Fully digital versus conventional workflow: Are removable complete overdentures equally good? A randomized crossover...

Area of Science:

• Dental Prosthetics
• Digital Dentistry
• Patient-Reported Outcome Measures

Background:

• Implant-supported removable complete overdentures (IODs) are a standard treatment for edentulism.
• Conventional IOD fabrication is time-consuming; digital workflows offer efficiency and reproducibility.
• 3D-IODs, produced via digital workflows, allow for rapid reproduction if lost or broken.

Purpose of the Study:

• To compare the efficacy of fully digitally produced IODs (3D-IODs) against conventionally fabricated IODs (C-IODs).
• To evaluate if 3D-IODs perform non-inferiorly to C-IODs based on patient-reported outcome measures (PROMs).
• The non-inferiority margin was set at 0.3 points per Oral Health Impact Profile-20 (OHIP-20) question.

Main Methods:

• A randomized crossover study involving 36 edentulous patients with severe maxillary alveolar resorption.
• Patients received both 3D-IODs and C-IODs, each worn for one year, with the order reversed between patient groups.
• Patient satisfaction was assessed using the OHIP-20 and Visual Analog Scale (VAS); general health status was evaluated with the SF-36 questionnaire.

Main Results:

• Patients reported significantly higher satisfaction with 3D-IODs compared to C-IODs.
• The mean improvement on the overall OHIP scale was 0.26 points greater for 3D-IODs (p < 0.001).
• VAS scores increased by 7.37 points for 3D-IODs (p < 0.001), and 'emotional well-being' improved significantly on the SF-36 scale (p = 0.033).

Conclusions:

• Fully digitally produced 3D-IODs demonstrate significantly better patient-reported outcomes than conventionally fabricated IODs.
• The digital workflow for IOD fabrication leads to enhanced patient satisfaction and oral health impact.
• 3D-IODs represent a superior treatment option for edentulous patients requiring implant-supported removable dentures.