Clinical outcomes of 3D printed complete dentures: A systematic review and meta-analysis

Statement of problem: Complete dentures can be fabricated using subtractive (milling) or additive (3-dimensional [3D] printing) technologies. Clinically, both methods offer a reduction in the treatment duration and number of appointments required for denture fabrication. However, 3D printing is more economical because of the lower cost of equipment and fabrication. Both methods have been termed digitally fabricated dentures and evaluated against conventional dentures in a cumulative manner. Systematic reviews investigating the clinical effectiveness of 3D printed complete dentures (3DPs) against conventional (CCDs) and milled dentures (MDs) are lacking. Purpose: The aim of this systematic review was to determine whether differences existed in the clinical outcomes of 3DPs when compared with CCDs and MDs. Material and methods: This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol and was registered in the International prospective register for systematic reviews (CRD420251132425). The review was formulated to answer the research question: “Is there a difference in the clinical outcomes of 3D printed complete dentures when compared with conventional and milled dentures?”. An electronic search was carried out independently in the PubMed/Medline, Scopus, Embase, and Cochrane databases by 2 authors by April 2025. The clinical outcomes evaluated in this review included denture base retention, patient satisfaction, oral health related quality of life (OHRQoL), masticatory force, and clinician satisfaction. Quantitative analysis was performed using a software program (RevMan 5.4.1; Cochrane group), and continuous outcomes were evaluated with standardized mean difference using the inverse variance method. Risk of bias was assessed for the included studies using the ROB2.0 tool for randomized trials and ROBINS-I tool for nonrandomized trials. The certainty of evidence was evaluated using the grading of recommendations assessment, development, and evaluation (GRADE) tool. Results: A total of 460 articles were identified by the search strategy, 12 of which were included in this review. Data related to the outcomes of denture base retention, patient satisfaction, OHRQoL, masticatory force, and clinician satisfaction were retrieved from the included studies. CCDs displayed better denture retention when compared with 3DPs (P=.04). No significant differences in any other clinical outcomes were found between 3DPs and CCDs or MDs (P>.05). Conclusions: 3DPs demonstrated similar clinical outcomes to CCDs and MDs, except in denture retention, where CCDs were found to be more retentive.