomagic X) was used to align the data of experimental scans and the reference scan to determine deviation values (trueness). Precision values were calculated with random superimposition in each intraoral scanner group. The Kruskal-Wallis test was used to compare differences between different substrates, and the Mann-Whitney test was used to compare the average values between the two scanners. RESULTS: Trios 3 was found to be significantly truer and more precise than Carestream 3600 (p value = .005, <0.001). There were no significant differences in the trueness of different substrates when they were scanned by Trios 3, while different materials showed significantly different trueness values in the Carestream 3600 group (p value = .003). Dentin showed the best trueness, and zirconia performed worse than other substrates. Regarding the precision of the scanners, neither of the scanners was affected by the type of scanning substrate. CONCLUSION: For Carestream 3600, substrate type did impact the trueness of intraoral scans, with dentin and zirconia showing the highest and lowest accuracy, respectively, while Trios 3 was similarly accurate across all substrates. Trios 3 had both higher trueness and precision than Carestream 3600.

Influence of the Manufacturing Trinomial (Technology, Printer, and Material) on the Marginal and Internal Discrepancies of Printed Metal Frameworks for the Fabrication of Tooth-Supported Prostheses: A Systematic Review and Meta-analysis.

PURPOSE: The purpose of this systematic review and meta-analysis was to compare the influence of fabrication method (conventional, subtractive, and additive procedures) and manufacturing trinomial (technology, printer, and material combination) on the marginal and internal fit of cobaltchromium (Co-Cr) tooth-supported frameworks. MATERIALS AND METHODS: An electronic systematic review was performed in five data bases: MEDLINE/PubMed, Embase, World of Science, Cochrane, and Scopus. Studies that reported the marginal and internal discrepancies of tooth-supported Co-Cr additive manufacturing (AM) frameworks were included. Two authors independently completed the quality assessment of the studies by applying the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. A third examiner was consulted to resolve lack of consensus. RESULTS: A total of 31 articles were included and classified based on the evaluation method: manufacturing accuracy, the dual- or triple-scan method, stereomicroscope, optical coordinate measurement machine, microCT, profilometer, and silicone replica. Six subgroups were created: 3D Systems, Bego, Concept Laser, EOS, Kulzer, and Sisma. Due to the heterogeneity and limited data available, only the silicone replica group was considered for meta-analysis. The metaanalysis showed a mean marginal discrepancy of 91.09 µm (I2 = 95%, P < .001) in the conventional group, 77.48 µm (I2 = 99%, P < .001) in the milling group, and 82.92 µm (I2 = 98%, P < .001) in the printing group. Additionally, a mean internal discrepancy of 111.29 µm (I2 = 94%, P < .001) was obtained in the conventional casting group, 121.96 µm (I2 = 100%, P < .001) in the milling group, and 121.25 µm (I2 = 99%, P < .001) in the printing group. CONCLUSIONS: Manufacturing method and selective laser melting (SLM) metal manufacturing trinomial did not impact the marginal and internal discrepancies of Co-Cr frameworks for the fabrication of tooth-supported restorations.

DIGITAL FABRICATION OF COMPLETE DENTURES, COMPARED TO CONVENTIONAL METHODS, MAY OFFER A MORE COST-EFFECTIVE APPROACH WITH IMPROVED PATIENT OUTCOMES.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Digitally versus conventionally fabricated complete dentures: A systematic review on cost-efficiency analysis and patient-reported outcome measures (PROMs). Tew, In Meei, Suet Yeo Soo, and Edmond Ho Nang Pow.The Journal of Prosthetic Dentistry (2023). SOURCE OF FUNDING: No fund was received. TYPE OF STUDY/DESIGN: Systematic review.