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Journal of Prosthetic Dentistry

Accuracy of anterior denture tooth arrangements of CAD-CAM complete removable dental prostheses made with a tooth mold template

      Abstract

      Statement of problem

      Research evaluating the accuracy of anterior tooth mold templates to computer-aided design and computer-aided manufacture (CAD-CAM) fabricated complete removable dental prostheses (CRDPs) is limited.

      Purpose

      The purpose of this in vitro study was to investigate the accuracy of the anterior denture tooth arrangement on CAD-CAM complete removable dental prostheses made with the anterior tooth mold template.

      Material and methods

      A maxillary and mandibular edentulous model was mounted on a semiadjustable articulator to simulate a patient’s maxillary arch. Definitive impressions and jaw relation records were made as per the manufacturer’s protocol. A maxillary and mandibular anatomic measuring device was completely seated onto the edentulous models, centered on the edentulous model midline, and horizontally positioned parallel to the mandibular ridge. A medium-size anterior tooth mold template sticker was attached on the anatomic measuring device to identify the maxillary dental midline and incisal edge position and was sent to the manufacturer as the proposed tooth arrangement reference for the definitive complete removable dental prostheses. A total of 10 milled complete removable dental prostheses were generated for 2 groups by using 2 different tooth arrangement techniques. One group (n=5) used the monobloc milling technique without bonding of denture teeth, while the other group (n=5) used the bonding system for denture teeth on the milled denture base. For comparison, a camera mounted on a tripod was used for photographic documentation. Reference markers placed on the edentulous model were used to orient and measure the difference of 4 aspects of the anterior tooth arrangement: average incisal edge position, intercanine distance, midline, and clinical crown length of the left central incisor. The difference values between the tooth mold template and definitive complete removable dental prostheses were statistically analyzed by multivariate ANOVA (α=.05) and 1-sample t tests (adjusted α=.0125).

      Results

      Overall, statistically significant differences were found between the tooth mold template (control) and definitive complete removable dental prostheses at all measuring aspects except for the midline of the midline of the milled arrangement technique (P<.0125). In terms of the midline value, the value of the milled group did not show a significant difference compared with tooth mold template (-0.19 mm). However, the value of the bonded group indicated a significant difference of midline (0.44 mm toward to the left of the tooth mold template midline). When the complete removable dental prosthesis milled denture tooth and complete removable dental prosthesis bonded denture tooth techniques were compared, there was no difference in the tested variables between the milled and the bonded groups (P>.0125).

      Conclusions

      The tooth mold template did not represent an accurate position for definitive complete removable dental prostheses for either the milled or bonded techniques. The largest differences were found at the average incisal edge of the anterior teeth and the intercanine distance for both groups. However, there was overall no clinical difference between the 2 groups (milled and bonded) of CAD-CAM complete removable dental prostheses.
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      References

        • Jacob R.F.
        The traditional therapeutic paradigm: complete denture therapy.
        J Prosthet Dent. 1998; 79: 6-13
        • Bidra A.S.
        • Taylor T.
        • Agar J.R.
        Computer-aided technology for fabricating complete dentures: systematic review of historical background, current status and future perspectives.
        J Prosthet Dent. 2013; 109: 361-366
        • Kattadiyil M.T.
        • Goodacre C.J.
        • Baba N.Z.
        CAD/CAM complete dentures: a review of two commercial fabrication systems.
        J Calif Dent Assoc. 2013; 41: 407-416
        • Masri R.
        • Driscoll C.F.
        Clinical applications of digital dental technology.
        1st ed. John Wiley & Sons, Inc., Chichester, UK2015: 107-138
        • Anusavice K.J.
        • Shen C.
        • Rawls H.R.
        Phillips’ science of dental materials.
        12th ed. Elsevier/Saunders, St Louis2012: 519
        • Goodacre B.J.
        • Goodacre C.J.
        • Baba N.Z.
        • Kattadiyil M.T.
        Comparing of denture base adaptation between CAD/CAM and conventional fabrication techniques.
        J Prosthet Dent. 2016; 116: 249-256
        • Goodacre C.J.
        • Garbacea A.
        • Naylor W.P.
        • Daher T.
        • Marchack C.B.
        • Lowry J.
        CAD/CAM fabricated complete dentures: concepts and clinical methods of obtaining required morphological data.
        J Prosthet Dent. 2012; 107: 34-46
        • Saponaro P.C.
        • Yilmaz B.
        • Heshmati R.H.
        • McGlumphy E.A.
        Clinical performance of CAD/CAM fabricated complete dentures: a retrospective study and assessment of patient satisfaction.
        J Prosthet Dent. 2016; 116: 431-435
        • Drago C.J.
        A retrospective comparison of two definitive impression techniques and their associated postinsertion adjustments in complete denture prosthodontics.
        J Prosthodont. 2003; 12: 192-197
        • Bidra A.S.
        • Farrell K.
        • Burnham D.
        • Dhingra A.
        • Taylor T.D.
        • Kuo C.L.
        Prospective cohort pilot study of 2-visit CAD/CAM monolithic complete dentures and implant-retained overdentures: clinical and patient-centered outcomes.
        J Prosthet Dent. 2016; 115: 578-586.e1
        • Abduo J.
        • Lyons K.
        • Bennamoun M.
        Trends in computer-aided manufacturing in prosthodontics: a review of the available streams.
        Int J Dent. 2014; 2014: 783948
        • Zarb G.A.
        • Hobkirk J.
        • Eckert S.
        • Jacob R.
        Prosthodontic treatment for edentulous patients.
        13th ed. Mosby/Elsevier, St. Louis2012: 210
        • Mandikos M.N.
        Polyvinyl siloxane impression materials: an update on clinical use.
        Aust Dent J. 1998; 43: 434-438
        • Kanazawa M.
        • Inokoshi M.
        • Minakuchi S.
        • Ohbayashi N.
        Trial of a CAD/CAM system for fabricating complete dentures.
        Dent Mater J. 2011; 30: 93-96
        • Yamamoto S.
        • Kanazawa M.
        • Ivaki M.
        • Jokanov A.
        • Minakuchi S.
        Effects of offset values for artificial teeth positions in CAD/CAM complete denture.
        Comput Biol Med. 2014; 52: 1-7
        • Kokich V.
        • Kiyak H.
        • Shapiro P.
        Comparing the perception of dentists and lay people to altered dental esthetics.
        J Esthet Dent. 1999; 11: 311-324