Digital versus Conventional Dentures: A Prospective, Randomized Cross-Over Study on Clinical Efficiency and Patient Satisfaction
Abstract
1. Introduction
2. Material and Methods
2.1. Study Design and Randomization
2.2. Conventional and Digital Dentures
2.3. Clinical Workflow
2.4. Clinical Evaluation Based on the Sato-Score
2.5. Oral Health-Related Quality of Life
2.6. Statistical Analysis
3. Results
3.1. Clinical Evaluation and Appointments
3.2. Oral Health-Related Quality of Life and Patient Satisfaction
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Stability of maxillary/mandibular denture under pressure and functional movements |
2: Within tissue displacement of a denture base under rotational/horizontal forces |
1: Displacement beyond normal tissue pattern |
0: Sliding of a denture base under rotational/horizontal forces |
Retention of maxillary/mandibular denture |
2: Very good resistance to vertical pulling and lateral force on central incisors |
1: Moderate resistance to vertical pulling and little resistance to lateral force on central incisors |
0: Poor resistance to vertical pulling and no resistance to lateral force on central incisors |
Border extension of maxillary/mandibular denture |
2: All satisfactory anatomical points |
1: max. three negative findings |
0: Overall flange overextension/sub-extension |
Denture polish |
2: no negative findings |
1: one negative finding |
0: two or more negative findings |
Aesthetics (teeth selection, arrangement of anterior teeth, smile line, lip support) |
2: no negative findings |
1: one negative finding |
0: two or more negative findings |
Phonetics |
2: proper pronunciation (“S”, “F”, “TH”) |
1: discreet lisping and/or mumbling |
0: pronounced lisping and/or mumbling |
Static occlusion |
2: continuously firm intermaxillary contacts in the posterior segment/soft contacts in the anterior segment |
1: incorrect intercuspation—up to two premature contacts |
0: incorrect intercuspation—three or more contacts to adjust |
Dynamic occlusion |
2: canine guidance on the working side |
1: balance contact in the posterior segment |
0: hyper-balanced articulation |
Vertical dimension |
2: interocclusal rest space 2 to 5 mm |
1: interocclusal rest space 1 or 6 mm |
0: interocclusal rest space < 1 mm or >6 mm |
CD Type | Conventional Dentures | Digital Dentures | |||||
---|---|---|---|---|---|---|---|
Grades | 0 | 1 | 2 | 0 | 1 | 2 | |
