CATEGORY AUSTRALASIAN DENTIST 67 CLINICAL surface scanning was essential for matching with the bite scan (figure 15). Denture design followed the same procedure as for the intermediate dentures. The final prostheses were fabricated subtractively using the 5-axis milling machine inLab MC X5 (Sirona, Bensheim, Germany). The STL files were first nested in the inLab CAM software (Sirona, Bensheim, Germany) (figures 16+17). The denture bases were milled from the PMMA disc CediTEC DB (denture base) (VOCO, Cuxhaven, Germany), whereas the denture teeth were milled from the composite disc CediTEC DT (denture teeth) (VOCO, Cuxhaven, Germany) (figures 18+19). After milling, connectors were trimmed and grounded. Subsequently, all parts of the denture were completely polished and the luting surfaces of the denture base and the tooth segments have been conditioned (figures 20+21). Again, for luting, the CediTEC system (VOCO, Cuxhaven, Germany) has been used as described previously. Finally, the bonding interfaces of the tooth segments and denture bases were polished. Figure 22 shows the final permanent dentures. During the appointment for insertion, the fit and pressure points of the maxillary and mandibular dentures were checked. Occlusion was finely adjusted and the dentures were polished to high gloss. The patient was satisfied with the outcome (figures 23+24). The digital workflow for full dentures offers numerous advantages over conventional techniques for patients, technicians, and dentists alike. These include in particular a reduction and simplification of work steps. Intraoral scans can be transferred directly to the lab without the need for shipping, eliminating work steps such as model fabrication and articulation. Digital design allows for rapid, symmetrical modifications of tooth positioning. Conventional grinding of denture teeth is no longer necessary. The finished virtual design can be reviewed with the patient beforehand, reducing the number of subsequent adjustments. Moreover, saved designs allow for quick reproduction in cases of prosthesis loss or the need for travel prostheses3. The Figure 1: Intraorally scanned patient situation with upper and lower jaw in relation. Figure 4: Tooth segments with support structures on the build plate in the nesting software Asiga Composer (3Shape). Figure 7: Checking the fit of the printed tooth segments in the printed denture bases. Figure 2: Virtual set-up in the Dental Designer software (3Shape). Figure 5: 3D-printed denture bases (V-Print dentbase, VOCO) with support structures on the build plate. Figure 8: Conditioning the denture segments with CediTEC Primer (VOCO). Figure 3: Denture bases with support structures on the build plate in the nesting software Asiga Composer (3Shape). Figure 6: 3D-printed denture segments after postprocessing. Figure 9: Filling the tooth compartments of the denture bases with CediTEC Adhesive (VOCO). Figure 10: Inserting the tooth segments into the filled denture bases. Figure 11: Temporary, 3D-printed full dentures after final polishing. Figure 12: 3D-printed prostheses in situ after two weeks of wear in frontal view.
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