Comparing Machined CAD/CAM Complete Dentures Vs. Conventional Fabrication

Objectives: Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) has revolutionized the way dentistry is executed. The primary objective is to determine if differences exist between machined vs. conventional dentures. The secondary objective is to determine if a denture wax-tryin has a significant clinical impact on either denture set.
Methods: Preliminary impressions, final impressions, and jaw relations were obtained for both patients in this pilot double-blinded study (n=2; OUHSC IRB #9336). The same master casts were used to scan and machine dentures using Avadent Digital Denture Solutions, and subsequently to flask and process conventionally in Lucitione 199 or E21. For one patient, a wax try-in was excluded. At delivery, and 7-day follow-up, the patients and PI scored the dentures on a Likert scale of 0-4, where 0 was very unsatisfied and 4 was very satisfied, on criteria of esthetics, phonetics, occlusion, lip support, comfort, fit, vertical dimension of occlusion, retention, and extensions.
Results: The mean assessment score for the conventional denture was 3.48 (after delivery adjustments) and 3.14 for the machined dentures for the patient given the wax-tryin. The machined set was preferred by the patient solely due to darker acrylic shade and lighter-weight, though the conventional set scored higher on retention, stability, extension, and occlusion. For the patient not given the wax-tryin, the mean value for the conventional set was 3.07, and 3.75 for the machined set. The machined dentures had better outcomes for speech, esthetics, and occlusion and were preferred by the patient for esthetics and speech.
Conclusions: The wax-tryin positively affected the outcome of the conventional dentures for retention, stability, extension, and occlusion. It did not however, affect the outcome of the machined dentures. Despite this positive effect, machined dentures were still favored over conventional due to esthetics and or speech. A larger study is needed to further study the differences.