International Journal of Prosthodontics and Restorative Dentistry

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VOLUME 13 , ISSUE 3 ( July-September, 2023 ) > List of Articles


Evaluation of the Linear Dimensional Stability of CAD/CAM Milled, 3-D Printed, and Heat-cured Denture Base Polymers Subjected to Thermocycling and Immersion in Artificial Saliva: An In vitro study

Mariya Dimitrova, Rada Kazakova, Angelina Vlahova

Keywords : Computer-aided designing/computer-aided manufacturing, Denture base materials, Linear stability, Removable dentures, Three-dimensional printing

Citation Information : Dimitrova M, Kazakova R, Vlahova A. Evaluation of the Linear Dimensional Stability of CAD/CAM Milled, 3-D Printed, and Heat-cured Denture Base Polymers Subjected to Thermocycling and Immersion in Artificial Saliva: An In vitro study. Int J Prosthodont Restor Dent 2023; 13 (3):177-183.

DOI: 10.5005/jp-journals-10019-1420

License: CC BY-NC 4.0

Published Online: 29-09-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Purpose: The purpose of the study was to evaluate and compare the linear dimensional stability of three types of denture base polymers—computer-aided designing/computer-aided manufacturing (CAD/CAM) resin, three-dimensional (3D) printed resin, and heat-cured polymethylmethacrylate (PMMA), subjected to immersion in artificial saliva and thermocycling. Materials and methods: A total of 300 test specimens were fabricated and divided into six groups (n = 50 each); [groups I and IV—CAD/CAM resin (Ivotion, Ivoclar Vivadent, Liechtenstein), groups II and V—3D printed resin (NextDent, 3D Systems, Netherlands), groups III and VI—PMMA denture base resin (Vertex BasiQ, 3D Systems, Netherlands)]. The dimensions of groups I, II, and III were measured with an accuracy of 0.02 mm with a digital caliper (Wireman, Brighton, United Kingdom), then they were immersed in artificial saliva for three intervals (7, 14, and 1 month), and measured after each period. Groups IV, V, and VI were subjected to thermocycling for 100 hours (5,000 cycles) between water baths of 5 and 55oC, then immersed in artificial saliva for the same intervals and measured again. The obtained data were submitted to a one-way analysis of variance (ANOVA) and the mean values were compared by the Tukey test. Results: The results obtained indicated that the distinctions in linear stability among denture base polymers manufactured via 3D printing, CAD/CAM milling, and conventional methods are most noticeable following a 7-day immersion in artificial saliva. During this period, the 3D-printed dental resins exhibited higher average values. Over the course of 14 days and 1 month, the various groups demonstrated similar mean values, while the heat-cured conventional PMMA displayed greater linear stability. Conclusion: To summarize, during the initial week of the study, 3D-printed denture base materials displayed more significant linear alterations, whereas CAD/CAM milled, and traditional resins showcased better resistance to dimensional changes throughout the entire test duration. It's important to note that substantial linear changes were observed in all groups after undergoing thermocycling. In the subsequent two observation periods, both CAD/CAM milled, and 3D-printed dental resins exhibited lower linear stability compared to conventional PMMA.

