Abdelnabi Mohamed H, Swelem Amal A
Oral and Maxillofacial Prosthodontic Department, King Abdulaziz University, Jeddah, SAU.
Prosthodontic Department, Cairo University, Cairo, EGY.
Cureus. 2024 Sep 19;16(9):e69698. doi: 10.7759/cureus.69698. eCollection 2024 Sep.
There has recently been an increasing trend to shift the fabrication of complete dentures from conventional to digital workflows to shorten the treatment time and increase patient comfort and satisfaction. Digital fabrication of complete dentures can be achieved either by a subtractive process (milling) or by an additive technique (3D printing). The milling process offers numerous advantages; however, they require large-size production machines and are associated with low production efficiency, increased cost, limited block size, and a considerable waste of material. On the other hand, 3D printing technology can potentially offer the benefits of lower manufacturing and equipment costs, good surface details, and lower material waste. Hence, 3D printing is being considered lately by some researchers as a valid choice for manufacturing digital dentures. Therefore, the aim of the current review was to identify and highlight studies on 3D-printed dentures, mainly those investigating clinical and patient-centered outcomes. A search was conducted using the databases PubMed/MEDLINE, Cochrane Library, Embase, and Google Scholar. After applying the inclusion and exclusion criteria, a total of 16 studies that investigated clinical outcomes (masticatory efficiency, biting force, retention and stability, computerized occlusal analysis, and post-insertion maintenance) as well as patient-based outcomes (patient satisfaction, oral health-related quality of life (OHRQoL), patient-related complications, patient preference, and willingness to pay) were included. After a thorough review and discussion of these articles, it could be concluded that 3D printing of complete dentures offers many advantages from both a clinical and patient-based perspective. Retention and comfort with 3D-printed dentures were found to be comparable or even superior to conventional dentures. Moreover, retention of 3D-printed dentures constructed from conventional impressions and digitized casts demonstrated improved retention when compared to a protocol adopting intraoral scanning (digital impressions). Masticatory efficiency, biting force, OHRQoL, and patient satisfaction with 3D-printed dentures varied and were inconsistent among the included studies. Most of the studies reported positive results in the different domains and assessed aspects, while others reported some concerns (especially in terms of aesthetics and phonetics). With regard to post-insertion maintenance, printed dentures showed comparable results to conventional dentures in the short term. The technique seems promising with numerous benefits; however, further clinical research with larger sample sizes and longer follow-up periods is still needed to confirm these conclusions and address the potential concerns.
近年来，全口义齿的制作出现了一种从传统流程向数字化流程转变的趋势，以缩短治疗时间，提高患者的舒适度和满意度。全口义齿的数字化制作可以通过减法工艺（铣削）或加法技术（3D打印）来实现。铣削工艺有许多优点；然而，它们需要大型生产机器，且生产效率低、成本高、块体尺寸有限，材料浪费也相当大。另一方面，3D打印技术可能具有降低制造和设备成本、表面细节良好以及材料浪费少等优点。因此，一些研究人员最近认为3D打印是制造数字化义齿的一个有效选择。因此，本综述的目的是识别和突出关于3D打印义齿的研究，主要是那些调查临床和以患者为中心的结果的研究。使用PubMed/MEDLINE、Cochrane图书馆、Embase和谷歌学术等数据库进行了检索。在应用纳入和排除标准后，共纳入了16项研究，这些研究调查了临床结果（咀嚼效率、咬合力、固位和稳定性、计算机化咬合分析以及戴入后维护）以及基于患者的结果（患者满意度、口腔健康相关生活质量（OHRQoL）、患者相关并发症、患者偏好以及支付意愿）。在对这些文章进行全面审查和讨论后，可以得出结论，从临床和基于患者的角度来看，全口义齿的3D打印具有许多优点。发现3D打印义齿的固位和舒适度与传统义齿相当，甚至更优。此外，与采用口内扫描（数字印模）的方案相比，由传统印模和数字化模型制作的3D打印义齿的固位有所改善。3D打印义齿的咀嚼效率、咬合力、OHRQoL和患者满意度各不相同，在所纳入的研究中也不一致。大多数研究在不同领域和评估方面报告了积极结果，而其他研究则报告了一些问题（特别是在美学和语音方面）。关于戴入后维护，打印义齿在短期内与传统义齿的结果相当。这项技术似乎前景广阔，有诸多益处；然而，仍需要进一步开展样本量更大、随访期更长的临床研究来证实这些结论，并解决潜在问题。
