Adherence assessment of Candida albicans on CAD/CAM and conventional resin for denture base: A systematic review and network meta-analysis.

PURPOSE: To evaluate whether Candida albicans adhesion differs between denture base resins fabricated using computer-aided design/computer-aided manufacturing (CAD/CAM; milled or 3D-printed) systems and those fabricated using conventional heat-polymerized resin (HPAR).

STUDY SELECTION: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PRISMA-Network Meta-Analyses (PRISMA-NMA) guidelines. The research question was, "For the fabrication of denture bases, are resins from the CAD/CAM system more prone to Candida albicans adhesion compared with conventional resins?" Searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, Lilacs, and Embase, as well as through manual searches up to May 2025, with no language or date restrictions. The risk of bias was assessed using RoBDEMAT software. Surface roughness and contact angle were assessed using NMA.

RESULTS

The search identified 2960 records, of which 16 in vitro studies met the eligibility criteria. In four studies, HPAR was compared with milled resins; in ten, HPAR was compared with milled and 3D-printed resins, and only 3D-printed resins were evaluated in two. Overall, the milled resins exhibited lower C. albicans adhesion, whereas the 3D-printed resins exhibited higher adhesion in five studies. NMA did not significantly differ in surface roughness or contact angle between the resin types.

CONCLUSIONS

Within the limitations of the in vitro evidence, CAD/CAM milled resins were less prone to Candida albicans adhesion than conventional and 3D-printed resins. NMA indicated that the resin type did not significantly influence the surface roughness or contact angle. Further clinical studies are required to validate these findings.