Digital dentures versus conventional dentures
Perhaps you’ve heard the term ‘digital dentures’ and wondered what they are. Perhaps you’ve even contemplated whether they might be an option for you. The relative newness of digital dentistry means there is limited objective information for you to base your choices on and let’s be honest, you probably wouldn’t choose to spend time trawling through academic articles trying to decipher the research results. To save you the trouble, the following article explores some of the research into the new technology of 3D printing and the advent of digital dentures as an option for those needing removable false teeth.
It is important to be mindful of the imbalance between bodies of research. Conventional, removeable dentures, have been around for much longer than computer-assisted design/computer manufactured or digital dentures which are relative newcomers to dental technology. At this stage the body of research for digital dentures is considerably smaller than for conventional dentures. Even less research comparing the two types of removeable denture exists.i
In this limited review, we examine how digital technology advances the manufacturing process of dentures and whether it results in a better product for the patient. We also consider the patient’s perspective and look at some measures of oral health-related quality of life for denture wearers. But firstly, what are digital dentures?
What are digital dentures?
Digital dentures are a recent innovation. In contrast to conventional dentures which are handmade, digital dentures are manufactured from resin using computer assisted design and manufacture (CAD/CM) and either additive 3D printing technology, or subtractive 3D milling.
This simply means that instead of your dental prosthetist taking impressions of your mouth with trays and a malleable impression material to get the exact fit before final manufacture, a laser scanning process is used to record the geography of your gums and any existing natural teeth. This information is transferred to denture design software in a 3D printer which constructs the denture automatically.
How does digital denture technology benefit me as a denture wearer?
Much has been made of the benefits to both the denture wearer and the denture laboratory.
For the patient
- Fewer appointments therefore less time in the chair
- No metal trays inserted into your mouth to take impressions – an issue for some with sensitive gagging response
- Faster manufacturing process means you have your denture quicker
- A digital record of your oral scan is kept on file for future reference although given the dynamic nature of the oral landscape it’s questionable how long this would be useful.
For the dental technician
- Less time spent making the denture - automated manufacture
- Quicker turn around
- Less labour intensive therefore eventually cheaper once the outlay for expensive equipment is recovered.
Are digital dentures worth the cost?
It seems the jury is still out on this question given the relatively recent appearance of digital denture technology. More research is needed.ii For example, given the relative newness of the technology, longevity of the product has not yet been tested. Some doubts have also been expressed regarding the digital denture aesthetic – that is, how the dentures look.iii Some frustration was also expressed by researchers with the inability of the digital system to allow individualised placement of front teeth. This can be a problem when some patients request their denture to resemble the natural teeth they are replacing, with small natural anomalies included.iv Therefore, it appears at this stage that the individual nature of a patient’s prosthetic needs is not as easily satisfied with the digital option although developments to overcome this issue are underway.v
Are digital dentures for me?
A brief review of the literature on digital dentures indicates more research on the efficacy of this new technology needs to be done.vi As with many new technological developments, outcomes improve with time and experience. As the scanning becomes more sophisticated and able to more accurately record soft tissue, and as software is further refined, nuances in individual oral geographies will be better catered for. A research study concluded that while no significant impact on oral-health-related quality of life was found, there were time advantages for the patient who needed only two visits to the prosthetist and one hour less than the conventional method spent in the chair. In addition, five fewer hours were spent by the dental technician in the manufacturing process.vii
Pain and functionality of digital dentures versus conventional dentures
According to one study, new digital denture recipients reported more pain (P=.039) two weeks after fitting, than those receiving conventional dentures. In the same study, conventional denture wearers reported better functionality in two weeks and were feeling less handicapped after three months.viii But one study doesn’t equal definitive results and we reiterate, more research into digital denture technology is needed.
Summary case for and against digital dentures
In summary, the literature review revealed the lack of research into the new technology and the need for continuing investigation into how it compares with the existing technology. However, even in this brief overview of what we currently know about this recent technology, there are clear advantages and disadvantages to both the patient and the dental industry.