n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | p Value | |
Upper stability | 0 (0%) | 8 (80%) | 2 (20%) | 0 (0%) | 3 (30%) | 7 (70%) | 0.025 |
Lower stability a | 1 (10%) | 8 (80%) | 1 (10%) | 0 (0%) | 6 (60%) | 4 (40%) | 0.102 |
Upper retention | 0 (0%) | 3 (30%) | 7 (70%) | 0 (0%) | 1 (10%) | 9 (90%) | 0.157 |
Lower retention a | 2 (20%) | 6 (60%) | 2 (20%) | 1 (10%) | 7 (70%) | 2 (20%) | 0.705 |
Upper border extension | 0 (0%) | 0 (0%) | 10 (100%) | 0 (0%) | 1 (10%) | 9 (90%) | 0.317 |
Lower bd. extension a | 0 (0%) | 2 (20%) | 8 (80%) | 0 (0%) | 1 (10%) | 9 (90%) | 0.317 |
Denture polish | 0 (0%) | 2 (20%) | 8 (80%) | 0 (0%) | 8 (80%) | 2 (20%) | 0.034 |
Aesthetics a | 0 (0%) | 5 (50%) | 5 (50%) | 0 (0%) | 3 (30%) | 7 (70%) | 0.414 |
Phonetics | 0 (0%) | 0 (0%) | 10 (100%) | 0 (0%) | 2 (20%) | 8 (80%) | 0.157 |
Static occlusion a | 0 (0%) | 9 (90%) | 1 (10%) | 1 (10%) | 6 (60%) | 3 (30%) | 0.564 |
Dynamic occlusion a | 1 (10%) | 4 (40%) | 5 (50%) | 0 (0%) | 5 (50%) | 5 (50%) | 0.564 |
Vertical dimension a | 0 (0%) | 0 (0%) | 10 (100%) | 0 (0%) | 0 (0%) | 10 (100%) | 1.000 |
Mean ± SD | Md (IQR) | Mean ± SD | Md (IQR) | p value | |||
Sato-score | 67.4 ± 11.8 | 68.0 (66.0–75.3) | 73.2 ± 12.3 | 74.0 (66.0–85.0) | 0.160 |
CD Type | OLD (O) | Conventional (C) | Digital (D) | p Values | ||||
---|---|---|---|---|---|---|---|---|
OHIP-Items | Mean ± SD | Md (IQR) | Mean ± SD | Md (IQR) | Mean ± SD | Md (IQR) | O–D/C | C–D |
Chewing difficulties | 3.5 ± 1.8 | 4.0 (1.8–4.8) | 4.2 ± 1.5 | 5.0 (4.0–5.0) | 3.7 ± 1.8 | 4.5 (2.3–5.0) | 0.530 | 0.363 |
Food debris accumulation | 2.6 ± 1.2 | 2.5 (2.0–3.8) | 4.4 ± 1.4 | 4.5 (4.0–5.0) | 4.3 ± 1.3 | 4.5 (4.0–5.0) | 0.008 | 0.591 |
Fit of the prosthesis | 3.4 ± 1.9 | 3.5 (1.5–5.0) | 4.7 ± 1.5 | 5.0 (4.3–5.8) | 4.1 ± 1.9 | 4.5 (3.3–5.8) | 0.206 | 0.425 |
Pain in the mouth | 4.4 ± 1.5 | 5.0 (4.0–5.0) | 4.3 ± 1.3 | 4.0 (4.0–5.0) | 4.3 ± 1.9 | 5.0 (3.0–6.0) | 0.879 | 1.000 |
Chewing efficiency | 3.3 ± 1.7 | 4.0 (2.0–4.0) | 4.5 ± 1.4 | 5.0 (4.3–5.0) | 4.3 ± 1.3 | 5.0 (3.3–5.0) | 0.107 | 0.678 |
Wounds in the mouth | 4.2 ± 1.8 | 4.0 (3.3–6.0) | 4.2 ± 1.5 | 4.0 (4.0–5.5) | 3.9 ± 1.9 | 4.0 (3.0–5.8) | 0.831 | 0.604 |
Discomfort | 4.2 ± 1.9 | 5.0 (3.3–5.8) | 5.1 ± 0.9 | 5.0 (4.3–6.0) | 4.6 ± 1.8 | 5.0 (4.3–6.0) | 0.399 | 0.427 |
Concerns | 4.6 ± 1.9 | 5.5 (3.5–6.0) | 5.5 ± 0.5 | 5.5 (5.0–6.0) | 5.0 ± 1.2 | 5.0 (5.0–5.8) | 0.301 | 0.138 |
Feeling of uneasiness | 3.7 ± 1.6 | 4.0 (3.3–4.8) | 5.4 ± 0.7 | 5.5 (5.0–6.0) | 5.3 ± 0.9 | 5.5 (5.0–6.0) | 0.007 | 0.591 |
