Digital versus conventional complete dentures: A randomized, controlled, double-blinded crossover trial

Statement of problem. The Baltic Denture System provides a digital way to fabricate complete dentures in 2 visits. Conventional dentures using injection or compression molding require additional visits and complex laboratory procedures. However, how the fabrication method affects clinical outcomes is unclear. Purpose. The purpose of this clinical, randomized, controlled, double-blinded crossover trial was to evaluate the impact of the fabrication method (digital versus conventional production) of complete dentures on clinical outcomes. Material and methods. Sixteen participants received 2 pairs of new complete dentures, produced in a digital and a conventional workflow. Each complete denture was worn for an observation period of 3 months. The order of the dentures was randomized. The primary outcome was the clinical assessment of the dentures by a blinded examiner, including peripheral extension, cutout for buccal and labial frenula, denture extension, and denture thickness. Denture esthetics were evaluated by the midline, position of anterior teeth, buccal corridor, and smile arc, and occlusal relationships were evaluated by the vertical dimension, sagittal relation, the Camper plane, and occlusion. In addition, the retention of maxillary and mandibular dentures and phonetics was evaluated. Differences between the prostheses were statistically analyzed with the McNemar test (a=.05). Results. The borders of the digital dentures were significantly more often overextended at the time of insertion (P=.021), reducing the retention of the digital dentures, especially the maxillary dentures (P=.016). The borders of the dentures could be corrected so that after 2 weeks and 3 months, no significant differences could be seen between digital dentures and conventional dentures. Conclusions. The fabrication method has a significant influence only on the dimension of the denture border. It was significantly more often overextended in digital dentures and impaired retention, especially of the maxillary dentures, at the time of insertion. As this parameter is correctable, no significant clinical differences could be observed over the observation time of 3 months between digital dentures and conventional dentures. (J Prosthet Dent 2024;132:132-8)