The document summarizes three studies that evaluated the accuracy of removable partial denture (RPD) frameworks fabricated using different techniques: 1) A study compared digital, analog, and analog-digital techniques and found the digital technique produced significantly more accurate frameworks than the other techniques. 2) A second study evaluated the accuracy of a digital RPD fabricated by 3D printing and casting a pattern, finding it an accurate method. 3) A third study used replica techniques to analyze the internal fit of 10 digital RPDs, measuring 348 points and finding acceptable internal fit.

1. GOOD MORNING

2. Evaluation of removable partial
denture frameworks fabricated
using 3 different techniques
Irving Tregerman, Walter Renne, Abigail Kelly, and Dalton Wilson
THE JOURNAL OF PROSTHETIC DENTISTRY 2018
JOURNAL CLUB

3. Contents
 AIM
 INTRODUCTION
 RESULTS
 DISCUSSION
 RELATED ARTICLES
 CONCLUSION
 REFERENCES

4. AIM OF THE STUDY
 to determine the quality of RPD frameworks
fabricated using 3 different fabrication methods:
DIGITAL
ANALOG
DIGITAL
ANALOG

5. INTRODUCTION
Benefits of introducing CAD/CAM in the fabrication of RPD
Saves time
automatic
determination of
a proposed path
of insertion
Inherent
repeatability
immediate
elimination of
undesirable
undercuts
rapid
identification of
desirable
undercuts

6. DIGITAL WORKFLOW-DESIGNING
retention grid and major connector are designed
Followed by the rests and clasps.
virtual block-outs are automatically calculated and
displayed on the virtual cast
Path of insertion is defined
Undercuts are color coded based on depth
obtaining a digital model of the oral hard and soft tissues
Direct intra oral digital scan Digital scan of stone cast

7. Completed
design
SLA(STEROLITHOGRAPHY) FILE
ADDITIVE
MANUFACTURING
3D PRINTING,SELECTIVE
LASER SINTERING
SUBSTRACTIVE
MANUFACTURING
CAD CAM MILLING,SPARK
EROSION
MANUFACTURNG
OF RPD
FRAMEWORK
Digital
workflow-
manufacturing
DEFINITIVE
PROSTHESIS
DIRECTLY FROM
DIGITAL DESIGN
INTERMEDIATE
PRODUCT – RESIN
ELIMINATION
PATTERN
INVESTED AND
CASTED

8. 3D PRINTING TECHNIQUES
• uses ultraviolet (UV) lasers for polymerization of photosensitive resin
materials in small layer thicknesses ranging from 10 nm to 100 nm
depending on the accuracy desired
SLA (steriolithography) TECHNIQUE
• melts metal powders using high-power lasers which results in fusion of the
powder particles into a solid layer. This technique can be used to print
titanium and cobalt-chromium alloy (Co- Cr) for RPD frameworks
SLM(selective laser melting) TECHNIQUE
• Similar accuracy and range of uses but is a much faster technology and can
polymerize an entire layer in 1 pulse.
DIGITAL LIGHT PROJECTION (DLP)
• uses a series of resin-jet print heads from which thin streams of resin
material are jetted onto the build platform to create each incremental
layer.
JET PRINTING
Postprint
polymerization is
used
with a light-
emitting diode UV
light source to
ensure
complete
polymerization
and
biocompatibility

9. Many clinicians are more comfortable with analog
impression techniques!!!?
 Edentulous tissue scanning is difficult and lacks the accuracy of hard-
tissue scanning.
 The scan pattern affects the accuracy of intraoral digital scans and
can lead to a wide discrepancy in precision.
 scanner type used can also lead to varying levels of trueness and
precision, with some scanners performing better than others
 For a removable prosthesis, due to the nature of the mode of an
intraoral scanner that stitches narrow areas, it is difficult to scan the
distally extended flat and broad edentulous area ,and a functional
impression is not possible as the technique is image-based.

