Comparative evaluation of patient satisfaction and clinical efficiency with conventionally and digitally fabricated removable partial denture-A non-randomized crossover clinical trial

Removable partial dentures remain an essential prosthetic consideration in many conditions of oral rehabilitation, especially when the posterior edentulous space to restored. • The objectives of RPD design have been well established. They include the restoration of function, enhancement of esthetic and, most importantly, the preservation of the remaining teeth and periodontal structures.  • The basic concepts of RPD framework design have been widely accepted for over 50 years. • Traditionally, the metal frameworks are produced by the lost-wax casting technique, which involves a series of demanding technical procedures even for experienced dental laboratory technicians. Due to the complexity of conventional RPD production, many possible sources of errors may compromise the framework’s strength, functionality and patient comfort.• Cobalt–chromium is usually the metal alloy used due to its good biocompatibility, appropriate wear and corrosion resistance, high fatigue strength, and low cost. • With continuous developments over several years, present-day technological advancements allow the use of different systems with computer-aided design/computer-aided manufacture (CAD/CAM) technology for the fabrication of removable dentures, including milling and rapid prototyping (RP). • A digital fabrication method has various advantages over conventional methods. In particular, electronic surveying performed in the virtual space, on the basis of the scan data, may determine the path of insertion and removal and control the undercut amount through computation in a more straightforward and accurate way than the conventional surveying.  • Satisfaction with RPD depends on individuality of patients, attitude towards RPD, previous RPD experience, encouragement for denture and design and fabrication procedure for RPD. Retention, chewing ability, aesthetics, seem to be the most important factors for RPD acceptance. The purpose of this study is to evaluate and compare the patient satisfaction and clinical efficiency with conventionally and digitally fabricated removable partial denture.

Primary Objective: To evaluate and compare patient satisfaction and clinical efficiency in conventionally fabricated removable partial denture and digitally fabricated removable partial denture.

Study design: An vivo study.

• Study area: Department of prosthodontics. Dental laboratory.

• Study duration: Approximately 18 months.

• Study expenditure: Approximately Rs. 75,000 – 90,000/-

Sample size for clinical trial is 20 considering dropout

INCLUSION CRITERIA-• Kennedys Class I and Class II with sufficient inter-arch space verified by tentative jaw relation. • Patient age between 25–60 years. • Patients willingness to participate in the study.

EXCLUSION CRITERIA- Patients with completely edentulous arch. • Patients experiencing problems with mouth opening and closing because of temporomandibular disorders. • Patients with congenital or acquired defects in the maxilla and in mandible. • Patients judged ineligible for study inclusion by principal investigator or designated contact person because of clinically significant medical or mental health findings.

Procedure- All the patients falling under the inclusion criteria will be given informed consent, and the participants will be allocated to an order of RPD placement. First conventionally fabricated RPD ii given and follow up is done for 3 months then digitally fabricated RPD is given to the same patients and follow up is done after 3 months. and the patient satisfaction is done with the help of questionnaire.

Clinical  efficiency will be assessed based on the factors of occlusion and phonetics to allow successful use. • Dentures will be independently evaluated by 2 prosthodontist with at least 5 years of experience using a 3 grade scale. • Scale – Poor -0 Fair-1 Good-2