Clinical analysis of CAD-CAM milled and printed complete dentures using computerized occlusal force analyser

Abstract

BACKGROUND: Digital complete dentures (CDs) by computer-aided designing and computer-aided manufacturing (CAD-CAM) techniques (milling and three-dimensional (3-D) printing) have been evaluated clinically and provided satisfactory results. But clinical studies assessing occlusal forces by digital dentures are lacking. OBJECTIVES: To compare the occlusal force parameters in complete dentures (CDs) fabricated by milling, 3-D printing and conventional techniques having 3 commonly used occlusal schemes, using computerized occlusal force analysis system (Tech-Scan III- T-Scan III). METHODS: A total of 45 CDs were fabricated for 5 patients. Nine sets of CDs were made for each patient and were divided into 3 groups: Conventional CDs (CCD), Milled CDs (MCD), and 3-D printed CDs (3-DP CD). The CDs in each group were further divided into 3 sub-groups based on occlusion schemes – bilateral balanced (BBO), lingualized (LO) and mono plane (MP). Occlusal force analysis [percentage (%) of occlusal force applied on the right and left sides of the arch difference between them, centralization of forces and % of maximum occlusal/bite force] was done using computerized occlusal analysis system (T-Scan III) at the time of denture insertion. Univariate regression analysis and logistic regression analysis were performed (p< 0.05). RESULTS: The intergroup comparison of force distribution on right and left side in CDs fabricated by various techniques showed insignificant differences (p> 0.05) but statistically significant differences (p< 0.01) were found in Right – Left side force difference, maximum bite force % and centralization of forces. The maximum force difference on right and left side was observed CCD with MO (37.48 ± 1.03 N) and maximum occlusal-bite force % was observed for 3-DPCD with LO (95.40 ± 1.30 N). In comparison to 3-DP CD, the chances of centre of force out of ellipse (centralization of forces) was 3.36 and 2.15 times more in CCD and MCD techniques made CDs respectively. CONCLUSIONS: The occlusal parameters in CDs were affected by the fabrication techniques and occlusal schemes of CDs. The digital CDs retain adjusted occlusal schemes better and 3-DP CDs with BBO and LO occlusal schemes provided centralization of forces, better distribution and high maximum occlusal force % respectively.

Biting Force and chewing efficiency of Conventional and CAD/CAM complete dentures. A Cross-over Study

“…In addition, the results of the present study can be comparable to the results of Chaturvedi et al 2021b 55 who compared occlusal force analysis (percentage of occlusal force applied on the right and left sides of the arch difference between them, centralization of forces and percentage of maximum occlusal/bite force ) in complete dentures (CDs) fabricated by milling, 3-D printing and conventional techniques having 3 commonly used occlusal schemes, using computerized occlusal force analysis system (Tech-Scan III-T-Scan III), they concluded that the occlusal parameters in CDs were affected by the manufacturing techniques and occlusal schemes of CDs.…”

Assessment of Conventionally and Digitally Fabricated Complete Dentures: A Comprehensive Review

“…CECDs showed better retention of occlusal schemes. Bilateral balanced and lingualized occlusal schemes provided better centralization of forces, improved distribution, and high maximum occlusal forces [ 67 ]. This is important, as a significant relationship exists between the distribution of occlusal contacts and temporomandibular joint disorders (TMD) [ 68 ].…”

Current Status of Digital Complete Dentures Technology

“…Digitally produced dentures seem to maintain the selected occlusal schemes better than conventionally produced ones [66]. However, the bond strength of denture teeth might be a concern with both CAM techniques [67].…”

“…than conventionally produced ones [66]. However, the bond strength of denture teeth might be a concern with both CAM techniques [67].…”