Is it time to embrace the printed digital denture?

Ashley Byrne compares the current denture process with the printed digital one and asks if 2024 is the time to revolutionise dentures.

I’ve written about digital dentures before and they remain a little controversial for many. But a new time is coming and, in all honesty, I can confidently see the end of flasking and packing, and the removal of gypsum plaster in denture manufacturing.

Let’s start with some honest truths about current denture manufacturing in terms of wax set ups and, of course, flasking and packing.

The current denture process

Wax try ins are challenging. They don’t always fit perfectly, they start to soften in the mouth and can be smashed, broken or damaged in the post all too easily.

We are also expecting a patient to choose their smile for the next five to 10 years of their lives, right there in the chair, having looked at them in the mirror for mere minutes. They can’t eat with them to test function, they can’t show their family for aesthetics, and once they say yes, that’s it. That’s their final smile.

It’s of no surprise that one paper quoted that less than 19% of patients were truly happy with their dentures.

Next, let’s look at the manufacturing process of flasking. We know gypsum is a dreadful material – it’s toxic to the water coarse and, sooner or later, my feeling is that it will be banned in labs.

You can argue that we can use silicones or alginates to flask, but it is wasteful. Alternatively, back to the wonderful world of PMMA, it’s shrinkage is a big problem. All PMMA shrinks which means that however we flask our dentures, they are always smaller than the original try in. Yes, they work, but the question is could they be better?

The printed digital denture process

Now, let’s look at the new printed manufacture methods of digital dentures and why it throws some very interesting thoughts about efficiency and process.

Firstly, when they are well manufactured via a quality printer, the evidence now shows they will fit better. In fact, they fit so well it’s possible that we don’t even need a post dam. No gypsum is used.

In fact, we have almost zero waste of any product at all in printed processes. We can print spares which will be near perfect replicas of the dentures. This is ideal for patients wanting additional spares, or for patients suffering from issues with memory loss and dementia – a misplaced denture can be simply reprinted in a matter of hours, with a name identifier if needed.

Many patients hold onto their denture for vastly too many years for fear of a new one not being as good or the cost being too high. Printing additional dentures is cost effective, fast and, of course, files can be held onto for years.

What about aesthetics?

While I look at the manufacture process of digital dentures being vastly leaner, better for the environment and much healthier for the technician, the elephant in the room remains the aesthetics.

With the improvements to process and materials in recent years, I think now is the time to start looking at this again. We are seeing huge advancements in teeth print materials and more manufacturers working with stock teeth. Many argue the pinks are lifeless, but again we are seeing a huge rise in denture staining kits which, in our hands, are transforming the modern printed denture.

At LMT Lab Day Chicago this February, I noticed a huge amount of the lectures have switched from titles like ‘Starting with printed dentures’ to titles such as ‘Building a million-dollar denture business’ and ‘Perfecting the aesthetics of printed dentures’.

Talking to many US labs, the concept of flasking dentures now seems antiquated and many labs have literally grown into million-dollar businesses solely on the back of printed dentures.

Is 2024 the time to revolutionise dentures?

The UK market has been much slower to grow with digital printed dentures but 2024 could see this change. In my own lab, our success rate of printed temporary dentures has now overtaken poured cold cure dentures, to the point that all temporary dentures are 3D printed, no exceptions. With the improvements of definitive teeth materials, we are now rolling out our definitive dentures complete with both teeth and gum colours.

One of the most remarkable aspects of printed dentures is the solid monolithic try in. The ability for a patient to take their try in home, wear it over dinner or a cup of tea and share the smile with the family is something we could never do with wax. This benefit also allows patients to keep their white try in as a spare should anything happen while their new denture is reprinted.

Like all things dental, printed dentures have possibly now crossed that line of being ‘innovative’ and are approaching more ‘mainstream’. We have been here with materials like Zi that launched in basic white, were opaque and often fractured.

Now it’s a proven staple material of the industry, and I have no doubt printed dentures and the material manufacturers will be following that same path of Zi. Maybe we are not quite there yet, but maybe this is the year we really see the growth of a product that, in my opinion, has the ability to revolutionise the world of dentures.

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