3D-Printed Complete Dentures: A Review of Clinical and Patient-Based Outcomes.

ABSTRACT

There has recently been an increasing trend to shift the fabrication of complete dentures from conventional to digital workflows to shorten the treatment time and increase patient comfort and satisfaction. Digital fabrication of complete dentures can be achieved either by a subtractive process (milling) or by an additive technique (3D printing). The milling process offers numerous advantages; however, they require large-size production machines and are associated with low production efficiency, increased cost, limited block size, and a considerable waste of material. On the other hand, 3D printing technology can potentially offer the benefits of lower manufacturing and equipment costs, good surface details, and lower material waste. Hence, 3D printing is being considered lately by some researchers as a valid choice for manufacturing digital dentures. Therefore, the aim of the current review was to identify and highlight studies on 3D-printed dentures, mainly those investigating clinical and patient-centered outcomes. A search was conducted using the databases PubMed/MEDLINE, Cochrane Library, Embase, and Google Scholar. After applying the inclusion and exclusion criteria, a total of 16 studies that investigated clinical outcomes (masticatory efficiency, biting force, retention and stability, computerized occlusal analysis, and post-insertion maintenance) as well as patient-based outcomes (patient satisfaction, oral health-related quality of life (OHRQoL), patient-related complications, patient preference, and willingness to pay) were included. After a thorough review and discussion of these articles, it could be concluded that 3D printing of complete dentures offers many advantages from both a clinical and patient-based perspective. Retention and comfort with 3D-printed dentures were found to be comparable or even superior to conventional dentures. Moreover, retention of 3D-printed dentures constructed from conventional impressions and digitized casts demonstrated improved retention when compared to a protocol adopting intraoral scanning (digital impressions). Masticatory efficiency, biting force, OHRQoL, and patient satisfaction with 3D-printed dentures varied and were inconsistent among the included studies. Most of the studies reported positive results in the different domains and assessed aspects, while others reported some concerns (especially in terms of aesthetics and phonetics). With regard to post-insertion maintenance, printed dentures showed comparable results to conventional dentures in the short term. The technique seems promising with numerous benefits; however, further clinical research with larger sample sizes and longer follow-up periods is still needed to confirm these conclusions and address the potential concerns.