Digital versus conventional complete dentures: A randomized, controlled, blinded study.

STATEMENT OF PROBLEM: Several manufacturers have developed a digital workflow for removable prosthodontics. The Baltic Denture System is a 2-visit procedure for the digital production of complete dentures, but clinical studies comparing the system with conventional methods are lacking. PURPOSE: The purpose of this randomized, controlled, blinded crossover trial was to evaluate the impact of the digital versus conventional production of complete dentures on oral health-related quality of life (OHRQoL) measures. MATERIAL AND METHODS: Sixteen participants received 2 sets of new complete dentures produced with a digital (2 visits) and conventional (5 visits) workflow. Each complete denture was in clinical service for an observation period of 3 months. The order of the dentures was randomized, starting with digital or conventional followed by changing the set of dentures after 3 months. The primary outcome was the time-dependent change in the OHRQoL, assessed by using the Oral Health Impact Profile, German version (OHIP-G49), comparing the digital with the conventional workflow. The secondary outcome was the time needed for the fabrication process. The median values of OHIP-G49 total sum scores and OHIP-G49 dimensions were calculated for baseline and 14 days and 3 months after insertion of the dentures. Changes of sum scores over time and differences between the workflows were analyzed by using the Wilcoxon signed-rank test (α=.05). RESULTS: The data of 16 participants (11 men and 5 women; 66 ±8.5 years) were evaluated. The median values of the total OHIP-G49 sum scores and the sum scores of OHIP-G49 dimensions did not differ between workflows (P>.05). With digital dentures, more physical pain was observed after 2 weeks (P=.039). Participants with conventional dentures had less functional limitation after 14 days and felt less handicapped after 3 months (P=.036). Digital dentures were fabricated within 4 hours, whereas fabrication of conventional dentures took 10.5 hours for dentists and dental laboratory technicians. CONCLUSIONS: From the perspective of the participants, the fabrication method of the complete dentures had no significant influence on OHRQoL. However, digital dentures needed only 2 visits, 1 hour less chair time, and 5 hours less time for the dental laboratory technicians.

Digital versus conventional complete dentures: A randomized, controlled, double-blinded crossover trial.

STATEMENT OF PROBLEM: The Baltic Denture System provides a digital way to fabricate complete dentures in 2 visits. Conventional dentures using injection or compression molding require additional visits and complex laboratory procedures. However, how the fabrication method affects clinical outcomes is unclear. PURPOSE: The purpose of this clinical, randomized, controlled, double-blinded crossover trial was to evaluate the impact of the fabrication method (digital versus conventional production) of complete dentures on clinical outcomes. MATERIAL AND METHODS: Sixteen participants received 2 pairs of new complete dentures, produced in a digital and a conventional workflow. Each complete denture was worn for an observation period of 3 months. The order of the dentures was randomized. The primary outcome was the clinical assessment of the dentures by a blinded examiner, including peripheral extension, cutout for buccal and labial frenula, denture extension, and denture thickness. Denture esthetics were evaluated by the midline, position of anterior teeth, buccal corridor, and smile arc, and occlusal relationships were evaluated by the vertical dimension, sagittal relation, the Camper plane, and occlusion. In addition, the retention of maxillary and mandibular dentures and phonetics was evaluated. Differences between the prostheses were statistically analyzed with the McNemar test (α=.05). RESULTS: The borders of the digital dentures were significantly more often overextended at the time of insertion (P=.021), reducing the retention of the digital dentures, especially the maxillary dentures (P=.016). The borders of the dentures could be corrected so that after 2 weeks and 3 months, no significant differences could be seen between digital dentures and conventional dentures. CONCLUSIONS: The fabrication method has a significant influence only on the dimension of the denture border. It was significantly more often overextended in digital dentures and impaired retention, especially of the maxillary dentures, at the time of insertion. As this parameter is correctable, no significant clinical differences could be observed over the observation time of 3 months between digital dentures and conventional dentures.

Replica denture technique: improvements through the use of CAD/CAM technology.

The majority of complete dentures are not initially made for the rehabilitation of an edentulous jaw; in most cases, they replace an existing complete denture. Since the ability to adapt to a new complete denture decreases with age, the replica denture procedure represents a smart opportunity. The aim is to copy the clinically successful parts of the old prosthesis and to change the destroyed parts. There are many advantages of this technique, including increased patient acceptance, especially among older people who may not be able to adapt easily to a new prosthesis. The advantages of digital technology are very apparent in the creation of a replica prosthesis. Various cases are presented in the present article to illustrate the procedure and the advantages of this technique using the example of computer-aided fabrication with the Baltic Denture System.

Measured accuracy of intraoral scanners is highly dependent on methodical factors.

PURPOSE: The accuracy of intraoral and model scanners has been widely investigated with heterogeneous results, but the impact of the applied diversity of measurement methods on the outcomes remains unknown. This study aimed to evaluate the influence of methodological factors on the measurement result when comparing full-arch scans. METHODS: The evaluation referred to a 5M model to analyze whether accuracy measurements are affected by (1) the reference geometry, (2) mesh density of the standard tessellation language (STL) datasets, (3) operator, (4) inspection software, and (5) alignment procedure. STL datasets of full-arch reference models were measured with 29 different combinations of these factors. For each combination, 10 repeated measurements of the intermolar width were performed. Trueness was statistically analyzed with one-way ANOVA and T-tests, repeatability with Levene tests, and reproducibility with interclass correlation coefficients. RESULTS: Measurement method variations affected the intermolar width by up to 186 µm. The alignment algorithm had a significant effect on the measurement outcome (p = 0.001). Likewise, reference geometry influenced trueness and repeatability significantly (p = 0.001), whereas mesh density affected the repeatability only in some cases. The operator had no impact on the measurement result. The inspection software affected the repeatability but not the trueness. CONCLUSION: The factors reference geometry and alignment algorithm highly affected the measurement outcome, while the operator, inspection software, and mesh density showed no impact on the trueness of the outcome. Cylindrical reference geometries showed fewer differences than bar-shaped ones and best-fit alignments fewer variations than alignments based on boundary parameters.

Antibacterial Effects of Modified Implant Abutment Surfaces for the Prevention of Peri-Implantitis-A Systematic Review.

The aim of the present study was to systematically review studies investigating antibacterial implant abutment surfaces or coatings, which may suppress bacterial growth to prevent plaque-induced peri-implant inflammatory disease. Data were collected after identification of case, assay/laboratory procedure, predicate/reference standard and outcome (CAPO). Seven hundred and twenty (720) records were identified through data base searching. After screening nine publications fulfilled inclusion criteria and were included. The following surfaces/coatings showed antibacterial properties: Electrochemical surface modification of titanium by the anodic spark deposition technique; doxycycline coating by cathodic polarization; silver coating by DC plasma sputter; titanium nitride; zirconium nitride and microwave assistant nano silver coating. Since the current state of the literature is rather descriptive, a meta-analysis was not performed. While several abutment coatings showed to have antibacterial capacity, some of them also influenced the behavior of investigated human cells. None of the studies investigated the long-term effect of surface modifications. Since surface changes are the main contributing factor in the development of antibacterial effects, the biodegradation behavior must be characterized to understand its durability. To date there is no effective structure, material or strategy to avoid peri-implant inflammation used as clinical routine. Furthermore, clinical studies are scarce.