Postgraduate student, Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China.
Associate Professor, Department of Prosthodontics, School & Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, PR China.
J Prosthet Dent. 2021 Feb;125(2):249-256. doi: 10.1016/j.prosdent.2020.01.004. Epub 2020 Feb 27.
Reports on digital complete dentures (CDs) are increasing. However, systematic reviews on their accuracy and influencing factors are lacking.
The purpose of this systematic review was to evaluate the accuracy of digital CDs and to summarize influencing factors.
An electronic search of the English language literature from January 2009 to October 2019 was performed in the database PubMed/MEDLINE, with the results enriched by manual searches and citation mining. Factors investigated in the selected articles included the fabrication technique, type of computer-aided design and computer-aided manufacturing (CAD-CAM) system, shape of reference model, long-term service, analytical method, and statistical indicators.
A total of 522 articles were identified, of which 14 in vitro articles met the inclusion criteria. Eight articles compared the adaptation of the denture base between digital and conventional methods, 4 studies evaluated the occlusal discrepancies, 4 compared the trueness or adaptation of the denture fabricated with CAD-CAM milling and 3D printing, 1 compared the denture adaptation with 4 different CAD-CAM systems, and 2 evaluated the adaptation of the denture base before and after incubation in artificial saliva.
Most of the studies reported clinically acceptable values for the occlusal trueness and adaptation of digital CDs. The digital CDs showed similar or better adaptation than conventionally fabricated CDs, and the greatest misfit of the intaglio surface was reported in the posterior palatal seal area and border seal area. The fabrication technique, CAD-CAM system, and long-term service were statistically significant in relation to denture accuracy. Clarification is needed concerning the accuracy of digital CDs according to the shape of the cast, the parameters related to the CAD-CAM process, the analytical method, and the statistical indicators. No clear conclusions can be drawn about the superiority of CAD-CAM milling and 3D printing regarding denture accuracy.
关于数字化全口义齿（CD）的报道越来越多。然而，缺乏关于其准确性和影响因素的系统评价。
本系统评价的目的是评估数字化 CD 的准确性，并总结影响因素。
从 2009 年 1 月至 2019 年 10 月，在数据库 PubMed/MEDLINE 中进行了英文文献的电子检索，通过手动检索和引文挖掘对检索结果进行了补充。所选文章中调查的因素包括制作技术、计算机辅助设计和计算机辅助制造（CAD-CAM）系统类型、参考模型形状、长期服务、分析方法和统计指标。
共确定了 522 篇文章，其中 14 篇体外文章符合纳入标准。8 篇文章比较了数字化和传统方法制作的义齿基托的适应性，4 项研究评估了咬合差异，4 项研究比较了 CAD-CAM 铣削和 3D 打印制作的义齿的精度或适应性，1 项研究比较了 4 种不同 CAD-CAM 系统制作的义齿的适应性，2 项研究评估了义齿基托在人工唾液浸泡前后的适应性。
大多数研究报告了数字化 CD 的咬合精度和适应性具有临床可接受的值。数字化 CD 的适应性与传统制作的 CD 相似或更好，凹面最大的不匹配发生在后腭封闭区和边缘封闭区。制作技术、CAD-CAM 系统和长期服务与义齿精度具有统计学意义。需要根据模型的形状、与 CAD-CAM 过程相关的参数、分析方法和统计指标来明确数字化 CD 的准确性。关于 CAD-CAM 铣削和 3D 打印在义齿精度方面的优势，无法得出明确的结论。
