Banca de DEFESA: ANNE KALINE CLAUDINO RIBEIRO

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : ANNE KALINE CLAUDINO RIBEIRO
DATE: 19/09/2024
TIME: 08:30
LOCAL: Departamento de Odontologia - Auditório
TITLE:

ACCURACY AND CLINICAL OUTCOME OF AN INNOVATIVE ABBREVIATED TECHNIQUE FOR COMPLETE DENTURES MANUFACTURED BY 3D PRINTING: CROSSOVER RANDOMIZED CLINICAL TRIAL

KEY WORDS:

3D Printing. CAD-CAM. Complete Denture. Patient satisfaction. Quality of Life. 

PAGES: 167
BIG AREA: Ciências da Saúde
AREA: Odontologia
SUBÁREA: Clínica Odontológica
SUMMARY:

Removable complete dentures (CDs) remain the standard treatment for edentulous patients with psychological and financial limitations so that future perspectives strengthen the importance of improving manufacturing techniques. New digital resources have provided advances in manufacturing complete dentures with promptness, quality, and reduced clinical and laboratory steps. Considering the advantages of additive manufacturing, this study aimed to evaluate the accuracy and clinical performance of an abbreviated and innovative technique for 3D-printed complete dentures. In this randomized crossover clinical trial, a total of 30 completely edentulous patients were randomized into two groups according to the processing technique: CD-DD (patients initially rehabilitated with conventional CD and, after 3 months, with 3D-printed CD) and DD-CD (patients initially rehabilitated with 3D-printed CD and, after 3 months, with conventional CD). The accuracy of outlining of extension of the denture foundation on preliminary casts and teeth arrangement were analyzed after digitizing and superimposition images in Standard Tesselation Language format (STL) for both techniques. The types and quantity of failures observed during the denture’s try-in step were registered in the medical record. Mapping of the occlusal contact points was collected during the delivery of each denture’s set. Patient satisfaction was evaluated by using a validated questionnaire, the impact on the oral health-related quality of life (OHRQoL) was measured using the OHIP-Edent-19, and an objective method based on the two-color chewing gum (Vivident Fruitdent Swing) was utilized for masticatory performance assessment. Occlusal and denture base adjustments and functional adaptation period required as well as the number of clinical appointments performed were recorded. These outcomes were collected after the use of each denture’s pair for 3 months. The time required for outlining the entire base seat, teeth assembly, and time total for fabrication and processing of the dental prosthesis (clinical and laboratory stages), including post-insertion clinical visits were recorded. At the end of the study, the choice of patient regarding the treatment modality was registered. Sensibility and specificity tests were applied to measure accuracy. The mapping of the occlusal contacts and functional adaptation were analyzed by using the Chi-square Test. The non-parametric Mann-Whitney Test was used for the evaluation of the patient-centered outcomes (satisfaction and quality of life), masticatory performance, number of clinical visits, and denture base adjustments required. Comparisons between means of working time were carried out using the paired-T Test. Statistical tests were performed considering a significance level of 5%. The final sample size was composed of 23 completely edentulous, mean age of 65.96 ±8.74. For outlining the denture foundation, the accuracy ranged from 0.57 to 0.92. The buccal and labial frenulum showed a lower value in the maxilla (0.57); while the area between the retromolar pad and buccal frenulum (0.64) showed a lower score in the mandible. The digital method revealed a higher significant mean for maxillary denture foundation (p<0.001). Maxillary teeth arrangement ranged from good to excellent accuracy for the new device (0.75 to 0.93) considering all parameters evaluated. The techniques were similar for patient overall satisfaction, quality of life, masticatory performance, denture base adjustments post-insertion, failures in the teeth try-in, occlusal contacts, and functional adaptation. The working time of the digital method for outlining the denture foundation for both arches was significantly longer compared to conventional ones (p<0.001). However, the maxillary teeth arrangement demonstrated a significantly lower operational time for the digital technique (p<0.001). The number of clinical appointments and total time for fabrication and processing of the DDs were significantly lower (p<0.001). Most patients reported a preference for conventional CDs (60.90%). The denture foundation extension outline exhibited sufficiently excellent accuracy for the digital method, except for the maxillary anterior region. The device was accurate in recording the maxillary occlusal rim and demonstrated promising clinical performance, with effective results compared with conventional techniques. Although the digital method required a longer working time for outlining of the denture foundation, the maxillary teeth arrangement using an intuitive device and the acquisition of the complete dentures by additive manufacturing using an abbreviated and novel technique were advantageous regarding time efficiency. 3D-printed complete dentures have comparable outcomes to conventional ones regarding overall satisfaction, quality of life, masticatory performance, occlusal contact points, denture base adjustments after placement, functional adaptation, and errors in the try-in of teeth, and required reduced number of clinical appointments.

COMMITTEE MEMBERS:
Presidente - 1459400 - ADRIANA DA FONTE PORTO CARREIRO
Interno - 1031499 - LAERCIO ALMEIDA DE MELO
Externo à Instituição - Raphael Freitas de Souza
Externa à Instituição - CRISTIANE MACHADO MENGATTO - UFRGS
Externa à Instituição - ARETHA HEITOR VERISSIMO