Digital denture advantages
Advantages included fewer appointments for the patient, less time investment for the dental technician in the manufacturing process, and the ability to save patient records on file to avoid the process of taking impressions if you happen to lose or break your denture.ix
Digital denture disadvantages
Disadvantages for the patient included the necessity of having the right oral configuration for digital dentures. If your mouth doesn’t conform to the normal, digital dentistry probably isn’t an option until technology has sorted this issue. In addition, according to one study, digital dentures cannot be customised in the same way as conventional dentures, leading to a standardised tooth configuration more commonly associated with budget dentures. Some studies expressed doubts about the biocompatibility of the materials from which digital dentures are made, and also the clinical performance of digital dentures. Again, more research was called for.x
In conclusion
Your choice of dentures is critical to your health, your appearance, your overall quality of life and of course, your pocket. Making a choice between conventional and digital dentures is not an easy one for the denture wearer given much of the available information from online reviews is industry based. Manufacturers have equipment to sell. Denture clinics, having purchased the expensive equipment, must pay for it. However, they all have a vested interest in making the technology successful. Digitalised dentures are very possibly the future of denture prosthetics.xi Although, like all new developing technology, there are wrinkles yet to be ironed out. If your jaw alignment does not conform to normal, or you require a more individualised aesthetic, it may be prudent to seek more than one professional opinion.
i Peroz S, Peroz I, Beuer F, Sterzenbach G, von Stein-Lausnitz M. Digital versus conventional complete dentures: A randomized, controlled, blinded study. J Prosthet Dent. 2021 Apr 8:S0022-3913(21)00073-1. doi: 10.1016/j.prosdent.2021.02.004. Epub ahead of print. PMID: 33838918. ii Anadioti E, Musharbash L, Blatz MB, Papavasiliou G, Kamposiora P. 3D printed complete removable dental prostheses: a narrative review. BMC Oral Health. 2020 Nov 27;20(1):343. doi: 10.1186/s12903-020-01328-8. PMID: 33246466; PMCID: PMC7694312. iii Alhallak KR, Nankali A. 3D Printing Technologies for Removable Dentures Manufacturing: A Review of Potentials and Challenges. Eur J Prosthodont Restor Dent. 2022 Feb 28;30(1):14-19. doi: 10.1922/EJPRD_2208Alhallak06. PMID: 34029014 iv Dai, Ning & yu, Xiaoling & Fan, Qilei & Yuan, Fulai & Liu, Lele & Sun, Yuchun. (2018). Complete denture tooth arrangement technology driven by a reconfigurable rule. PLOS ONE. 13. e0198252. 10.1371/journal.pone.0198252. v Dai, Ning & yu, Xiaoling & Fan, Qilei & Yuan, Fulai & Liu, Lele & Sun, Yuchun. (2018). Complete denture tooth arrangement technology driven by a reconfigurable rule. PLOS ONE. 13. e0198252. 10.1371/journal.pone.0198252. vi Alhallak KR, Nankali A. 3D Printing Technologies for Removable Dentures Manufacturing: A Review of Potentials and Challenges. Eur J Prosthodont Restor Dent. 2022 Feb 28;30(1):14-19. doi: 10.1922/EJPRD_2208Alhallak06. PMID: 34029014. vii Peroz S, Peroz I, Beuer F, Sterzenbach G, von Stein-Lausnitz M. Digital versus conventional complete dentures: A randomized, controlled, blinded study. J Prosthet Dent. 2021 Apr 8:S0022-3913(21)00073-1. doi: 10.1016/j.prosdent.2021.02.004. Epub ahead of print. PMID: 33838918. viii Peroz S, Peroz I, Beuer F, Sterzenbach G, von Stein-Lausnitz M. Digital versus conventional complete dentures: A randomized, controlled, blinded study. J Prosthet Dent. 2021 Apr 8:S0022-3913(21)00073-1. doi: 10.1016/j.prosdent.2021.02.004. Epub ahead of print. PMID: 33838918. ix Alhallak KR, Nankali A. 3D Printing Technologies for Removable Dentures Manufacturing: A Review of Potentials and Challenges. Eur J Prosthodont Restor Dent. 2022 Feb 28;30(1):14-19. doi: 10.1922/EJPRD_2208Alhallak06. PMID: 34029014. x Alhallak KR, Nankali A. 3D Printing Technologies for Removable Dentures Manufacturing: A Review of Potentials and Challenges. Eur J Prosthodont Restor Dent. 2022 Feb 28;30(1):14-19. doi: 10.1922/EJPRD_2208Alhallak06. PMID: 34029014. xi https://www.foydentures.com/trial-reveals-limitations-of-digital-dentures
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