  1. Goodacre CJ, Garbacea A, Naylor WP, et al. CAD/CAM fabricated complete dentures: concepts and clinical methods of obtaining required morphological data. J Prosthet Dent 2012;107(1):34–46. DOI: 10.1016/S0022-3913(12)60015-8
  2. Kattadiyil MT, Goodacre CJ, Baba NZ. CAD/CAM complete dentures: a review of two commercial fabrication systems. J Calif Dent Assoc 2013;41(6):407–416. DOI: 10.1080/19424396.2013.12222317
  3. Fenlon MR, Juszczyk AS, Rodriguez JM, et al. Dimensional stability of complete denture permanent acrylic denture bases; a comparison of dimensions before and after a second curing cycle. Eur J Prosthodont Restor Dent 2010;18(1):33–38. PMID: 20397501.
  4. Saponaro PC, Yilmaz B, Johnston W, et al. Evaluation of patient experience and satisfaction with CAD-CAM-fabricated complete denture: a retrospective survey study. J Prosthet Dent 2016;116(4):524–528. DOI: 10.1016/j.prosdent.2016.01.034
  5. Bilgin MS, Erdem A, Aglarci OS, et al. Fabricating complete dentures with CAD/CAM and RP technologies. J Prosthodont 2015;24(7):576–579. DOI: 10.1111/jopr.12302
  6. Smith PB, Perry J, Elza W. Economic and clinical impact of digitally produced dentures. J Prosthodont 2021;30(S2):108–112. DOI: 10.1111/jopr.13283
  7. Steinmassl PA, Wioedemair V, Huck C, et al. Do CAD/CAM dentures really release less monomer than conventional dentures? Clin Oral Investig 2016;21(5):1697–1705. DOI: 10.1007/s00784-016-1961-6
  8. Baba NZ, AlRumaih HS, Goodacre BJ, et al. Current techniques in CAD/CAM denture fabrication. Gen Dent 2016;64(6):23–28.
  9. Abduo J, Lyons K, Bennamoun M. Trends in computer-aided manufacturing in prosthodontics: a review of the available streams. Int J Dent 2014;2014:783948. DOI: 10.1155/2014/783948
  10. Kazakova R, Vlahova A, Tomov G, et al. A comparative analysis of post-retraction changes in gingival height after conventional and surgical gingival displacement: rotary curettage, diode and Er:YAG laser troughing. Healthcare 2023;11(16):2262. DOI: 10.3390/healthcare11162262
  11. Van Noort R. The future of dental devices is digital. Dent Mater 2012;28(1):3–12. DOI: 10.1016/
  12. Dimitrova M, Corsalini M, Kazakova R, et al. Comparison between conventional PMMA and 3D printed resins for denture bases: a narrative review. J Comp Sci 2022;6(3):87. DOI: 10.3390/jcs6030087
  13. Kanazawa M, Inokoshi M, Minakuchi S, et al. Trial of a CAD/CAM system for fabricat ng complete dentures. Dent Mater J 2011;30(1):93–96. DOI: 10.4012/dmj.2010-112
  14. Hazeveld A, Huddleston Slater JJ, Ren Y. Accuracy and reproducibility of dental replica models reconstructed by different rapid prototyping techniques. Am J Orthod Dentofacial Orthop 2014;145(1):108–115. DOI: 10.1016/j.ajodo.2013.05.011
  15. Chang CC, Lee MY, Wang SH. Digital denture manufacturing-an integrated technologies of abrasive computer tomography, CNC machining and rapid prototyping. Int J Adv Manufact Technol 2006;31:41–49.
  16. Maeda Y, Minoura M, Tsutsumi S, et al. A CAD/CAM system for removable denture. Part I: fabrication of complete dentures. Int J Prosthodont 1994;7(1):17–21. PMID: 8179777.
  17. Official webpage of Ivoclar Vivadent, available at: (Assessed on 12.08.2023).
  18. Official webpage of Next. Official webpage of NextDent, available at: (Assessed on 12.08.2023).
  19. Dimitrova M, Capodiferro S, Vlahova A, et al. Spectrophotometric analysis of 3D printed and conventional denture base resin after immersion in different colouring agents—an in vitro study. Applied Sciences 2022;12(24):12560. DOI: 10.3390/app122412560
  20. Chuchulska B, Hristov I, Dochev B, et al. Changes in the surface texture of thermoplastic (monomer-free) dental materials due to some minor alterations in the laboratory protocol-preliminary study. Materials (Basel) 2022;15(19):6633. DOI: 10.3390/ma15196633
  21. Mystkowska J, Car H, Dąbrowski JR, et al. Artificial mucin-based saliva preparations - physicochemical and tribological properties. Oral Health Prev Dent 2018;16(2):183–193. DOI: 10.3290/j.ohpd.a40304
  22. Eliasson ST, Dahl JE. Effect of thermal cycling on temperature changes and bond strength in different test specimens. Biomater Investig Dent 2020;7(1):16–24. DOI: 10.1080/26415275.2019.1709470
  23. Gad MM, Alshehri SZ, Alhamid SA, et al. Water sorption, solubility, and translucency of 3D-printed denture base resins. Dent J 2022;10(3):42. DOI: 10.3390/dj10030042
  24. Alp G, Murat S, Yilmaz B. Comparison of flexural strength of different CAD/CAM PMMA-based polymers. J Prosthodont 2019;28(2):491–495. DOI: 10.1111/jopr.12755
  25. Clark WA, Duqum I, Kowalski BJ. The digitally replicated denture technique: a case report. J Esthet Restor Dent 2019;31(1):20–25. DOI: 10.1111/jerd.12447
  26. Kalberer N, Mehl A, Schimmel M, et al. CAD-CAM milled versus rapidly prototyped (3D-printed) complete dentures: an in vitro evaluation of trueness. J Prosthet Dent 2019;121(4):637–643. DOI: 10.1016/j.prosdent.2018.09.001
  27. Schwindling FS, Stober T. A comparison of two digital techniques for the fabrication of complete removable dental prostheses: a pilot clinical study. J Prosthet Dent 2016;116(5):756–763. DOI: 10.1016/j.prosdent.2016.03.022
  28. Inokoshi M, Kanazawa M, Minakuchi S. Evaluation of a complete denture trial method applying rapid prototyping. Dent Mater J 2012;31(1):40–46. DOI: 10.4012/dmj.2011-113
  29. Cristache CM, Totu EE, Iorgulescu G, et al. Eighteen months follow-up with patient-centred outcomes assessment of complete dentures manufactured using a hybrid nanocomposite and additive CAD/CAM protocol. J Clin Med 2020;9(2):324. DOI: 10.3390/jcm9020324
  30. Venus H, Boening K, Peroz I. The effect of processing methods and acrylic resins on the accuracy of maxillary dentures and toothless denture bases: an in vitro study. Quintessence Int 2011;42(8):669–677. PMID: 21842007.
  31. Lin WS, Harris BT, Pellerito J, et al. Fabrication of an interim complete removable dental prosthesis with an in-office digital light processing three-dimensional printer: a proof-of-concept technique. J Prosthet Dent 2018;120(3):331–334. DOI: 10.1016/j.prosdent.2017.12.027
  32. Al Helal A, Goodacre BJ, Kattadiyil MT, et al. Errors associated with a digital preview of computer-engineered complete dentures and guidelines for reducing them: a technique article. J Prosthet Dent 2018;119(1):17–25. DOI: 10.1016/j.prosdent.2017.02.023
  33. Bidra AS, Farrell K, Burnham D, et al. Prospective cohort pilot study of 2-visit CAD/ CAM monolithic complete dentures and implant-retained overdentures: clinical and patient-centred outcomes. J Prosthet Dent 2016;115(5):578–586.e1. DOI: 10.1016/j.prosdent.2015.10.023
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