Methods & Systems for Digital Denture 

Digital Removable Denture Design & Manufacturing

In the previous blog we saw how it is worthy to take your practice to the next level with digital Dentistry. Yet, you want to learn more about adopting a CAD- CAM as a method of producing dental prosthesis. 

In this blog, I will focus on removable complete dentures using digital design and manufacturing. This blog will help you to decide on what to invest and how to move smoothly, or take a bold step digitizing your practice for removable dentures’ workflow if you decide so. 

First thing to learn is about the methods used to fabricate digital complete denture, then you can decide if you would like to spend money on equipment and trainings, or to content with  small investment on trainings for specific equipment.

Then, let’s begin,

In Canada, and in many other countries, most dental appliances in different treatment cases are produced by computer. these appliances are easy to manufature by CAD- CAM, but The fabrication of removable denture involves other factors that make this kind of appliance more complicated. the fabrication of digital denture vary depending on the methods manufacturers and laboratories use in CAD- CAM, and on systhem used with the methods. Respectively, there is milled & printed method for manufacturing, and closed & open system for transfering data.

The two systems used in fabricating digital denture are very important to know, this will help you to choose correctly your equipment. The closed system use specific trays, materials, and equipment compatible with the system. The open system, recently developed allowed more practitioners to swich to combined method using their trays, instruments, and records, then send them for scanning, designing, and manufacturing. The open digital system provide trays fabricated digitaly too, for practitioner who choose to use full digitized method. 

Many industrials are proposing different kind of softwares and manufacturing equipments, the fielf of CAD- CAM for removable dentures design and manufacturing has registered fast growing and an undergoing improvement. 

The Development of softwares using open system had a very positive impact on digitalizing dentures, and is expected to improve more its techniques in the future.

In overal, open system is flexible and reduce the overall treatment’s cost and procedures. 

Before to switch to digital denture fabrication and spending money, it is important to understand the equipment available on the market. 

One thing is sure, the methods you use for manufacturing have an impact on the final product. 

 Digital denture manufacturing involves two kind of methods, milled and printed method. 

Decades before, rarely you hear about digital complete dental prosthesis proposal from the practitioner, even when this method exists from 90s. Digital softwares were not developed enough to produce a perfect adoptable prosthesis to the patient. The method used was a milled method under closed system, and the cost of the prothesis was very expensive. 

Big and expensive equipment was needed and softwere not developed enough and very limited. The realisation of these kind of dentures needed extra expenses from the practitioner and the patients. The milled method used closed system in manufacturing wich means specific materials and protocols are involved using this method. By These days, this method is an excellent choise for the final product. The prosthesis is aesthetically and functionally perfect compared to printed method. The software and equipment are more adaptable but still quite expensive and still under ongoing improvement.

These last decades, printed method have merged and gained popularity on the market place reducing the cost of the digital denture production. Practitioners feel more confortable to propose this product to their patient. With affordeble equipment, and the open system use in manufacturing, the cost of the digital dentures have been reduced. The open system is now used for both methods, the milled and the printed methods depending on the equipment laboratory and manufacturer have.

Most used method in dental clinics and laboratories is the printed one, the software is easy to handle, the cost of the denture affordeble, and manufacturing procedures are easy. Using full digital procedures, or combining traditional and digital (printed, or melled) method, both methods are available and the choice is adapted to the patient preferences and the practitioner recommendations. 

The well known procedure on the marketplace is the open system, using conventional impressions & maxilo-mandibular reccords and digital design & fabrication. it is the most utilized method for most dental clinics.

Because of many issue using intraoral scanners to register all features needed to have a very stable denture combined system remains the best to use in term of accuracy. The use of full digital method for Complete Denture Rehabilitation remains questionable but useful for specific patients, in nurcing home and medically compromised patients.

The last point to notice for both methods is the material used for manufacturing digital denture. Manufacturing uses substractive or additive method respectively called milled and printed methods as we saw above. Milled method uses a prepolymerazed resin block, while 3D printing method uses layer by layer fabrication. In milled method, a large portion of the blank is wasted, when in Printed method material wastage is reduced after manufacturing. I should notice that manufacturers are investigating on improving shades of resin for more aesthetic results.

Scanners are a key tool for digital denture. Data acquisition can use a direct on chair intra oral scanning, or by sending impressions to the laboratory to proceed with scanning. 

The practitioner can use scanner on chairside, or use traditional methods of impression and records of maxillary and mendibulary relationship, then laboratory will switch all work on computer by extra oral scanning. This method is suitable and very effective for regulare cases, for clinics offring general traitement, and in case of availability of laboratories in the clinic’s neighbourhood.

In general, practitiners who use on chair scanner for different dental appliances, already they are using a combined or fully digital method for making dentures.

The practitioner can have all the procedures done in- house, just by purchasing full equipment and investing on trainings for his/her dental professionals, assistant and hygienist. In-house production is more suitable to prosthodontist and denturist, because of the amount of cases. It is more beneficial for general dentist and specialist in other discipline to outsource their dental laborathory procedures for their appliances.

Now, you can decide to start in investing just on scanner, if you have a concederable workflow for different appliances in fixed and removable prosthecs. This will help you to save time in back and forth cases.

You can continue using traditional methods if you have no concerns for time savings, data storage for reproducing broken or lost prosthesis for your patient, if your patients are not requiring specific needs, and when the laboratory is just in your neighbouring area.

We can conclude:

that scanners need specific training for the practitioner to successfully realise digital denture.

The costs can be reduced by using printed method.

The Quality of the future denture is improved by using milled method.

The Use of open system is now evailable for both methods.

Next blog, I will resume for you the different stages of fabrication to understand all the protocol and I will give more details on advantages and desadvantages of diferent methods.

Hope you enjoyed reading my blog, always stay turned for new and improved version of software.

Thank you