Omitting certain foods | 3.3 ± 1.6 | 3.0 (2.0–4.8) | 4.4 ± 1.1 | 4.5 (4.0–5.0) | 4.3 ± 1.2 | 4.5 (4.0–5.0) | 0.084 | 0.678 |
Impaired dietary habits | 4.5 ± 1.7 | 5.0 (3.3–6.0) | 5.0 ± 1.4 | 5.5 (5.0–6.0) | 4.8 ± 1.0 | 5.0 (4.0–5.8) | 0.438 | 0.662 |
Inability to eat | 4.6 ± 1.6 | 5.0 (3.5–6.0) | 5.4 ± 1.0 | 6.0 (5.0–6.0) | 5.2 ± 0.9 | 5.5 (4.3–6.0) | 0.234 | 0.509 |
Interruption of meals | 4.5 ± 1.4 | 4.5 (4.0–5.8) | 5.1 ± 0.7 | 5.0 (5.0–5.8) | 4.7 ± 1.7 | 5.5 (4.0–6.0) | 0.405 | 0.309 |
Anger | 3.8 ± 1.3 | 4.0 (3.0–5.0) | 5.1 ± 0.7 | 5.0 (5.0–5.8) | 4.6 ± 1.6 | 5.0 (4.0–6.0) | 0.054 | 0.343 |
Embarrassment | 4.5 ± 1.6 | 5.0 (3.3–6.0) | 5.4 ± 0.7 | 5.5 (5.0–6.0) | 5.0 ± 1.5 | 5.0 (5.0–6.0) | 0.163 | 0.269 |
Averse to go out | 4.8 ± 1.8 | 6.0 (3.5–6.0) | 5.9 ± 0.3 | 6.0 (6.0–6.0) | 5.5 ± 1.6 | 6.0 (6.0–6.0) | 0.121 | 0.343 |
Social intolerance | 4.9 ± 1.2 | 5.0 (4.3–6.0) | 6.0 ± 0.0 | 6.0 (6.0–6.0) | 5.5 ± 1.3 | 6.0 (6.0–6.0) | 0.053 | 0.435 |
Irritability | 5.0 ± 1.2 | 5.0 (5.0–6.0) | 5.7 ± 0.5 | 6.0 (5.3–6.0) | 5.4 ± 1.3 | 6.0 (6.0–6.0) | 0.093 | 0.468 |
Inability to enjoy company | 4.9 ± 1.4 | 5.0 (5.0–6.0) | 5.9 ± 0.3 | 6.0 (6.0–6.0) | 5.6 ± 1.3 | 6.0 (6.0–6.0) | 0.052 | 0.496 |
Life less satisfying | 4.4 ± 1.8 | 5.0 (3.5–5.8) | 5.5 ± 0.8 | 6.0 (5.3–6.0) | 5.5 ± 1.1 | 6.0 (6.0–6.0) | 0.068 | 1.000 |
OHIP-20 TOTAL SCORE | 83.1 ± 27.1 | 95.5 (63.0–99.5) | 101.7 ± 12.0 | 106.0 (93.8–109.3) | 95.6 ± 24.2 | 105.0 (87.8–110.8) | 0.116 | 0.332 |
CD Type | Old (O) | Conventional | Digital | p-Value | ||||
---|---|---|---|---|---|---|---|---|
Satisfaction Factors | Mean ± SD | Md (IQR) | Mean ± SD | Md (IQR) | Mean ± SD | Md (IQR) | O–D/C | C–D |
Ease of cleaning | 8.9 ± 2.1 | 9.7 (9.4–9.8) | 8.8 ± 1.9 | 9.6 (9.4–9.9) | 9.8 ± 0.2 | 9.8 (9.7–9.9) | 0.631 | 0.140 |
Satisfaction with dentures | 5.1 ± 3.7 | 6.1 (2.0–8.1) | 8.0 ± 1.9 | 8.7 (6.3–9.4) | 8.3 ± 1.8 | 9.2 (6.6–9.7) | 0.048 | 0.592 |
Ability to speak | 7.3 ± 3.6 | 9.6 (4.9–9.8) | 9.3 ± 0.5 | 9.6 (8.8–9.7) | 8.6 ± 1.7 | 9.5 (8.0–9.7) | 0.232 | 0.112 |
Comfort | 5.2 ± 3.8 | 6.0 (2.0–7.9) | 7.8 ± 2.3 | 8.4 (5.9–9.6) | 8.6 ± 1.7 | 9.5 (7.0–9.8) | 0.053 | 0.294 |
Aesthetics | 6.4 ± 4.0 | 8.3 (3.9–9.5) | 9.4 ± 0.6 | 9.7 (9.2–9.9) | 9.8 ± 0.3 | 9.9 (9.6–9.9) | 0.031 | 0.121 |
Stability | 4.6 ± 3.8 | 5.1 (1.2–8.0) | 8.0 ± 2.9 | 9.6 (5.9–9.9) | 8.4 ± 2.8 | 9.8 (8.7–9.9) | 0.021 | 0.300 |
