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

Abstract

IntroductionImplant‐supported removable complete overdentures (IODs) are a common treatment in case of edentulism and malfunctioning of the conventional denture. Manufacturing IODs in a conventional way (C‐IODs) is time‐consuming, but in a digital workflow, this can be done in three sessions. Digitally produced IODs (3D‐IODs) are also more advantageous than C‐IODs because lost or broken 3D‐IODs can be swiftly reproduced as the digital design is always available.PurposeTo prove in a non‐inferiority study, with a margin of 0.3 point per Oral Health Impact Profile‐20 (OHIP‐20) question, that IODs made according to a fully digital workflow (3D‐IODs), function as good as C‐IODs with respect to patient‐reported outcome measures (PROMs).Materials and MethodsThis randomized crossover study included 36 fully edentulous patients who showed extreme resorption of the maxillary alveolar process, making denture retention difficult. After a maxillary bone augmentation and the installation of 4–6 implants, each patient wore both types of IOD for 1 year each, with the order reversed in two subsets of patients. The 3D‐IODs and C‐IODs were fabricated in advance for both jaws (at least two mandibular implants were already present).The OHIP‐20 survey was performed at baseline, after 1 year (before the IOD switch), and after 2 years to determine patient satisfaction scores using a visual analog scale (VAS). The general health status was assessed using the Short Form (SF‐36) questionnaire.ResultsRegarding the PROMs, patients preferred the 3D‐IOD: the improvement on the overall OHIP scale (0–4), expressed as a mean, was 0.26 points greater than for the C‐IOD (p < 0.001). This applied also to the VAS scale (1–100) with an increase of 7.37 points (p < 0.001). Regarding the SF‐36 scale, only for the item “emotional well‐being,” the 3D‐IOD scored significantly better (p = 0.033).ConclusionCompared with conventionally fabricated C‐IODs, fully digitally produced 3D‐IODs resulted in significantly higher OHIP‐20 and satisfaction scores.