Developing solutions for complex oral rehabilitation: the potential of subtractive manufacturing

Abstract

Background: The use of digital technologies expands the possibilities for manufacturing complete dentures, allowing for greater standardization of procedures and a reduction in laboratory steps. Among these approaches, subtractive manufacturing enables the fabrication of dentures from pre-polymerized discs with conventional mechanical properties. Objective: To present a clinical case of oral rehabilitation with complete dentures manufactured using a digital workflow with subtractive production. Case report: A 70-year-old edentulous patient presented with aesthetic dissatisfaction, reduced masticatory efficiency, loss of vertical dimension of occlusion, and compromised mandibular retention associated with prolonged use of complete dentures. After obtaining study models and functional impressions, trial bases with wax rims were fabricated to determine the vertical dimension of occlusion and centric relation. The models were scanned with a benchtop scanner for digital planning. The prostheses were manufactured by milling from a monolithic pre-polymerized PMMA disc (Ivotion, Ivoclar, Schaan, Liechtenstein), which allows milling of the base and teeth in a single step. Results: After delivery, the prostheses showed adequate retention and stability. The patient reported improvements in comfort, masticatory function, and esthetic appearance. Conclusion: The digital workflow can represent a viable alternative for the fabrication of complete dentures, enabling efficient clinical procedures while providing satisfactory retention, stability, and patient comfort.

KEYWORDS

CAD/CAM; Complete denture; Dental prosthesis design; Digital technology; Mouth rehabilitation