The introduction of technology has revolutionized the field of dentistry, bringing improvements in every type of treatment from implantology to orthodontics and considerably speeding up the workflows of the Dental Laboratory.
In particular, CAD-CAM technology has brought benefits to the manufacturing processes for CRDPs and clinical protocols needed to produce them.
Analog Method VS Digital Method with Technology CAD-CAM
The realization of removable dentures can be done by following 2 different methodologies:
- traditional (or analog) method: involves manual fabrication of prostheses;
- digital method through CAD-CAM technology.
Traditional method refers to the technique of making a dental prosthesis from a duplicate of the patient's mouth (the classic plaster model).
On the other hand, CAD-CAM technology would involve taking a virtual impression by means of Intraoral Scanner enabling digital reproduction of the patient's anatomy and providing data to the software, through which a virtual model of the prosthesis (CAD) can be obtained, which will then be fabricated by milling with CAM.
In fact, there is still some reservation about the extensive acquisition of fornices digitally.
Many operators currently still use the traditional elastomer impression method for this step. From the next step, one enters fully into digital.
Analysis of costs, benefits, and implementation time
Making removable dental prostheses by the digital method, through the use of CAD-CAM technology has advantages for the dentist who has the ability to digitally survey the patient's anatomy and access the information in a short time and with extreme precision, but also for the patient who sees reduced sessions at the dentist's office (which results not only in reduced treatment time but also reduced costs).
In a study published in the January 2019 Journal of Dentistry, the authors compared the clinical time required and costs incurred for the fabrication of removable complete dentures using a two-visit digital CAD-CAM protocol compared with the conventional protocol, in a university setting.
Final-year dental students at the University of Geneva made removable total dentures following both digital and traditional denture protocols. 2 sets of total dentures (CDs) were constructed for patients who required an upper CD with antagonist, a partial natural dentition, or for patients who required both upper and lower total dentures.
Time and costs (clinics, materials and laboratory) were calculated. 
A minimization analysis was performed to compare the costs of the two protocols. From the results that emerged, it could be seen that:
- the conventional protocol requires longer clinical times than those needed in the digital protocol;
- material costs were found to be higher for the digital protocol; in contrast, overall costs are significantly higher for the conventional protocol than for the digital prosthesis protocol.
It can, therefore, be concluded that digital protocol for removable prostheses production has lower costs than conventional protocol.
Except for material costs, costs for clinical chair time, laboratory time, and overall expenses are significantly lower for the digital prosthesis protocol (discover the All4Dentures integrated solution by 88dent).
Clinical implications: the digital protocol for fabricating removable total dentures could prove to be extremely beneficial for the elderly and/or particularly compromised edentulous individuals, as it can decrease the treatment burden on the patient, reducing clinical procedures, number of visits, treatment time, and costs incurred
Sources:
Figini Lara, Dentistry33 - Total dentures: traditional vs CAd/CAm technique. Cost and time analysis, February 2019.
Srinivasan M., Schimmel M., Naharro M., O’ Neill C., McKenna G., Muller F., CAD/CAM milled removable complete dentures: time and cost estimation study.