Digital Complete Dentures — How CAD/CAM Changes Edentulous Prosthodontics

For decades, edentulous prosthodontics relied on the same algorithm: impressions, stone models, wax try-in, polymerization. Today, this algorithm has an alternative. A digital workflow for complete dentures shortens working time, reduces the number of appointments, and allows for denture reproduction from an archive — without starting from scratch.

How the Digital Workflow Differs from Traditional

In the traditional approach, each stage requires the patient's presence: anatomical impression, functional impression, bite registration, wax rim try-in, wax try-in, denture delivery. The digital workflow consolidates these stages. An intraoral scan or scan of diagnostic models goes into CAD software. The technician designs the denture on screen — setting teeth, modeling gingiva, controlling occlusion. The finished design goes to a CNC milling machine or a 3D printer.

Materials — Milled PMMA vs. Printed Resins

Milled PMMA (polymethyl methacrylate) dentures are the current standard in digital edentulous prosthodontics. PMMA blanks offer high structural density, lack of porosity, and reproducible color. Flexural strength is over 100 MPa for the best laboratory blocks — a result superior to conventional polymerizates. Printed dental resins (Class IIa) are rapidly developing but still have lower mechanical properties and require more rigorous post-processing (light curing, washing). At deltalabs., we use PMMA milling as the standard for definitive dentures; 3D printing is used for trial dentures.

How Many Appointments Does a Patient Need with a Digital Approach?

A standard digital workflow for complete dentures can be completed in 3 appointments instead of the traditional 5–6:

1. Appointment 1 — Diagnosis and Functional Impression: Recording of prosthetic foundation tissues, bite registration, photographic records.
2. Appointment 2 — Trial Denture Try-in: A printed or milled trial denture checks aesthetics, phonetics, and occlusal relationships before the definitive denture is made.
3. Appointment 3 — Definitive Denture Delivery: Milled PMMA, in situ occlusal adjustments.

The ability to quickly produce a duplicate ( from a ready CAD file) is especially important for patients who lose or damage their dentures — a new denture within 24–48 hours without repeating diagnostics.

When is a Digital Complete Denture Indicated?

The digital workflow is particularly effective in these situations:

• Patients requiring a denture duplicate — CAD file archiving eliminates the need to repeat impressions
• Implant-supported overdentures — the precision of attachment fit is better with CNC milling
• Patients with difficult anatomical conditions — CAD software allows for multiple iterations without the material cost of wax-ups
• Clinics with a high volume of edentulous prosthodontics — the digital workflow is faster for serial production

The traditional workflow remains justified for a patient's first denture with a very complex foundation and requiring detailed functional analysis beyond the capabilities of standard CAD.

Implant-Supported Complete Denture — Digital Workflow for Bar Attachments

An overdenture on a bar attachment or with locators is a case where digital precision is particularly important. The fit of attachments to the implant must be within <50 µm — this cannot be achieved with manual modeling. Overdenture workflow at deltalabs.:

1. Scanning of models with implant transfers
2. Denture design considering space for retention matrices
3. Milling of the overdenture framework (PEEK or titanium for bars, PMMA for full dentures)
4. Polymerization of the prosthetic base onto the finished framework