Do Simplified Complete Denture Protocols Preserve Patient-Reported Outcomes? A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

Background

Conventional complete dentures (CDs) fabrication involves multiple clinical and laboratory steps. Simplified protocols reduce treatment burden. However, their impact on patient-reported outcomes remains debated.

Objective

This systematic review and meta-analysis evaluated the oral health-related quality of life (OHRQoL), patient satisfaction, and masticatory ability of CDs fabricated using simplified versus traditional protocols.

Methods

Seven databases were searched up to July 2026 for randomised controlled trials (RCTs) comparing simplified and conventional CDs fabrication protocols. Two reviewers independently assessed records and risk of bias using the Cochrane RoB 2 tool. Mean differences and 95% confidence intervals were meta-analysed using random-effects models. Heterogeneity (I2), subgroup analyses according to follow-up periods, small-study effects/funnel plot asymmetry using Egger's test when applicable, and evidence certainty using GRADE were assessed.

Results

Twenty-two RCTs were included. Simplified procedures were typically characterised by single-stage impression procedures, absence of facebow records, and a single trial denture session. Most studies had some concerns or a high risk of bias. Meta-analyses showed no statistically significant differences between protocols regarding OHRQoL (p = 0.620; I2 = 0%), overall satisfaction (p = 0.440; I2 = 5%), and masticatory ability (p = 0.610). Evidence of funnel plot asymmetry/small-study effect was detected only for patient satisfaction (p = 0.033). The certainty of the evidence was rated as moderate to very low across outcomes.

Conclusion

Greater procedural complexity in complete denture fabrication was not associated with superior OHRQoL, patient satisfaction, or masticatory ability. Within the certainty limits of the available evidence, simplified protocols may be a pragmatic alternative to conventional fabrication.