Clinical performance of CAD-CAM-fabricated complete dentures: A cross-sectional study

Abstract

Statement of problem: Computer-aided design and computer-aided manufacture (CAD-CAM)-fabricated complete dentures (CD) seek to address the disadvantages associated with conventional CD fabrication. However, few if any randomized clinical trials, cross-sectional, and/or retrospective analyses are available for the clinical performance of CAD-CAM-fabricated CDs.

Purpose: The purpose of this retrospective study was to evaluate clinician experience with digital CD fabrication attempted in a 2-visit protocol. The actual number of appointments required for insertion and the number of postinsertion adjustment visits, and whether the incidence of treatment complications was related to operator experience were recorded and evaluated.

Material and methods: Patients who had received CAD-CAM-fabricated CDs were identified from a retrospective chart review. The number of appointments needed to insert digital CDs in attempting the 2-visit fabrication protocol marketed by the company, the number of postinsertion adjustments, and the reported complications were counted. There was no control group for comparative purposes used in this study. Whether the experience level of the operator influenced the frequency of a complication, the number of appointments needed to insert the definitive prostheses, and the number of postinsertion visits was determined by using an analysis of variance assessed at the 95% confidence level (α=.05). The frequency of a complication at each of the levels of operator experience was analyzed using the Exact Mantel-Haenszel chi-square test.

Results: Of the 48 rehabilitated participants, 24 participants were treated at the predoctoral level and 24 were treated at the graduate prosthodontics resident level. A total of 31 participants satisfied the true 2-visit fabrication protocol, and the remaining 17 participants required additional clinical visits because of complications on the day of insertion. The CD prostheses of 5 participants from the sample population required remaking using the conventional method. The mean number of postinsertion adjustment visits was 2.08. Of the 90 arches completed, 22 prostheses could not be inserted at the second appointment.

Conclusions: The mean number of appointments needed to insert the prostheses in both groups was 2.39 visits--not 2 as claimed by the company. The most common types of complications observed were lack of denture retention, inaccurate occlusal vertical dimension, and incorrect centric relation.