Abstract
Statement of problem
Comparative cost-analysis related to different manufacturing workflows for removable
complete denture fabrication is seldom performed before the adoption of a new technology.
Purpose
The purpose of this study was to compare the clinical and laboratory costs of removable
complete dentures fabricated with a conventional (workflow C), a partial digital (workflow
M), and a complete digital (workflow D) workflow and to calculate the break-even points
for the implementation of digital technologies in complete denture fabrication.
Material and methods
Clinical and laboratory costs for each of the investigated workflows and the manufacturing
options related to denture base and denture teeth fabrication were collected from
10 private Italian dental laboratories and clinics. The selected variables included
the clinical and laboratory manufacturing time needed to complete each workflow (opportunity
cost); costs for materials, labor, packaging, and shipping; and capital and fixed
costs for software and hardware, including maintenance fees. The effect of manufacturing
workflows and their options on the outcomes of interest was investigated by using
generalized estimated equations models (α=.05). Cost minimization and sensitivity
analysis were also performed, and break-even points were calculated for the equipment
capital costs related to the implementation of workflows M and D.
Results
From a laboratory standpoint, workflows M and D and related manufacturing options
significantly (P<.001) reduced manufacturing time (5.90 to 6.95 hours and 6.30 to 7.35 hours, respectively),
and therefore the opportunity cost of each denture compared with workflow C. Workflow
M allowed variable costs savings between 81 and 169 USD, while workflow D allowed
for an additional saving of 34 USD. The sensitivity analysis showed that the break-even
point related to the capital investment for the equipment needed to implement workflows
M and D could be reached, depending on the manufacturing options adopted, between
170 and 933 dentures for workflow M and between 73 and 534 dentures for workflow D.
From a clinical standpoint, workflows C and M were almost identical. Conversely, workflow
D, which included intraoral scanning, required 1 fewer appointment, saving 0.6 hours
of chairside time and about 14 USD for materials compared with M.
Conclusions
Digital workflows (partial and complete digital workflows) were more efficient and
cost-effective than the conventional method of fabricating removable complete dentures,
with workflow D showing the lowest opportunity and variable costs and break-even point.
Savings increased when stock denture teeth were replaced with milled denture teeth
and still further with the adoption of 3-dimensionally (3D) printed denture teeth.
Milling equipment and materials for denture base fabrication were more expensive than
those for 3D-printing. Milling monobloc dentures reduced opportunity and labor costs
but increased material cost.
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Article info
Publication history
Published online: May 31, 2022
Accepted:
March 23,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 by the Editorial Council for The Journal of Prosthetic Dentistry.
