Digital complete dentures: clinical performance, fabrication methods, and occlusal considerations: a systematic review.

Digital denture fabrication represents a significant advancement in prosthodontics, offering enhanced precision and reproducibility compared with conventional techniques. The role of occlusal schemes in optimizing the clinical performance of digitally fabricated complete dentures remains an important area of investigation. This systematic review aimed to evaluate the clinical performance of digitally fabricated complete dentures and compare the outcomes associated with different fabrication methods, including CAD-CAM milling and 3D printing, relative to conventional denture fabrication techniques, while assessing the available evidence related to occlusal considerations in complete denture therapy.

methodsA comprehensive literature search was conducted in PubMed, Web of Science, and the Cochrane Library (PROSPERO registration ID: CRD420251229805). Following screening and eligibility assessment, eight clinical studies were included in the qualitative synthesis. These comprised randomized controlled trials and comparative clinical studies evaluating CAD-CAM milled and 3D-printed complete dentures. Data extraction and risk-of-bias assessment were performed independently by two reviewers using the Cochrane Risk of Bias (RoB 2) tool for randomized controlled trials and the ROBINS-I tool for non-randomized studies. Outcomes assessed included denture fit, retention, occlusal performance, and patient satisfaction.

resultsThe included studies demonstrated that digital denture fabrication techniques provide improved or comparable clinical outcomes relative to conventional methods. Compared with conventionally fabricated complete dentures, digitally fabricated complete dentures demonstrated comparable or improved clinical outcomes. CAD-CAM milled dentures showed favorable denture base adaptation and retention, while CAD-CAM 3D-printed dentures offered potential advantages in customization and design flexibility. Most studies showed high methodological quality and low to moderate risk of bias. Patient satisfaction was generally higher with digitally fabricated dentures, likely due to improved fit, comfort, and reduced need for post-insertion adjustments. Digital workflows may offer improved control over denture design and occlusal relationships; however, direct evidence evaluating the influence of specific occlusal schemes on functional outcomes remains limited.

conclusionDigital denture fabrication demonstrates promising clinical outcomes with respect to denture fit, retention, and patient satisfaction. However, evidence regarding the influence of occlusal considerations remains limited. Nevertheless, the specific impact of different occlusal schemes within digital workflows remains insufficiently investigated. Further well-designed clinical studies are required to establish definitive evidence.