10. MATERIALS AND METHODS
3 RPD FRAMWORKS EACH
9 PARTICIPANTS
KENNEDY
S CLASS
I(4)
ALL
MANDIBULAR
KENNEDY
S CLASS
II(3)
MANDIBULAR(2) MAXILLARY(1)
KENNEDY
S CLASS
III(2)
ALL
MAXILLARY

12. • stone cast was poured using Type IV stone
physical impression was made using polyvinyl siloxane
border molding was first accomplished using a green
modeling plastic impression compound
• framework pattern, identical to the pattern design for the other
pathways, was hand drawn using a red pencil
stone cast was surveyed
laboratory technician waxed an RPD framework using
the design, invested it, and cast it in Co-Cr alloy
ANALOG

13. ANALOG DIGITAL
physical definitive impression was made and a stone
cast was fabricated as before
stone cast was then scanned using a laboratory
scanner (D800; 3Shape) to generate a digital model.
The digital RPD design was then sent to the Dental
Laboratory to be selective laser melted in Co-Cr alloy

14. DIGITAL
• 3Shape TRIOS III; 3Shape
intraoral digital scan was used to make a
definitive scan
• Dental System 2016 Premium; 3Shape
uploaded to the CAD software (for
digitally designing the RPD framework)
• (EOS CobaltChrome SP2; EOS GmbH).
Digital RPD frameworks were exported
and sent to be SLM-formed in Co-Cr alloy

15.  Five clinicians, 3 prosthodontists and 2 general dentists, were calibrated for
participation.
 The examining clinicians were calibrated in several sessions that reviewed ideal RPD
framework fit, with several examples seated on partially edentulous casts that had
areas of fit and misfit corresponding to the survey.
 Only the initial fit was evaluated with no adjustments.
 All frameworks were polished, and the examining clinicians were instructed to place
the RPD frameworks in the mouth without looking at the intaglio surfaces to avoid
bias from the visible 3D-printed layers
 The overall best fit was then determined by each evaluator, and that RPD
framework was ultimately used for the definitive processing and delivery of the
prosthesis to the patient.

17. RESULTS

18. DISCUSSION
 Once the operator becomes proficient at scanning complete
arches, this technique is quick and accurate. Because the
problems with complete-arch impressions are avoided, patient
compliance is enhanced.
 This technique is also better for those patients with a sensitive
gag reflex.
 The ability to see the scanned arches on the computer screen
allows immediate feedback, and any errors can be relatively
easily corrected.
 Minimal chairside time was needed to assess the fit of the RPD
frameworks fabricated from the digital pathway.

19. CRITICAL EVALUATION
 The critical areas of RPD framework fit were around the hard
tissues with limited soft-tissue contacts. Therefore, with only
the tissue- stops on the framework to evaluate soft tissue
accuracy, it is difficult to tell whether all areas of the tissue are
accurately captured from just a framework evaluation.
 The authors used a yes/no questionnaire rather than a Likert
scale because of the difficulty in calibrating 5 different
clinicians on a Likert-type scale. However, a Likert scale would
have provided more information

20. CONCLUSIONS
 The digital method of RPD framework fabrication
was significantly better than the analog method
of fabrication.
 The digital method was also significantly better
than the analog-digital method of framework
fabrication.
 The analog method was better than the analog-
digital method of framework fabrication.

21. Accuracy of a digital removable partial
denture fabricated by
casting a rapid prototyped pattern: A
clinical study
Jong-Won Lee, Ji-Man Park, Eun-Jin Park,
Seong-Joo Heo, Jai-Young Koak,Seong-Kyun Kim
J Prosthet Dent 2017
RELATED ARTICLES

22. AIM OF THE STUDY
 The purpose of this clinical study was to analyze the accuracy of digital RPDs
by using the replica technique.

