When 3D-Printed Dentures Meet Precision: Which Design Delivers the Most Accurate Bite?

Exploring how socket design and tooth splinting affect occlusal accuracy in CAD-CAM complete dentures

Digital technologies are transforming how complete dentures are made. Among these, 3D printing has gained attention for its affordability, speed, and ability to produce multiple dentures at once. But one critical question remains: how accurate is the final bite? Even small tooth movements during fabrication can affect comfort, stability, and chairside adjustment time.

A recent study published in BMC Oral Health (2025) takes a closer look at this issue, examining how different socket designs and tooth splinting approaches influence the occlusal trueness of 3D-printed complete dentures.

Why Occlusal Trueness Matters in Denture Fabrication

Occlusal inaccuracies are not unique to digital dentures—they also occur in conventional techniques. However, in digital workflows, post-fabrication correction is limited. Research shows that a tooth displacement of just 0.25 mm can lead to noticeable changes in vertical dimension and occlusal balance.

While monoblock CAD-CAM dentures are known for excellent accuracy, they are costly and less flexible esthetically. More commonly, denture teeth are fabricated separately and bonded to the base—a step that can compromise occlusal precision. This study set out to identify which digital and hybrid approaches offer the best balance between accuracy, cost, and clinical practicality.

What Did the Researchers Investigate?

The research team fabricated 80 maxillary complete dentures, divided into eight different groups, each representing a different fabrication strategy:

• Socketed vs. thimble-shaped tooth sockets

• Unsplinted teeth vs. 1-unit or 3-unit splinted teeth

• Fully 3D-printed dentures

• A semi-conventional pack-and-press technique, using a 3D-printed castable wax pattern

• A monoblock denture as the reference standard

All dentures were digitally designed, fabricated using SLA 3D printing, scanned, and then compared with their original CAD designs using 3D analysis software. The researchers measured tooth deviation in millimeters to assess occlusal trueness.

Key Findings: Which Dentures Performed Best?

The results revealed statistically significant differences among the fabrication methods:

🥇 Best Overall Accuracy

• Monoblock dentures showed the lowest tooth deviation (median ≈ 0.104 mm), confirming their reputation as the gold standard.

🥈 Best Practical Alternative

• Socketed bases with 1-unit splinted teeth delivered accuracy very close to monoblock dentures, making them the best fully digital alternative.

🔄 Hybrid Approach Performs Well

• The semi-conventional pack-and-press technique (3D-printed wax pattern + conventional processing) also showed good occlusal trueness, outperforming several fully printed designs.

⚠️ Less Favorable Designs

• Unsplinted teeth, especially when combined with thimble socket designs, showed the highest deviations.

• Anterior teeth tended to deviate more than posterior teeth, particularly the incisors.

Overall, measured deviations across all groups ranged from 0.104 to 0.282 mm, remaining within clinically acceptable limits—but with clear differences in performance.

What Do These Results Mean for Clinicians and Labs?

This study provides practical guidance for choosing denture fabrication strategies:

• Monoblock dentures remain the most accurate, but cost and esthetics may limit their use.

• Socketed bases with splinted teeth offer an excellent balance between precision and flexibility.

• Hybrid digital–conventional workflows can achieve high accuracy without the expense of full CAD-CAM systems.

• Simply adding retention features like thimbles does not automatically improve occlusal accuracy.

For clinics and labs working in cost-sensitive settings, these findings help narrow down which digital workflows truly deliver predictable results.

Conclusion

Not all 3D-printed dentures are created equal. While monoblock dentures still lead in occlusal accuracy, thoughtful design choices—especially socket configuration and tooth splinting—can significantly improve the performance of printed dentures. By optimizing these parameters, clinicians can reduce adjustment time, improve denture stability, and enhance patient satisfaction.

Reference

Sallam RMAM, Metwally NA, Khamis MM.

Evaluation of the occlusal trueness among 3-dimensionally printed CAD-CAM complete dentures with different socket designs and teeth splinting assemblies.

BMC Oral Health. 2025;25:626.

DOI: 10.1186/s12903-025-05894-7