Overall chewing efficiency | 4.4 ± 2.9 | 4.8 (2.1–5.1) | 7.6 ± 1.9 | 8.4 (6.0–8.8) | 7.5 ± 2.7 | 8.5 (5.7–9.5) | 0.009 | 0.855 |
Ability to chew white bread | 7.8 ± 2.3 | 8.5 (6.9–9.4) | 9.0 ± 1.5 | 9.5 (8.8–9.9) | 8.6 ± 2.4 | 9.7 (8.9–9.9) | 0.277 | 0.664 |
Ability to chew cheese | 5.0 ± 3.7 | 4.2 (3.2–8.5) | 7.2 ± 3.3 | 9.0 (4.9–9.8) | 7.1 ± 3.3 | 8.2 (6.4–9.3) | 0.067 | 0.891 |
Ability to chew beets | 3.1 ± 2.7 | 2.4 (1.4–4.6) | 5.9 ± 3.3 | 7.5 (3.2–8.4) | 5.8 ± 3.2 | 6.9 (3.0–7.8) | 0.029 | 0.786 |
Ability to chew sausages | 3.4 ± 3.1 | 2.3 (1.5–4.6) | 6.0 ± 3.0 | 7.4 (3.1–8.0) | 7.1 ± 2.9 | 7.9 (6.8–8.9) | 0.022 | 0.122 |
Ability to chew steaks | 4.6 ± 4.1 | 3.6 (1.1–8.3) | 7.1 ± 3.5 | 8.7 (5.4–9.8) | 7.7 ± 3.1 | 8.9 (7.0–9.7) | 0.161 | 0.524 |
Ability to chew apples | 4.0 ± 3.2 | 3.2 (1.3–6.4) | 7.1 ± 3.0 | 8.3 (5.6–9.2) | 6.8 ± 3.0 | 7.1 (5.3–9.2) | 0.016 | 0.734 |
Ability to chew salad | 7.0 ± 3.0 | 7.8 (5.9–9.3) | 8.2 ± 2.9 | 9.4 (8.4–9.8) | 8.6 ± 2.0 | 9.6 (8.3–9.8) | 0.175 | 0.425 |
Satisfaction with oral health | 6.1 ± 3.5 | 7.3 (4.2–8.8) | 7.7 ± 2.8 | 8.5 (7.4–9.4) | 7.7 ± 3.0 | 9.3 (6.3–9.7) | 0.147 | 0.925 |
Health affection by oral health status | 20.0% | 10.0% | 10.0% |
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Zupancic Cepic, L.; Gruber, R.; Eder, J.; Vaskovich, T.; Schmid-Schwap, M.; Kundi, M. Digital versus Conventional Dentures: A Prospective, Randomized Cross-Over Study on Clinical Efficiency and Patient Satisfaction. J. Clin. Med. 2023, 12, 434. https://doi.org/10.3390/jcm12020434
Zupancic Cepic L, Gruber R, Eder J, Vaskovich T, Schmid-Schwap M, Kundi M. Digital versus Conventional Dentures: A Prospective, Randomized Cross-Over Study on Clinical Efficiency and Patient Satisfaction. Journal of Clinical Medicine. 2023; 12(2):434. https://doi.org/10.3390/jcm12020434
Chicago/Turabian StyleZupancic Cepic, Lana, Reinhard Gruber, Jaryna Eder, Tom Vaskovich, Martina Schmid-Schwap, and Michael Kundi. 2023. "Digital versus Conventional Dentures: A Prospective, Randomized Cross-Over Study on Clinical Efficiency and Patient Satisfaction" Journal of Clinical Medicine 12, no. 2: 434. https://doi.org/10.3390/jcm12020434
APA StyleZupancic Cepic, L., Gruber, R., Eder, J., Vaskovich, T., Schmid-Schwap, M., & Kundi, M. (2023). Digital versus Conventional Dentures: A Prospective, Randomized Cross-Over Study on Clinical Efficiency and Patient Satisfaction. Journal of Clinical Medicine, 12(2), 434. https://doi.org/10.3390/jcm12020434