Comparison of Fit of Dentures Fabricated by Traditional Techniques Versus CAD/CAM Technology

Purpose To compare the shrinkage of denture bases fabricated by three methods: CAD/CAM, compression molding, and injection molding. The effect of arch form and palate depth was also tested. Materials and Methods Nine titanium casts, representing combinations of tapered, ovoid, and square arch forms and shallow, medium, and deep palate depths, were fabricated using electron beam melting (EBM) technology. For each base fabrication method, three poly(vinyl siloxane) impressions were made from each cast, 27 dentures for each method. Compression-molded dentures were fabricated using Lucitone 199 poly methyl methacrylate (PMMA), and injection molded dentures with Ivobase's Hybrid Pink PMMA. For CAD/CAM, denture bases were designed and milled by Avadent using their Light PMMA. To quantify the space between the denture and the master cast, silicone duplicating material was placed in the intaglio of the dentures, the titanium master cast was seated under pressure, and the silicone was then trimmed and recovered. Three silicone measurements per denture were recorded, for a total of 243 measurements. Each silicone measurement was weighed and adjusted to the surface area of the respective arch, giving an average and standard deviation for each denture. Results Comparison of manufacturing methods showed a statistically significant difference (p = 0.0001). Using a ratio of the means, compression molding had on average 41% to 47% more space than injection molding and CAD/CAM. Comparison of arch/palate forms showed a statistically significant difference (p = 0.023), with shallow palate forms having more space with compression molding. The ovoid shallow form showed CAD/CAM and compression molding had more space than injection molding. Conclusion Overall, injection molding and CAD/CAM fabrication methods produced equally well-fitting dentures, with both having a better fit than compression molding. Shallow palates appear to be more affected by shrinkage than medium or deep palates. Shallow ovoid arch forms appear to benefit from the use of injection molding compared to CAD/CAM and compression molding.