Summary

Digital technology has brought about a wave of effective, more accessible and pleasant dental treatments. Digital dentures are a vital aspect of this technological advancement and a key player in removable prosthetic dental rehabilitation. It has cut short laborious work hours for the dentist and laboratory processing time, and provided a more accurate fit of the denture and patient satisfaction. Digital denture-making includes everything from intraoral scanners, virtual AI models, and CAD/CAM manufacturing of dentures to 3D printers.

Introduction

Complete dentures have stood the test of time in dental rehabilitation. The conventional method of denture fabrication, though scientific, tested and proven clinically accurate, is often a hurdle in today’s fast-paced tech-savvy world. You’re often asked, ‘Is it necessary to visit the dentist multiple times?’, ‘Why make multiple moulds?’, and so on.

Yes, undoubtedly, for the edentulous or partially edentulous crowd and their families, the process of denture-making is a long, tedious process, uncomfortable, and sometimes prone to errors and repeated trials. The advent of digital dentures has been a much-awaited disruption in removable prosthetics and offers a simpler, more accurate, comfortable, and faster solution to the challenges of removable dentures.

The process of fabricating digital dentures with digital is essentially a sequential step of digital impression making, virtual moulds, virtual bite registrations, digital designing, and an automated process of manufacturing.1 Together with advanced high-strength dental materials for removable dentures, modern prosthetic rehabilitation is a new chapter in dentistry.1

Let us understand digital dentures and the nuances of digital denture-making in detail:

Digital Impressions for Edentulous Arches:

“So comfortable”- this is the most common feedback from patients who see their prosthodontist use an intraoral scanner over conventional impressions for denture-making.

As a Prosthodontist, I say that the success of dentures lies in an accurately recorded impression of the anatomical areas of the jaw.

It is usually a two-step procedure, whether done conventionally or digitally. The main drawbacks of the traditional technique are the uncontrolled finger pressure while recording the impression, placement of the impression trays and subjective manipulation of the impression-making dental material.  The messy impression materials and vigorous massaging of the cheeks and the tongue add to the woe.

Intro-oral can do away with manual techniques they use artificial landmarks, intraoral scan bodies, specific scanning patterns, auxiliary geometry parts, splinted intraoral scan bodies, etc. to ensure a complete scan of the denture bearing area.2 Though fully impression-free dentures are not yet a reality, the technology is rapidly advancing, and making complete denture patients entirely digital is the near horizon.

Some of the most widely studied digital scanners include Primescan, Omnicam, Carestream, Planmeca, Trios Health 4, Trios 3, Aoral Scan Shining3D Canada, and Medit i500. The digital scanner industry is rapidly evolving. Regular upgrades ensure precision and make the scanners user-friendly, wireless, ergonomic and affordable.

CAD/CAM (Computer Aided Designing) Softwares

3D scans of the bite registration are typically used in CAD software to virtual models and make trial dentures. Software’s like exocad, Stratos 300, and 3 Shape are routinely used to determine the occlusal planes, tooth arrangement landmarks and setting up teeth. CAD designs can be transferred to the STL file for making trial dentures either using wax or PMMA.

Exocad is known for its open architecture, compatibility with most systems, offers flexibility and seamless integration across various scanner technologies.

This is beneficial for dentists with diverse hardware setups or those who are considering upgrading their technological systems.

PlanCAD offers intuitive drawing tools and enhanced visualisation features for efficient prosthetic design.

Another brand named Cerec SW includes advanced features like the biojaw algorithm, which automatically generates natural-looking restorations, saving time without compromising quality.

Computer Aided Manufacturing (CAM)

CAMs are essentially of 2 types – the additive method or the subtractive method.

Additive manufacturing includes 3-D printing the dentures slowly from the scratch by adding layer after layer of materials. Subtractive method is milling of dentures from a larger block of denture material using milling disks. Denture teeth often need to be bonded into the dedicated sockets in CAD/CAM dentures too, and the strength of the bond still needs to be assessed. 3

TrueDent by Stratasys is a multi-material 3D printing solution specifically designed for denture production. It allows users to digitally select from a wide range of shade profiles and produce various combinations of base and teeth materials simultaneously in a single, continuous print. This enhances the customization and efficiency of denture production, offering dental labs a powerful tool for scaling prosthetic manufacturing and matching patients’ expectations of a life-like denture.

