20 March 2019

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Removable complete dentures: time and costs analysis for traditional technique vs CAD-CAM technique

Lara Figini

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The conventional manufacturing protocols for the realization of removable complete dental prostheses (CRDP) are well established and are still considered  the "gold-standard" in university teaching. The introduction of CAD/CAM technology has revolutionized both the manufacturing processes for CRDPs and the clinical protocols required for denture construction.
These protocols  require only two visits, significantly reducing the number of visit for patients and for dentist, and employ new clinical materials, including specific impression holders, elastomeric impression materials, specific instruments for recording vertical dimension and centric relations. For digital technique is necessary a specific clinical training  for the operators.
In comparison, the conventional protocol uses traditional low-cost materials, universally available tools and does not require additional training for  experienced operators.     

MATERIALS AND METHODS
In a study published in the Journal of Dentistry of January 2019, the authors compared the necessary clinical time and costs incurred for the construction of removable complete dentures using a two-visit digital CAD-CAM protocol compared to the conventional protocol, in university environment. Twelve undergraduate final-year dental students utilized both the digital denture protocol and the conventional complete denture protocol to construct two sets of CDs for patients requiring either an upper CD opposing a partial natural dentition restored using a partial removable prosthesis [Group#1: students: n=6, upper CD: n=12 (6-digital complete dentures +6-conventional complete dentures)] or both upper and lower CDs [Group#2: students: n=6, upper and lower CDs: n=24 (12-digital complete dentures+ 12-conventional complete dentures)]. Overall time spent and costs (clinical, materials, and laboratory) were calculated. A cost minimization analysis was performed to compare the economic costs of the two protocols. Paired t-tests were applied for the statistical analyses (p < 0.05).     

RESULTS
From the results of this study it was found that the traditional protocol requires longer clinical times than those required in the digital protocol for both group n. 1 and group n. 2 . The costs of the materials were higher for the digital protocol in both groups, but the overall costs were instead significantly higher for the conventional protocol than for the digital protocol.     

CONCLUSIONS
From the data of this Swiss study, it can be concluded that the digital protocol for the realization of total removable prostheses has lower costs compared to the conventional protocol of complete prosthesis. Except for material costs, costs for clinical chair time, laboratory costs, and overall costs are significantly lower for the digital prosthesis protocol.  

For additional informations: 
CAD / CAM milled removable complete dentures: time and cost estimation study.