Effectiveness of CAD-CAM Milled Versus DMLS Titanium Frameworks for Hybrid Denture Prosthesis: A Narrative Review

This narrative review aimed to evaluate the effectiveness of computer-aided design (CAD), computer-aided manufacturing (CAM) milled, and direct metal laser sintering (DMLS) titanium frameworks in hybrid denture prostheses. A structured PICO analysis and a review of ten publications were used to compare titanium frameworks for hybrid dentures made through milling, DMLS, and CAD-CAM milling. Prosthesis success, bone loss, patient satisfaction, framework fit, and biofilm adhesion were among the outcome indicators. The inclusion criteria included comparisons between DMLS and milled titanium frameworks, investigations of hybrid dentures with metal frameworks, and various study designs. The exclusion criteria included reviews, case reports, non-comparative research, and studies unrelated to hybrid dentures. A comprehensive search was performed up to December 2023 across PubMed, PubMed Central, Cochrane Library, Scopus, and Google Scholar, using terms such as CAD-CAM, dental implantation, dental prosthesis, bone loss, damaged maxilla/mandible, implant framework, and bone volume. Ten studies were available for the final analysis. These studies shed light on milled titanium framework's relative effectiveness and characteristics versus DMLS for implant-supported hybrid dentures. This narrative analysis clarifies the critical roles of the CAD-CAM and DMLS frameworks in implant-supported hybrid dentures. Despite the significant benefits of both of these technologies, it is evident that more investigation is required to identify the optimal framework option for specific clinical scenarios, highlighting the importance of continuing research in this field.