Comparative Cost-Effectiveness of Resin 3D Printing Protocols in Dental Prosthodontics: A Systematic Review
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Selection of the Studies
3.2. Evaluation of the Included Studies
3.3. Methodological Framework and Study Characteristics
3.4. Economic Outcomes
3.5. Clinical Outcomes and Quality Metrics
3.6. Time Efficiency and Workflow Analysis
3.7. Patient-Centred Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Technology | Printer Cost (USD) | Material Cost per Unit | Print Speed | Clinical Use Case | Key Advantages | Main Limitations |
---|---|---|---|---|---|---|
SLA (Stereolithography) | USD 2000–15,000 | USD 3–6 | Moderate (45–90 min/unit) | Crowns, bridges, and precision parts | High accuracy and fine detail | Requires post-processing (curing and cleaning) and is slower for volume |
DLP (Digital Light Processing) | USD 3000–20,000 | USD 2.50–5 | Fast (30–60 min/unit) | Chairside applications and dentures | Fast printing and good detail | Surface quality may be slightly lower than SLA |
SLS (Selective Laser Sintering) | USD 10,000–100,000+ | USD 8–15 | Moderate–fast | Frameworks, splints and RPDs | No support needed and strong parts | High cost, complex maintenance and not widely used chairside |
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PICO Element | Details |
---|---|
P—Population/problem | Dental prosthodontic manufacturing processes (specifically involving resin 3D printing techniques) |
I—Intervention | Use of digital protocols for 3D printing in dental prosthodontic manufacturing |
C—Comparison | Use of analogue (traditional) or subtractive protocols for 3D printing in dental prosthodontic manufacturing |
O—Outcome | Cost-effectiveness metrics—including material costs, time efficiency, production accuracy, labour costs, patient outcomes, and overall economic impact |
Screening Criteria | Description |
---|---|
Dental application | Study examines dental prosthodontic applications specifically. |
Protocol comparison | Study directly compares both digital and analogue protocols. |
3D printing materials | Study examines resin 3D printing processes. |
Cost-effectiveness data | Study reports both cost-related metrics AND effectiveness measures (e.g., accuracy, fit, durability). |
Study design | Study is a primary research study, systematic review, or meta-analysis with a sample size of at least 10 subjects/cases. |
Study setting | Study conducted in a dental laboratory, clinical setting, or manufacturing facility. |
Application scope | Study focuses exclusively on dental prosthodontic applications (not general dental or non-dental applications). |
Comparative analysis | Study provides direct comparative data between digital and analogue protocols or two digital protocols. |
Type of dental restoration manufactured | Type of dental restoration described. |
Written in English | Yes. |
MINORS Criteria | Lo Russo et al. (2024) [21] | Mangano et al. (2024) [26] | Daher et al. (2022) [9] | Smith et al. (2020) [28] | No-Cortes et al. (2021) [27] | Srinivasan et al. (2021) [13] | Van de Winkel et al. (2025) [25] |
---|---|---|---|---|---|---|---|
Clearly stated aim | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Inclusion of consecutive patients | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Prospective collection of data | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Endpoints appropriate to the aim | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Unbiased assessment of endpoints | 1 | 1 | 1 | 1 | 1 | 2 | 1 |
Follow-up period appropriate | 1 | 1 | 1 | 1 | 1 | 2 | 2 |
Loss to follow-up <5% | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Prospective calculation of study size | 0 | 0 | 0 | 0 | 2 | 1 | 1 |
Adequate control group | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Contemporary groups | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Baseline equivalence of groups | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Adequate statistical analyses | 2 | 2 | 2 | 2 | 2 | 2 | 2 |