23. MATERIALS AND METHODS
INCLUSION CRITERIA
 10 adult participants who had a
treatment plan, including the
restoration of oral function with an
RPD
EXCLUSION CRITERIA
 individuals younger than 20 years
of age
 women who were pregnant or
potentially childbearing age
 those with alcoholism or a mental
disease
 clinical findings that an
investigator considered
inappropriate for this study upon
medical judgment

24. • determined by a radiological or clinical examination
After the extraction of teeth that could not be used as an
abutment tooth owing to poor periodontal support
• followed by generation of a digital RPD
surveyed crowns were fabricated for the remaining teeth and
Intraoral functional impressions, including border molding, were
made, on the basis of which a definitive cast was obtained.
• standard tessellation language (STL) files were extracted and loaded onto the CAD
software
cast was scanned using a laboratory scanner (Activity 101;
Smartoptics)

25. The framework of the RPD was
designed by setting a surveying axis and computing the
undercut to determine an ideal path of insertion and
removal
The appropriate components,
including the major connector, clasps,
rests, proximal
plates, and finish line, were designed

26.  completed design, a pattern was
printed in resin(VisiJet M3
Dentcast; 3D Systems) using a rapid
prototyping machine (ProJet DP
3000; 3D Systems)
pattern was
invested,
eliminated, and cast
to generate the RPD
framework
The RPD was completed
by using the conventional
method, using
heatpolymerized
resin and artificial teeth. After
adjustments
were made to ensure that the
rests were seated on the
rest seats of the abutment
teeth, the denture was
delivered
to the participant

27.  At the first recall after the delivery appointment, a
replica was produced in order to analyze internal fit.
 After the internal fit between the oral tissue and denture
was determined using a silicone registration material an
impression of the RPD,including the internal registration
material, was made with an alginate impression material
 Abutment teeth were replicated by injecting silicone
impression material
 while the silicone registration material was maintained on
the tissue surface of the RPD, buried in the alginate
impression material. A base of silicone putty was used to
fabricate a replica of the RPD

28.  To analyze the accuracy of a digital RPD, sections containing the imprint of
framework components were cut and the thickness of the silicone
registration material in those fragments was measured. The 10 components of
the RPD metal structure were divided into 5 items: rest, clasp, minor
connector, major connector, and edentulous area

29. A total of 348 measurements
in 10
participants with Kennedy
classifications I, II, and III
were analyzed.
The internal discrepancies,
according to
the support type of the
denture, and the measured
position
below the rest were
measured at 147 points in
the cingulum rest and
occlusal rest areas
The thickness of the
registration material in each
fragment
was measured with a
stereomicroscope at ×130
magnification. Software
(ImageJ v1.45;
NIH) was used for image
analysis.

30. RESULTS An analysis of the internal
discrepancy under 2 types
of rests based on the
denture support type
showed that
the mean discrepancy of
the tooth support denture
group
was similar to that of the
tooth-tissue support
denture
group for the cingulum rest
Similarly for the
occlusal rest, the average
sizes of the internal
discrepancies
were similar in tooth-tissue
support dentures to
tooth support dentures

31.  For the internal discrepancies under 2 types of rests,
based on the measurement position, the center area
showed a greater mean discrepancy than the periphery for
the cingulum rest, and the difference was statistically
significant
 Similarly for the occlusal rest, the internal discrepancies
were similar under the center of the rest to the periphery
 Overall, the internal discrepancy under the periphery of
the rest was determined to be smaller than that of the
center

32. Major connector >>> rest, clasp, and minor connector
Edentulous area >> clasp and minor connector
Rest > minor connector
No significant differences were found between the clasp and minor connector

33. DISCUSSION

34. CONCLUSION
 Based on the findings of this clinical study,
the following conclusions were drawn:
1. Digital RPDs fabricated using electronic
surveying varied in accuracy of fit.
2. In the analysis of the discrepancies under
the cingulum and occlusal rests the accuracy
of the periphery was higher than that of the
center

35. Accuracy of CAD-CAM-fabricated
removable partial dentures
Christin Arnold, DiplIng, Jeremias Hey, Ramona Schweyen, and Jürgen M. Setz
J Prosthet Dent 2017

36. AIM OF THE STUDY
 To compare the fit of the retentive clasps of RPDs
created by means of 4 different CAD-CAM
techniques and conventional LWT.

