Author: Paola C. Saponaro Parra

Publisher:

Published: 2015

Total Pages: 51

ISBN-13:

Abstract: Conventional methods of complete denture (CD) fabrication involve multiple and complex clinical and laboratory procedures. With the introduction of CAD/CAM fabricated CDs, these techniques seek to ameliorate the potential disadvantages associated with conventional complete denture fabrication and highlight potential advantages such as reduced number of patient visits and improved fit of the prostheses. However, comprehensive clinical data on CAD/CAM complete dentures, that conform to an evidence based approach, are severely lacking in the available literature. To date, there are few, if any, randomized clinical trials or retrospective analyses evaluating the clinical performance and behavior of CAD/CAM fabricated dentures. In this study, patients who received CAD/CAM fabricated CDs (AvaDent® Global Dental Science LLC, Scottsdale, Ariz.) at The Ohio State University College of Dentistry were identified. Using a dental software search tool (Windent EE; Carestream Dental), the total number of CAD/CAM fabricated CDs treated within the Pre-doctoral Comprehensive Care Clinics, Advanced Prosthodontics Clinic and Dental Faculty Practice Clinic between the years 2012 and 2014 were identified. Retrospectively, data were collected from these charts of patients. Data were collected from the reviewed charts to identify and assess objective and subjective treatment outcomes including: number of appointments needed to deliver the final complete denture prostheses, number of post delivery adjustments needed due to presence of sore spots, and the reported complications with these prostheses such as compromised denture retention, fractures, incorrect vertical dimension of occlusion and/or incorrect centric relation. It was also determined whether the experience level of the operator had an influence on the number of appointments needed to deliver the final prosthesis and in the total amount of complications observed. In addition, a 13-item questionnaire was sent in the mail to those patients included in this study, in order to determine overall patient satisfaction with questions referencing their current complete denture experience. A total of fifty patients were included in this study (25 female and 25 male) between the ages of 26-90 with a mean of 62.64 years of age. The mean number of appointments needed to deliver the prosthesis in all operator experience categories (PRED, GRPR, DFP) was 2.38 compared to the control number of appointments claimed by the company as 2. In regard to post insertion adjustment visits, the mean number for the fifty patients treated was 2.12. Of the 94 arches completed, 23 prosthesis could not be delivered at the second appointment. For this, the most common reported reason were lack of retention (9/23) and incorrect vertical dimension of occlusion (4/23). All 23 dentures not delivered in the second appointment were delivered at the third appointment. No significant differences were found for number of appointments needed to deliver the prostheses in relation to operator experience. No differences were found for occurrence of a complication versus the level of operator experience. In regard to the survey component of this study, out of the 19 patients who participated, 14 of those were experienced denture wearers and it was concluded that this group, a significant difference could not be demonstrated in their ratings of agreement regarding the digital complete dentures being better than their conventional set. This data could suggest, as the company claims, that this is a cost-effective treatment modality and proves beneficial for both the clinician and patient as the number of appointments needed to deliver these dentures was considerably less than those fabricated the conventional way, thus potentially enhancing productivity. This outcome, in turn, could translate into reduced chair time and cost burden to the clinician without compromising the quality of the overall treatment.