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Three-Dimensional Printing and CAD/CAM Milling in Prosthodontics: A Scoping Review of Key Metrics Towards Future
Catalina Cioloca Holban1, Monica Tatarciuc1, Anca Mihaela Vitalariu1
1Department of Dental Prosthesis Technology, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Abstract:
Background/Objectives: Digital prosthodontics increasingly utilize both additive (3D printing) and subtractive Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM), yet comprehensive comparisons remain limited. This scoping review evaluates their relative performance across prosthodontic applications. Methods: Systematic searches (PubMed, Scopus, Web of Science, Embase, 2015-2025) identified 28 studies (27 in vitro, 1 retrospective). Data were extracted on accuracy, efficiency, materials, and outcomes. Results: CAD/CAM milling demonstrated superior accuracy for fixed prostheses, with marginal gaps for milled zirconia (123.89 ± 56.89 µm), comparable to optimized 3D-printed interim crowns (123.87 ± 67.42 µm, p = 0.760). For removable prostheses, milled denture bases achieved a trueness of 65 ± 6 µm, while SLA-printed dentures post-processed at 40 °C for 30 min showed the lowest root mean square error (RMSE) (30 min/40 °C group). Three-dimensional printing excelled in material efficiency (<5% waste vs. milling > 30-40%) and complex geometries, such as hollow-pontic fixed dental prostheses (FDPs) (2.0 mm wall thickness reduced gaps by 33%). Build orientation (45° for crowns, 30-45° for veneers) and post-processing protocols significantly influenced accuracy. Milled resins exhibited superior color stability (ΔE00: 1.2 ± 0.3 vs. 3D-printed: 4.5 ± 1.1, p < 0.05), while 3D-printed Co-Cr frameworks (SLM) showed marginal fits of 8.4 ± 3.2 µm, surpassing milling (130.3 ± 13.8 µm). Digital workflows reduced chairside time by 29% (154.31 ± 13.19 min vs. 218.00 ± 20.75 min). All methods met clinical thresholds (<120 µm gaps). Conclusions: Milling remains preferred for high-precision fixed prostheses, while 3D printing offers advantages in material efficiency, complex designs, and removable applications. Critical gaps include long-term clinical data and standardized protocols. Future research should prioritize hybrid workflows, advanced materials, and AI-driven optimization to bridge technical and clinical gaps.
