Are There Clinical Differences Between 3D-Printed and Milled Complete Dentures? A Systematic Review and Meta-analysis

Abstract

Limited studies assess clinical key factors in the success of digitally fabricated complete dentures between additive and subtractive methods. This study aimed to compare 2 determinants of clinical success-retention and patient satisfaction- in complete dentures fabricated using additive and subtractive approaches. PubMed, Scopus, Web of Science, Embase, Cochrane Library, and Google Scholar were searched up to August 2024. Records were screened by title, abstract, and full text against the eligibility criteria. The standardized mean difference (SMD) was calculated using the data extracted from each included study. A random effects model pooled the effect sizes, and heterogeneity was assessed with Cochran's Q test, I-squared, and Tau-squared indices; publication bias was evaluated using Begg's funnel plot and the Egger test, while sensitivity analyses checked result robustness. The risk of bias was assessed using the Cochrane RoB 2 and ROBINS-I tools. Of the initial 1098 records, a total of 4 articles were deemed eligible. Although mean denture retention was higher in the additive compared to the subtractive method, the difference was not statistically significant (SMD = 0.165 N, 95 CI = -0.176, 0.506, P = .343, I(2) = 58.72%). Similarly, mean satisfaction was lower in the additive compared to the subtractive method, but this difference was not statistically significant (SMD = -0.595, 95% CI = -1.579, 0.389, P = .236, I(2) = 85.94%). Considering the high heterogeneity and the small number of studies, it can be cautiously concluded that there is no significant difference between complete dentures fabricated by 3D printing and milling approaches.