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Renishaw and Cardiff University Dental Hospital have teamed up to research 3D printing of CoCr removable partial dentures to give a flavour of what the future holds for the humble skeletal framework.
In the era of digital dentistry, dentures appear to have been placed on the back burner. The glamorous world of implants and their intertwined CAD/CAM options have resulted in the humble removable denture being gently passed over. Well that's not strictly true. Wrap around bars and all-on-four dentures are seeing continued usage but their hard and soft tissue supported cousins have not seen the same sort of extensive makeover.
Implant sales have seen consistent growth year-on-year - an ageing population has meant there is still a steady flow of patients requiring major restoration of dentition whilst the proliferation of makeover programs have helped to educate potential patients as to what options are available. Even a healthy diet no longer helps – the once detoxifying glass of apple juice has since been found out. A 150ml serving has been claimed by the Telegraph to contain 4tsp of sugar. Ignoring the other health implications this is a major dental concern and has led to people who believed they were following a healthy lifestyle, requiring premature dental care including extractions.
So to treat loss of dentition, implants are an obvious and now popular treatment. But not everyone can afford implants (which are not covered by the NHS unless there's a medical need) and are only available on limited insurance policies. In fact not everyone likes the idea of the invasive surgery required to place implants. So dentures are still a go-to, tried and tested treatment. Many patients happily wear CoCr dentures, which will need replacing when anatomical changes occur overtime, so an existing market is present and is just as important to service. But as previously mentioned they have been largely passed by on the CAD/CAM circuit.
The removable partial denture is still very much alive and kicking and is a crucial tool where cost is an issue.
Currently Cardiff University Dental Hospital (CUDH) manufacture 380 to 400 chromes per year and although remakes are generally kept to a minimum they still see miscasts, the number of which they are constantly aiming to reduce. There are numerous variables that can result in a miscast as a result of the protracted workflow and complex nature of an RPD. In addition to miscasts a number of other factors can affect the need for a remake including design changes, longevity between appointments and/or impression inaccuracies which may be attributed to the inexperience of dental undergraduates in the teaching environment. Industry feedback suggests there could be between 14 to 20% of castings requiring remakes, figures which would be unthinkable in most other manufacturing industries.
With increasing environmental and economic pressures it's critical that this situation is brought under control so that lab efficiency can be further enhanced and quality dental care be made available to a larger proportion of the populous.