[Short-term clinical outcomes of complete dentures fabricated by conventional and CAD/CAM milling techniques: A self-controlled study with randomized wearing sequence].

OBJECTIVE

To preliminarily compare the short-term clinical outcomes of conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) monolithic milled complete dentures and to provide clinical evidence for selecting a digital complete-denture fabrication technique.

METHODS

Seven edentulous patients were enrolled in a self-controlled study with a randomized wearing sequence. Each participant received one conventionally fabricated complete denture and one CAD/CAM monolithic milled complete denture. The fabrication technique was not actively disclosed before subjective assessment. A 2-week washout period, during which the participants wore their previous dentures, separated the two wearing periods. Subjective visual analogue scale (VAS) scores for overall satisfaction, mandibular denture retention, masticatory function, mucosal comfort, speech, and esthetics, together with pressure-point count, objective mandibular retention force, and objective masticatory efficiency, were assessed at insertion, 1 week, and 1 month. Within-patient comparisons between the two techniques were performed at each time point. Overall satisfaction, pressure-point count, objective retention force, and objective masticatory efficiency were additionally analyzed using a 2×3 fully within-subject repeated-measures analysis of variance (ANOVA), followed by Bonferroni-adjusted post hoc comparisons.

RESULTS

Significant between-process differences in satisfaction, aesthetics, retention VAS, mastication VAS, and pressure point counts were found over three time points (all P < 0.05), favoring CAD/CAM milling. No significant between-group difference in phonation. CAD/CAM milling yielded higher mandibular retention force at insertion, 1 week, and 1 month (P < 0.001, P=0.004, and P < 0.001, respectively). Objective masticatory efficiency was 38.53%±3.75% versus 42.73%±3.67% at insertion (P=0.057), 45.09% ±3.89% versus 52.93%±2.60% at 1 week (P=0.001), and 52.22%±3.88% versus 56.69%±3.28% at 1 month (P=0.031) for the conventional and CAD/CAM groups, respectively. Repeated-measures ANOVA revealed significant technique and time effects for all four variables. A significant technique×time interaction was identified only for pressure-point count [F(2, 12)=5.550, P=0.020]; the interaction for objective mandibular retention force was not significant after Greenhouse-Geisser correction [F(1.090, 6.540)=2.547, P=0.162].

CONCLUSION

In this small, short-term, within-patient study with a randomized wearing sequence, CAD/CAM monolithic milled complete dentures showed advantages in several patient-reported outcomes, objective mandibular retention force, and objective masticatory efficiency at 1 week and 1 month. These advantages did not extend to all outcomes or time points, and the between-technique difference in pressure-point count narrowed over time.