37. MATERIALS AND METHODS
The master model was fabricated from a typhodont
model of a partially edentulous maxilla with the
canines and second molars as the only remaining
teeth
The residual ridge and teeth were milled from a
cobalt-chromium disk by using a 5-axis
milling machine and was attached to the cast with
acrylic resin
The margins of the prepared modified
clasps and teeth were intended to be parallel,
allowing the measurements of the distance between
the finish line of the teeth and the modified clasps
using light microscopy.

38. To evaluate the fit of the retentive clasps in a standardized
manner, horizontal and vertical lines comparable
to a milled shoulder finish line (Fig. 2) were scribed
in the abutment teeth.
The clasps were designed without
undercuts (Fig. 3).
The master model (Fig. 1) was duplicated by using
a polyvinylsiloxane material and 3 dental
stone casts were made for each
group

39. A quadrangularly supported
framework with a palatal strap
major connector was designed
using CAD-CAM software with the
manufacturing module for metal
frameworks.
The modified clasps were
designed by using the
manufacturing module for
inlay restorations.

40. INDIRECT RP
(wax injection printing
combined wit LWT)
DIRECT RP
(SELECTIVE LASER
MELTING)
DIRECT MI
( resin-milling)
INDIRECT MI (wax
milling with the LWT)
4 CAD CAM
TECHNIQUES-
15 RPDS
• Dental Shaper software
(3Shape A/S) was used to
associate the standard
tessellation language data
sets, allowing the different
manufacturing modules to be
compared.
• The definitive standard
tessellation language data set
was used for all CAM
techniques.
• LWT group, 3 frameworks
were identically fabricated in
wax. The wax patterns were
attached to a sprue former,
invested and cast in cobalt-
chromium alloy

42. Because of the anatomical
differences between canines
and molars, different measurement
areas distributed
over the horizontal and vertical
margins of the
modified clasp were defined
In each area, the fit was defined as
the distance (in mm) between the
shoulder
finish line of the tooth and the
margin of the modified
clasp and was measured 10 times.
In total, 60 measurements were
thus obtained for each canine (30
horizontal and 30 vertical values)
and 50 measurements
for each molar
 Both the evaluation and measurement of fit were
performed by a single investigator
 finished frameworks were first rated subjectively for
design and stability.
 Frameworks were then placed on the master model,
and accuracy of fit of each modified clasp (12 clasps
per group) was analyzed using light microscopy at
×560 magnification.

43. For each modified clasp, horizontal and vertical
measurement values were averaged, and mean values
for both the horizontal and vertical fit accuracy were
provided.
The horizontal and vertical mean values for all
clasps from 1 group (n=6) were summed and assessed
descriptively differences in the horizontal
and vertical fit accuracy were compared between
canines and molars which were found to be statistically
insignificant between vertical and horizontal fit
accuracy were compared, considering all clasps (n=12).
Finally, differences between the horizontal and vertical
fit accuracy values of the groups were compared
10 modified clasps were measured by the same
investigator after a period of 3 months.

44. RESULTS
 In the indirect RP and direct RP groups, frameworks showed a reduced
stability to transverse and sagittal movements, and pronounced
imperfections were found in the clasps.
 Indirect RP and indirect MI groups exhibited defects, including rough
surfaces, small discontinuities, pores, and holes.
 Highest variations in measurement values were found in the two RP groups.
 The horizontal values were greater than the vertical values in all groups.
 Differences between these values were statistically significant in the LWT
 The direct RP group showed statistically significantly higher vertical values
than the other 4 groups

45. CONCLUSIONS
 Based on the findings of this in vitro study, the following
conclusions were drawn:
1. Well-fitting RPDs with a clasp assembly can be accurately
manufactured with CAD-CAM techniques.
2. In comparison with the LWT method, the direct CAD-CAM
milling process showed a significantly better fit.
3. RPDs produced by RP exhibited the highest discrepancies.
4. All RPDs fabricated by using techniques that included
casting procedures revealed higher horizontal than vertical
discrepancies because of greater distortion.