Dentsply Sirona offers both digital print and mill denture solutions. They are transitioning to powder-free systems, wireless technology, and open architectures while integrating AI and cloud connectivity. The focus is on more compact and sleek designs, enhancing efficiency and user experience.

NextDent by 3D systems introduced a multi-material, jetted monolithic denture solution with NextDent Jet Denture Teeth and NextDent Jet Denture Base. These advancements, combined with Polyjet printers, allow the printing of multi-coloured monolithic dentures, expanding the possibilities for customization in denture fabrication.

Quantica’s NoVo Jet OPEN printer is a benchtop, inkjet-based multi-material system that supports up to seven different materials in a single process, surpassing the capabilities of Stratasys’ DentaJet J5, a close competitor that handles up to five materials.

Ivoclar Ivotion: Ivotion’s monolithic disc, used for milling dentures, combines both tooth and base materials, allowing for the fabrication of customised complete dentures in one continuous process, requiring only polishing after milling.

These are a few examples amongst the many that are catering to the different steps of the denture-making sequence. We can expect further innovations soon, that benefit both patients and dental practitioners.

Takeaway

The dental prosthetic and material industry has come a long way in the search of simpler, more comfortable, faster and exceptionally accurate solutions for removable dental rehabilitation for both fully and partly edentulous patients. With new technology emerging every year, prosthodontists and dentists, in general, must be trained and orientated to understand which tech to use, how best to leverage them and the practical skills, investments and maintenance required in the process.

Explore the Different Digital Applications in Prosthetic Dentistry with the Global Dentists’ Pool

NamNR Pro’s Global Dentist Pool is an assortment of industry-experienced dental specialists who help in the product development, marketing and product training of digital tools and advanced biomaterials used in prosthetic dentistry. With a cohort of clinicians & Premium Dental Advisors with proficiency in both clinical practice and industry expertise, the Pool ensures that your product for dental rehabilitation and prosthetics addresses the most pressing clinical challenges, with direct input from specialised professionals.

For manufacturers –

With a 100+ dentists spread across 21 countries; this Pool supports dental companies by helping them

(1) validate their design ideas by running surveys in a large global cohort of practitioners and/or

(2) hire premium dental advisors to support various clinical, regulatory, marketing and sales projects.

The Global Dentists’ Pool Members are all dentists specialized in MedTech in different domains. The core focus is to avoid hiring multiple ‘non-dental trained’ freelancers and consultants and hire a premium dental advisor instead – a single substitute for multiple human resources – in the form of one highly specialized advisor.

For dentists –

The Global Dentists’ Pool provides general dentists, specialists, and dental tutors, with opportunities to participate in dental projects without disrupting their clinical practice. The number of hours of engagement is flexible and dentists can upskill themselves by taking the “premium dental advisor program” which teaches how devices and software products are made & marketed, by learning the medical device industry fundamentals.

If you would like to engage with us to support your project or advance your dental career, then reach out to us at contactus@namnrpro.org.

References:

1.Dusmukhamedov, S.; Lee, C.-N.; Jeong, S.-M.; Choi, B.-H. Digital Denture Fabrication: A Technical Note. Appl. Sci. 2021, 11, 8093.

2.Leggeri, A.; Carosi, P.; Mazzetti, V.; Arcuri, C.; Lorenzi, C. Techniques to Improve the Accuracy of Intraoral Digital Impression in Complete Edentulous Arches: A Narrative Review. Appl. Sci. 2023, 13, 7068.

3. Wimmer T, Eichberger M, Lümkemann N, Stawarczyk B. Accuracy of digitally fabricated trial dentures. J Prosthet Dent. 2018;119:942–947.

Disclaimers

The opinions expressed in this article are the author’s own and are not necessarily shared by NamNR Pro.

Author’s Profile:

Dr Alpa Newaskar is a practicing oral and maxillofacial prosthodontist and implantologist; she is a celebrated aesthetic dentist specializing in TMJ management. Her captivating paper & poster presentations at global dental conferences have been instrumental in shaping her profile as a dental clinician and educator. As a dental education enthusiast, she offers her clinical experiences and ideas to train professionals in dental companies, helping them drive innovation in this healthcare niche.