Retrospective analysis of CAD-CAM occlusal devices.
TL;DR
Evaluated occlusal devices fabricated using digital techniques showed clinical outcomes and participant satisfaction similar to those produced using hybrid workflows, and a significant material‑based difference was found.
Abstract
STATEMENT OF PROBLEM Limited evidence is available regarding the clinical behavior of the newly developed materials and computer-aided technologies used to fabricate occlusal devices.
Purpose
The purpose of this retrospective study was to evaluate the effect of digital manufacturing techniques and materials on the clinical performance of occlusal devices. MATERIAL AND
Methods
A total of 49 participants treated with computer-aided design and computer-aided manufacturing (CAD-CAM) occlusal devices were included in this retrospective clinical study. Two different manufacturing technologies, 3-dimensional (3D) printing and milling, and 3 different materials were investigated. Fully and hybrid digital workflows were applied. In the fully digital workflow, intraoral scans were imported into a dental software program, where the occlusal devices were designed and subsequently 3D printed or milled. In the hybrid workflow, maxillary and mandibular stone casts were scanned with an extraoral scanner, after which the devices were digitally designed and produced either additively or subtractively. The participants wore the occlusal devices for 6 months. Dental arch fit, surface wear, and participant satisfaction were evaluated. Descriptive statistical methods were used to evaluate the study data. ANOVA and the t test were used for comparisons. The chi-squared test was used to compare qualitative data (α=.05).
Results
Milled occlusal devices demonstrated significantly better fit accuracy compared with the 3D printed ones (0.039 ±0.075 mm versus 0.28 ±0.304 mm; P<.001). Material-based analysis indicated that milled polymethyl methacrylate (PMMA) and polyetheretherketone (PEEK) occlusal devices exhibited lower fit deviations than 3D printed PMMA devices (P<.001). Additively manufactured occlusal devices, regardless of workflow, revealed greater surface wear (P<.001). Occlusal contact counts did not differ significantly between workflows (P>.05). However, a significant material‑based difference was found, with PEEK showing higher contact values than PMMA‑printed devices (P=.010).
Conclusions
The results suggested that occlusal devices fabricated using digital techniques showed clinical outcomes and participant satisfaction similar to those produced using hybrid workflows.