46. An In Vitro Investigation of Accuracy and
Fit of Conventional and CAD/CAM
Removable Partial
Denture Frameworks
Pooya Soltanzadeh, Montry S. Suprono,Mathew T. Kattadiyil, Charles
Goodacre, & Wendy Gregorius
J Prosthet Dent 2018;119:586-592

47. AIM OF THE STUDY
To evaluate the overall accuracy and fit of
conventional versus computer-aided
design/computer-aided manufactured (CAD/CAM)
removable partial denture (RPD) frameworks based
on standard tessellation language (STL) data
analysis, and to evaluate the accuracy and fit of
each component of the RPD framework.

48. Figure 2. Flowchart depicting the fabrication of
RPD frameworks of each group.
4 groups of 10 specimens in each group, for a total of 40 specimens (n = 40). All
RPD frameworks were fabricated using Co-Cr alloy

49. Materials and methods
 The impression was poured
with type IV scannable dental
stone and was used as the
reference model throughout
the study
 The same reference stone
model was used to fabricate
the specimens for all groups

50. the model was duplicated using a silicone-based duplication material After 24 hours of setting time, the reference model was
scanned using a desktop scanner and the STL file generated was used as the reference data set
Outlines measuring 0.5 × 0.5 mm2 of the clasps for all abutment teeth were created using a high-speed rotary instrument.
Four pyramid shaped structures (2.0 × 2.0 mm2 with 2.0 mm height), as well as 3 notches (2.0 mm width) at the rest areas, were
created and served as landmarks for software measurements and analyses.
For each abutment tooth, the positions of the terminal end of the retentive clasps were identified and marked using a 0.01”
undercut gauge
The printed model was surveyed and modified to ensure parallel guiding planes
Four rest seats were prepared on the abutment teeth
# 3, 6, 12, and 14.
A 3D printed model of a maxillary arch with a Kennedy class III modification I situation
Acrylonitrile Butadiene Styrene (ABS)

51. • reference model was duplicated using a silicone-based duplication
material
• casts were made using a type IV scannable dental stone.( poured in 1
day and stored in a dark non humid environment for 24 hours)
• RPD frameworks were cast using Co-Cr alloy finished, and then
airborne particle abraded with 50 μm aluminum oxide (Al2O3) under
2 bar pressure.
Group1: Conventional
method: Lost-wax technique
from stone model
• Ten scans were made of the reference model using the TRIOS 3
intraoral scanner
• digital files were sent directly to the 3DRPD® Company for
fabrication of the RPD frameworks.
Group2: CAD-printing
• The reference model was duplicated using a silicone-based
duplication material, and 10 stone casts were made using a type IV
scannable dental stone.
• The casts were scanned using the 3ST intraoral scanner.
• framework was designed on the computer and emailed as STL files to
the 3DRPD® company for fabrication of the RPD frameworks.
Group3: CAD-printing from
stone model
• The reference model was scanned using the Trios intraoral scanner
10 times and exported as an STL file from the database and imported
into a 3D printing software.
• Each scan data was printed using a desktop, stereolithographic
printer coupled with synergistic biocompatible resin
• Each printed model sent to a commercial lab for fabrication of the
frameworks and casted using Co-Cr alloy, finished, and airborne
Group4: Lost-wax technique
from resin model

53. All areas (25) of each specimen, in each group, were analyzed. Between-group comparisons were
made of the RPD components. Three additional comparisons were made for the major connector,
specifically the anterior strap, the posterior strap, and the combined anterior-posterior strap of each
group.

