Digital denture fabrication has matured from experimental technology to clinically validated alternative to conventional methods. Multiple systems offer complete digital workflows from impression to final prosthesis.

Digital Workflow Overview

Digital denture workflows eliminate many conventional steps. After preliminary impressions and jaw relation records, final impressions are captured digitally or conventionally and scanned. Virtual denture design occurs in specialized software, followed by milling or 3D printing.

Major systems include Ivoclar Digital Denture System, AvaDent Digital Dentures, and Dentca CAD/CAM Denture System. Each offers proprietary workflows with varying degrees of clinician control over design parameters.

Impression and Records

Most digital denture systems still require conventional preliminary impressions and jaw relation records. Some systems accept intraoral scans for dentate or partially edentulous patients, though completely edentulous scanning remains challenging.

Accurate jaw relation records are critical. Digital workflows do not eliminate the need for proper vertical dimension, centric relation, and esthetic records. Some systems provide try-in dentures for verification before final fabrication.

Materials and Fabrication

Digital dentures use either milled PMMA (polymethyl methacrylate) blocks or 3D-printed resins. Milled dentures offer superior strength and polish retention. 3D-printed dentures allow more complex designs and faster production but may have inferior surface properties.

Industrially polymerized PMMA in milled dentures has higher flexural strength (90-110 MPa) and lower residual monomer than conventionally processed acrylic. This translates to better fracture resistance and reduced tissue irritation.

Clinical Outcomes

Clinical studies comparing digital and conventional dentures show comparable or superior outcomes for digital prostheses. A 2025 systematic review found digital dentures achieved better fit accuracy (measured by pressure-indicating paste) and required fewer adjustment appointments.

Patient satisfaction studies show mixed results. Some patients prefer digital denture esthetics and fit, while others find no difference. The learning curve for clinicians affects outcomes—experienced digital denture providers achieve better results.

Economic Considerations

Digital denture laboratory fees typically range from $800-1,500 per arch—comparable to or slightly higher than high-quality conventional dentures. The value proposition is reduced chair time and fewer adjustments rather than lower cost.

In-office milling requires significant capital investment ($40,000-100,000 for mills plus CAD software). Practices fabricating 10+ dentures monthly may achieve ROI, but most practices use commercial laboratories.

Clinical Recommendations

Digital dentures work best for patients with adequate ridge anatomy and realistic expectations. Severely resorbed ridges or complex esthetic requirements may still benefit from conventional techniques allowing more try-in modifications.

Clinicians should maintain conventional denture skills. Digital systems do not eliminate the need for understanding denture principles—proper impressions, accurate records, and appropriate tooth selection remain essential.

Starting with simple cases builds confidence. Single-arch dentures opposing natural dentition or existing prostheses are good initial cases. Complex complete denture cases are better attempted after gaining experience.