Workflows and Laboratory Cost for Removable Digital Complete Denture: Two Case Reports with and without Existing Denture

Abstract

The integration of digital dentistry in the fabrication of complete dentures (CDs) has been facilitated through the use of intraoral scanners and computer-aided design and manufacturing (CAD/CAM). However, the financial implications associated with the fabrication of digital CDs have been rarely explored. This study is aimed at presenting two different approaches to CD fabrication, combining conventional with digital techniques, and comparing the total cost of fabrication. The first case involved a 70-year-old woman without existing denture, while the second case involved a 97-year-old woman with inadequate retention and stability of CDs in both jaws. In the first patient, who lacked information about her old denture, the first approach was employed, utilizing milling technology for denture processing. The second patient, who already had an existing denture, underwent the second approach, which employed printing technology for denture processing. CAD/CAM replicas of the existing dentures were used for the final impression, bite registration, and as a guide for tooth arrangement. Two digital protocols and laboratory cost in CD fabrication have been proposed. The relatively high cost of CAD/CAM CDs restricts the widespread of digital technology in CD fabrication.

Figure 1

(a) Printed custom impression trays with screw-like patterns to serve as a guide for the occlusion rim wax-up. (b) Custom impression trays with a wax occlusion rim after adding autopolymerized acrylic resin on the retromolar pad area and border molding.

Figure 2

(a) Maxillomandibular relationship record silicone on the occlusion rim with polysulfide impression. (b) Flowable composite placed on the polysulfide final impression to transfer the PPS.

Figure 3

(a) Modifications done on the printed trial denture with the maxillomandibular relationship recorded with Aluwax. (b) Finished denture and delivery.

Figure 4

(a) Duplicate dentures tried in the patient's oral cavity. (b) Poured dental stone casts mounted on the articulator. (c) Notches made on the land area of the master casts.

Figure 5

(a) Maxillary posterior tooth arrangement. (b) Mandibular posterior tooth arrangement. (c) Maxillomandibular relationship with no horizontal overlapping of the left maxillary and mandibular molar teeth.

Figure 6

(a) Finished denture. (b) Denture delivery.