Virtual Evaluation of the Accuracy of Fit and Trueness in Maxillary Poly(etheretherketone) Removable Partial Denture Frameworks Fabricated by Direct and Indirect CAD/CAM Techniques

Purpose: To compare the accuracy of fit and trueness of maxillary poly(etheretherketone) (PEEK) removable partial denture (RPD) frameworks fabricated by direct and indirect computer-aided design/computer-aided manufacturing (CAD/CAM) techniques.

Materials and methods: A definitive maxillary class I master epoxy model was duplicated to create a stone cast. The cast was scanned, and an RPD was designed. Standard tessellation language (STL) data were used to fabricate 20 identical RPD frameworks using two CAD/CAM techniques: direct milling of PEEK and indirect additive manufacturing (resin printing combined with PEEK thermopressing using the lost-wax technique). All the frameworks for each technique (n = 10) and the reference cast were scanned. To assess the accuracy of fit, a color map was constructed using metrology software, and the misfit (distance between each framework and the reference cast) was measured at 25 standardized points. To assess the overall trueness, each framework STL file was superimposed over the original design's STL file, and the average deviation was recorded in microns. Data were statistically analyzed using t-test.

Results: Color mapping showed distinct pressure areas in the anterior and posterior straps of the major connector in the indirect technique, while a more uniform distribution of the color map was observed in the direct technique. A significant difference was found between the two techniques regarding the overall accuracy of fit. Compared with the indirect technique, the milled frameworks showed significantly better overall trueness (p < 0.001).

Conclusions: Although a significant difference in the overall fit accuracy was noted between both techniques, the fit was an acceptable clinical fit. The fabrication method affects the fit in the anterior and posterior strap areas. The frameworks of the direct technique revealed better overall trueness values compared with the indirect technique.