Comparison of denture base adaptation between CAD-CAM and conventional fabrication techniques.
BACKGROUND
Currently no data comparing the denture base adaptation of CAD-CAM and conventional denture processing techniques have been reported.


OBJECTIVE
The purpose of this in vitro study was to compare the denture base adaptation of pack and press, pour, injection, and CAD-CAM techniques for fabricating dentures to determine which process produces the most accurate and reproducible adaptation.


METHODS
A definitive cast was duplicated to create 40 gypsum casts that were laser scanned before any fabrication procedures were initiated. A master denture was made using the CAD-CAM process and was then used to create a putty mold for the fabrication of 30 standardized wax festooned dentures, 10 for each of the conventional processing techniques (pack and press, pour, injection). Scan files from 10 casts were sent to Global Dental Science, LLC for fabrication of the CAD-CAM test specimens. After specimens for each of the 4 techniques had been fabricated, they were hydrated for 24 hours and the intaglio surface laser scanned. The scan file of each denture was superimposed on the scan file of the corresponding preprocessing cast using surface matching software. Measurements were made at 60 locations, providing evaluation of fit discrepancies at the following areas: apex of the denture border, 6 mm from the denture border, crest of the ridge, palate, and posterior palatal seal. The use of median and interquartile range was used to assess accuracy and reproducibility. The Levine and Kruskal-Wallis analysis of variance was used to evaluate differences between processing techniques at the 5 specified locations (α=.05).


RESULTS
The ranking of results based on median and interquartile range determined that the accuracy and reproducibility of the CAD-CAM technique was more consistently localized around zero at 3 of the 5 locations. Therefore, the CAD-CAM technique showed the best combination of accuracy and reproducibility among the tested fabrication techniques. The pack and press technique was more accurate at 2 of the 5 locations; however, its interquartile range (reproducibility) was the greatest of the 4 tested processing techniques. The pour technique was the most reproducible at 2 of the 5 locations; however, its accuracy was the lowest of the tested techniques.


CONCLUSIONS
The CAD-CAM fabrication process was the most accurate and reproducible denture fabrication technique when compared with pack and press, pour, and injection denture base processing techniques.
Graduate student, Prosthodontics and Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif. Electronic address: bgoodacre@llu.edu.
Brian J
BJ
Goodacre
Distinguished Professor, Loma Linda University School of Dentistry, Loma Linda, Calif.
Charles J
CJ
Goodacre
Professor and Director, Hugh Love Center for Research and Education in Technology, Loma Linda University School of Dentistry, Loma Linda, Calif.
Nadim Z
NZ
Baba
Professor and Director Advanced Specialty Education Program in Prosthodontics, Loma Linda University School of Dentistry, Loma Linda, Calif.
Mathew T
MT
Kattadiyil
D017076:Computer-Aided Design; D003735:Dental Casting Technique; D003819:Denture Bases; D003779:Denture Design; D003827:Denture, Complete, Upper; D006801:Humans; D015203:Reproducibility of Results