Total score (out of 24) | 20 | 20 | 22 | 21 | 22 | 23 | 22 |
Study | Bias Due to Confounding | Bias in Selection of Participants | Bias in Classification of Interventions | Bias Due to Deviations from Intended Interventions | Bias Due to Missing Data | Bias in Measurement of Outcomes | Bias in Selection of the Reported Result | Overall Risk of Bias |
---|---|---|---|---|---|---|---|---|
Lo Russo et al. (2024) [21] | Moderate | Low | Low | Low | Low | Moderate | Low | Moderate |
Mangano et al. (2024) [26] | Low | Low | Low | Low | Low | Moderate | Low | Low to Moderate |
Daher et al. (2022) [9] | Low | Low | Low | Low | Low | Moderate | Low | Low to Moderate |
Smith et al. (2020) [28] | Moderate | Low | Low | Low | Low | Moderate | Low | Moderate |
No-Cortes et al. (2021) [27] | Low | Low | Low | Low | Low | Moderate | Low | Low to Moderate |
Study | Bias from Randomization Process | Bias Due to Deviations from Intended Interventions | Bias Due to Missing Outcome Data | Bias in Measurement of Outcomes | Bias in Selection of the Reported Result | Overall Risk of Bias |
---|---|---|---|---|---|---|
Van de Winkel et al. (2025) [25] | Low Risk | Low Risk | Low Risk | Some Concerns | Low Risk | Low/Some concerns |
Srinivasan et al. (2021) [13] | Low Risk | Low Risk | Low Risk | Low Risk | Low Risk | Low Risk |
Study | Study Design | Technology Type | Manufacturing Protocol | Primary Outcomes |
---|---|---|---|---|
Smith et al., 2020 [28] | Economic modelling study | CAD/CAM milling and 3D printing | Digital: four-step Ivoclar system (3D printing, milling); analogue: traditional five-visit process | Cost savings and chair time reduction |
Lo Russo et al., 2022 [21] | Economic modelling study | CAD/CAM (open technologies) | Conventional (C), mixed analogue-digital (M), and fully digital (D) | Manufacturing time, costs, and break-even points |
Mangano et al., 2024 [26] | In vitro study | 3D printing (SLA) and CAD/CAM milling | Additive chairside, subtractive chairside, and lab-based subtractive | Trueness, precision, time efficiency, and cost |
Daher et al., 2024 [9] | In vitro study | 3D printing (composite resin) and CAD/CAM milling | 3D printing, milled PMMA, and milled lithium disilicate | Time efficiency, cost, and fatigue resistance |
Srinivasan et al., 2021 [13] | Randomized crossover clinical trial | CAD-CAM complete dentures | Milled vs. 3D-printed dentures | Patient satisfaction, cost, and clinical efficiency |
Van De Winkel et al., 2024 [25] | Randomized controlled trial (crossover) with economic modelling | CAD/CAM (not specified) | Digital: CAD/CAM workflow; conventional: traditional workflow | Costs, treatment time, and quality of life |
No-Cortes et al., 2021 [27] | In vitro study | 3D printing (SLA) | CAD/CAM milling additive chairside, subtractive chairside, and lab-based subtractive | Trueness, precision, time efficiency, and cost |
Study | Digital Protocol Costs | Analogue/Subtractive Protocol Costs | Cost Difference | Additional Economic Details | Currency and Year |
---|---|---|---|---|---|
Smith et al., 2022 [28] | USD 8.20 per unit | USD 29.20 per unit | USD 21 per unit saved | Initial equipment investment: USD 30,500 for in-house digital system | USD (2022) |
Lo Russo et al., 2022 [21] | USD 81–169 savings per denture; Workflow D: Additional USD 34 saving | Reference (conventional workflow) | USD 81–203 per denture saved | Break-even point: 170–933 dentures (Mixed) and 73–534 dentures (Digital); Equipment investment: USD 28,750–81,075 (Mixed) and USD 14,950–67,275 (Digital); Yearly fixed costs: USD 1150–2300 | USD (2021) |
Mangano et al., 2024 [26] | EUR 8.20 (≈USD 9.43) per crown | EUR 8.10 (≈USD 9.31)/EUR 29.20 (≈USD 33.58) per crown | EUR 21 (≈USD 24.15) per unit saved | Equipment costs: Additive: EUR 30 (≈USD 34.5), 500 (≈USD 575.0); Subtractive: EUR 36 (≈USD 41.4), 281.50 (≈USD 323.72)–EUR 48 (≈USD 55.2), 865.80 (≈USD 995.67) | EUR (2023) |
