Research indicates that digital dentures offer numerous advantages over traditional methods.
These include improved denture retention and fit, (1,2) streamlined clinical and laboratory procedures, (3) heightened patient satisfaction, (4) and cost reduction (5) compared to analog approaches.
Despite these benefits, many practitioners are stuck in the past. They use conventional analog techniques for impression-taking and occlusal recordings, which are subsequently digitized in the laboratory. This analog approach can result in increased time, expense, and potential risk to patient Oral Health-Related Quality of Life (OHRQoL) and functional outcomes.
A new study at the University of Siena aimed to address these challenges.
The study tested a simplified digital workflow protocol for immediate dentures (ID) and root-supported overdentures. The study objectives were twofold:
1. Introduce a digital workflow for fabricating immediate dentures prior to extractions
2. Evaluate patient outcomes in terms of OHRQoL, bite force, and masticatory performance
As an integral part of the digital workflow, the Innobyte bite force measurement device was used to assess pre- and post-treatment function.
The authors found that digital workflows for immediate dentures are an “innovative, promising, and predictable procedure worthy of additional research.”
To learn more about how the authors integrated digital workflows and the Innobyte into their treatment plan, read the case study excerpt below.
New Study: Patient evaluation after full digital denturesAuthors:Alessio Casucci, DDS, PhD, Department of Prosthodontics, University of Siena, Siena, Italy G. Verniani, DDS, Department of Prosthodontics, University of Siena, Siena, Ital L. F. D’Arienzo, DDS, MSc, Department of Prosthodontics, University of Siena, Siena, Italy. A. Keeling, BSc, BDS, MFGDP, PhD, Department of Restorative Dentistry, School of Dentistry, University of Leeds, Leeds, United Kingdom. M. Ferrari, MD, DMD, PhD, Department of Prosthodontics, University of Siena, Siena, Italy. Study clinical report [EXCERPT]A 58-year-old man presented in the Prosthodontics Department of the University of Siena with terminal dentition. Clinical examination and radiographic assessment revealed an unrestored mouth due to severe periodontitis and several non-restorable teeth to support a prosthetic rehabilitation. Facial, dento-labial and phonetic analyses were performed. Patient needs and Quality of life were recorded at the first visit. An oral health–related quality of life test, OHIP-14 in the Italian version, was administered before treatment. Initial data on the patient’s maximum bite force and masticatory function were also recorded. Using Innobyte, the patient’s bite force was calculated at 167N. Denture design software (Dental System 2021 3Shape A/S, Copenhagen, Denmark) was used for ID design. The next step involved the virtual avulsion of dental elements residues resulting in two models of edentulous arches properly oriented in space. The software automatically generated a suggestion for setting up the selected teeth that were selected according to the patient teeth dimension and shape. This setup was customized according to the information obtained by the superimposition of the patient picture in order to better evaluate the aesthetic parameters (Fig.4).  After the designs had been completed for an oversized milling process (Vivadent AG, Ivoclar Vivadent, Schaan, Liechtenstein) PMMA disks for bases and teeth (Ivotion base and Dent multi A3 (Ivoclar Vivadent AG Schaan, Liechtenstein) were selected and positioned inside a five-axis milling unit (PrograMill 7; Ivoclar Vivadent AG, Schaan, Liechtenstein). After the complete milling, the immediate dentures were sent to the office for delivery. The remaining teeth were extracted according to the treatment plan and the two lower canines previously endodontic treated, were cut. The set of dentures was immediately inserted after the extractions. Very good adaptation was found so that no chair-side adjustments were needed. After 7 days the patient reported no pain and we proceeded with soft tissue conditioning (Gc Tissue conditioner, GC, Tokyo Japan). The IDs were anchored after 3 weeks, the patient achieved improved stability and satisfaction. After the healing time of 6 months, thanks to aesthetic and functional results, the patient decided to refuse implants and to maintain the ID relined as a definitive solution (Fig 7). The data collected for OHIP-14, bite force and masticatory performances were reported pre-treatment, three weeks after ID delivery, and three months after root anchorage. As measured on the Innobyte bite force measurement device, the patient’s bite force increased almost 200N from pre-treatment to 3 months after anchorage.  Read the full article here: Outcomes evaluation of a patient treated with roots immediate digital denture: patient evaluation after full digital dentures |
Notes:
1. AlHelal A, AlRumaih HS, Kattadiyil MT, Baba NZ, Goodacre CJ. Comparison of retention between maxillary milled and conventional denture bases: A clinical study. J Prosthet Dent. 2017 Feb;117(2):233-238.
2. Steinmassl O, Dumfahrt H, Grunert I, Steinmassl PA. CAD/CAM produces dentures with improved fit. Clin Oral Investig. 2018 Nov;22(8):2829-2835.
3. Kattadiyil MT, AlHelal A. An update on computer-engineered complete dentures: A systematic review on clinical outcomes. J Prosthet Dent. 2017 Apr;117(4):478-485.
4. Kattadiyil MT, Jekki R, Goodacre CJ, Baba NZ. Comparison of treatment outcomes in digital and conventional complete removable dental prosthesis fabrications in a predoctoral setting. J Prosthet Dent. 2015 Dec;114(6):818-25.
5. Srinivasan M, Schimmel M, Naharro M, O'Neill C, McKenna G, Müller F. CAD/CAM milled removable complete dentures: time and cost estimation study. J Dent. 2019 Jan;80:75-79.
6. Wimmer T, Gallus K, Eichberger M, Stawarczyk B. Complete denture fabrication supported by CAD/CAM. J Prosthet Dent. 2016 May;115(5):541-546.
7. Schwindling FS, Stober T. A comparison of two digital techniques for the fabrication of complete removable dental prostheses: A pilot clinical study. J Prosthet Dent. 2016 Nov;116(5):756-763.