Optimising Contemporary Workflows to Improve Digital Dentures
Objectives: 3-D printing holds the potential to eliminate polymerisation distortion of conventional processing. However, before a RCT could investigate printed dentures, the construction methodology needed to be tested and standardised. A clinical trial comparing and assessing potential workflows was indicated. The objective was to establish a contemporary gold standard clinical workflow for printed dentures.
Methods: Variations in the workflow were assessed in a clinical trial involving 20 patients. Each patient was provided with 2 sets of dentures, one conventional, one printed. Two sets of jaw registration blocks were provided for each patient, one with a printed baseplate and one without. The patients were randomly allocated to have the fitting surface of the digital dentures created from:
1. scan of the impression, or
2. scan of the cast, or
3. hybrid scan constructed by Flexible Scan Patching.
Customized Software was developed for:
1. 5-axis scanning
2. Merging the scan of the denture bearing area with a scan of the wax trial denture.
3. Flexible Scan Patching
4. Digitally removing teeth producing appropriate tooth sockets.
Post printing, the teeth were bonded in position.
1. Quality of the virtual fitting surface.
2. Preferred baseplate on occlusal registration blocks.
3. Preference for conventional or printed denture.
Results: The preliminary results from the first 16 patients demonstrated the workflow can produce high quality printed dentures. The scans from Flexible Scan Patching had fewer deficiencies. 76.9% dentists preferred printed baseplates for jaw registration. At the time of submitting the abstract, results from the final 4 cases are awaited before the statistical analysis is undertaken.
Conclusions: Conventional gold standard techniques to capture the fitting surface and tooth position can be used for printed dentures. Flexible Scan Patching produces better quality virtual files. Printed baseplates improve registration blocks. Consistent high-quality printed dentures are possible. Further development is required to improve resins and printers.