Daher et al., 2024 [9] | 3D printing: 5.5× less expensive than PMMA | Milled PMMA, Milled Composite Resin, and Lithium Disilicate | 3D printing 5.5–10.2× cheaper | 3D printing more efficient for >8 restorations and lower initial equipment cost | Not specified (2024) |
Srinivasan et al., 2021 [13] | 3D-printed: 2593.33 CHF (≈USD 3189.8) ± CHF 773.18 (≈USD 951.01) | Milled: CHF 3200.00 (≈USD 3936.0) ± 1211.85 (≈USD 1490.58) | Est. average: CHF 2207.28 (≈USD 2714.95) | Willing to pay CHF 606.67 (≈USD 746.2) more for milled; 3D-printed required more maintenance | CHF (2021) |
Van De Winkel et al., 2024 [25] | Digital IOD: EUR 4030.61 (≈USD 4635.2) | Conventional IOD: EUR 4700.33 (≈USD 5405.38) | EUR 669.72 (≈USD 770.18) saved | Treatment time reduced by 41.1%; 47.1% fewer sessions; and bar-retained 39% less costly | EUR (2021) |
No-Cortes et al., 2021 [27] | 3D Printing: EUR 0.003 (≈USD 0.0034) per unit | Milled: EUR 0.91 (≈USD 1.04) per unit | Milling ~300× more expensive per unit time than 3D printing | Device cost: Milling EUR 35,000 (≈USD 40,250) vs Printing EUR 252 (≈USD 290); Yearly production: 7680 units (Milling) vs 19,200 units (3D Printing) | EUR (2021) |
Study | Digital Including 3D Printing Protocol Time | Digital Subtractive or Analogue Protocol Time | Time Difference (3D Printing vs. Other) |
---|---|---|---|
Smith et al., 2020 [28] | Four visits, 7 h total | Five visits, 8 h total (analogue) | 1 h saved with 3D printing |
Lo Russo et al., 2022 [21] | A total of 5.90–7.35 h less than analogue | A total of 5.90–7.35 h longer than digital | A total of 5.90–7.35 h saved |
Mangano et al., 2024 [26] | Chairside additive: 90 min (10 crowns) | Subtractive chairside: 450 min (10 crowns); and lab-based: 930 min | 360 min saved vs. subtractive chairside; 840 min saved vs. lab-based |
Daher et al., 2024 [9] | Less time for 8+ restorations | Longer for bulk production (subtractive) | More efficient for large cases with 3D printing |
Srinivasan et al., 2024 [13] | Variable by case, with lower production time | Higher adjustment time (p = 0.0003) (analogue) | Faster production but longer adjustments with 3D printing |
Van De Winkel et al., 2024 [25] | A total of 182 min | A total of 309 min (analogue) | A total of 127 min saved with 3D printing |
No-Cortes et al., 2021 [27] | Additive chairside: 90 min (10 crowns) | Subtractive chairside: 450 min (10 crowns); and lab-based: 930 min | A total of 360 min saved vs. subtractive chairside; 840 min saved vs. lab-based |
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Share and Cite
Popescu, M.; Perieanu, V.S.; Burlibașa, M.; Vorovenci, A.; Malița, M.A.; Petri, D.-C.; Ștețiu, A.A.; Costea, R.C.; Costea, R.M.; Burlibașa, A.; et al. Comparative Cost-Effectiveness of Resin 3D Printing Protocols in Dental Prosthodontics: A Systematic Review. Prosthesis 2025, 7, 78. https://doi.org/10.3390/prosthesis7040078
Popescu M, Perieanu VS, Burlibașa M, Vorovenci A, Malița MA, Petri D-C, Ștețiu AA, Costea RC, Costea RM, Burlibașa A, et al. Comparative Cost-Effectiveness of Resin 3D Printing Protocols in Dental Prosthodontics: A Systematic Review. Prosthesis. 2025; 7(4):78. https://doi.org/10.3390/prosthesis7040078
Chicago/Turabian StylePopescu, Mircea, Viorel Stefan Perieanu, Mihai Burlibașa, Andrei Vorovenci, Mădălina Adriana Malița, Diana-Cristina Petri, Andreea Angela Ștețiu, Radu Cătălin Costea, Raluca Mariana Costea, Andrei Burlibașa, and et al. 2025. "Comparative Cost-Effectiveness of Resin 3D Printing Protocols in Dental Prosthodontics: A Systematic Review" Prosthesis 7, no. 4: 78. https://doi.org/10.3390/prosthesis7040078
APA StylePopescu, M., Perieanu, V. S., Burlibașa, M., Vorovenci, A., Malița, M. A., Petri, D.-C., Ștețiu, A. A., Costea, R. C., Costea, R. M., Burlibașa, A., Drăguș, A. C., Ștețiu, M. A., & Burlibașa, L. (2025). Comparative Cost-Effectiveness of Resin 3D Printing Protocols in Dental Prosthodontics: A Systematic Review. Prosthesis, 7(4), 78. https://doi.org/10.3390/prosthesis7040078