54. A gap from 0 to 50 μm - close contact (no
gap)
gap from 50 to 311 μm-clinically
acceptable fit.
The lowest value (best fit) for overall
framework adaptation
was obtained from the conventional
group, and the highest value (worst fit)
was found with the CAD-printing group
(Table 1).
There was no significant difference
between the conventionally cast
frameworks (group I and group IV)
or between the 3D-printed frameworks
(group II and group III)

55. The mean values measured for rests, posterior straps of major connectors, and reciprocal
plates from all groups were less than 50 μm, and were considered as close contacts
For the major
connectors, the
lowest values
obtained were from
conventionally cast
frameworks (0.04
mm), and were
significantly
different when
compared to the
printed frameworks

56. The overall gaps (the mean discrepancy between the frameworks and
the reference model) were significantly less with the conventional
fabrication methods (either from
stone or resin), when compared to the 3D-printed framework groups

57. Figure 5. Digital superimposition and
measurements of specific areas of an RPD
framework

58. CONCLUSIONS
1. The conventional processed RPD frameworks revealed better fit
and accuracy when compared to 3D printed frameworks; however,
all methods revealed clinically acceptable fit (50-311 μm).
2. No significant differences in the fit of 3D-printed frameworks were
observed with regards to scanning methods.
3. High fit accuracy (<50 μm gap) in the areas of the rests and
reciprocal plates for all fabrication methods was observed.
4. The poorest fit was seen with the major connectors, particularly
the anterior straps fabricated using the CAD printing technique.

59. Comparison of the retention of
conventional versus digitally
fabricated removable partial
dentures. A cross over study
Waleed Hamed Maryod, Eatemad Rekaby Taha
Int J Dent & Oral Heal. 5:2, 13-19

60. AIM OF THE STUDY
 The clinical trial
compared retention of
digital RPD fabricated
with digital
impression, digital
designing and casting
a 3D printed pattern
with conventional
RPD.
PARTICIPANTS ENROLMENT
 Twenty partially
edentulous patients
(11 women, 9 men,
mean age 58.4 ± 8.3
years) All patients
having mandibular
Kennedy class I with
all posterior teeth
missing.

61. MATERIALS AND METHODS
A conventional RPD were constructed for the lower arch
and delivered for each patient.
• full-arch digital impression of the mandibular arch was made with an
intraoral scanner
After 3 months of follow up and retention
measurement, they were recalled
• with special attention to capturing the soft tissues including the buccal
and lingual vestibule.
A digital impression was made recording both the
remaining teeth and the edentulous areas
Also, a digital impression of the opposing arch and a
digital buccal inter-occlusal record were made

62. MATERIALS AND METHODS
The path of insertion was
determined on the digital file, and
the survey line was drawn with
digital block-out for the undesirable
undercuts.
A three-dimensional image was
produced and was read by computer-
aided design (CAD) software. The CAD
software was then used to design the
framework and generate a standard
triangulation language (STL file).

63. entire framework design was built virtually in
3D format and the different components of
framework were added

64.  The standard triangulation language
(STL) file was then transferred to a 3D
printer.This professional 3 D printer
uses a digital light processing
technology (DLP), a process similar to
stereolithography (SLA)
 A HD resolution DLP projector , using a
LED light source to photo cure liquid
resin, layer by layer to build a 3d resin
framework pattern of the RPD. The
polyamide physical model was also
obtained using the same 3D printer
The 3D printed materials were post
cured in UV curing unit by U V light
treatment . The printed resin
pattern of the digital RPD is then
invested and casted into cobalt-
chromium framework using
conventional casting technique. Metal
try in of the framework was
performed to check the fit and
accuracy

65. Evaluation of denture retention
Lower denture retention is most accurately measured by pulling the denture
in vertical direction from its geographic center
Measurements were carried out using digital force gauge
advanced type of force meter device
used to measure tension or compression up to
20 Kg.
Measurements were performed for each RPD at the time of denture insertion
AFTER 1 MONTH 3 MONTHS LATER

66. Determination of the geographic center
of the mandibular denture
 A trough was
drilled at (point
a) by round
surgical bur. The
bur maintained
in the trough
leaving about 25
mm of its length
projecting from
the cast.
 This length was
the most
appropriate
length from
which the
application of
force took place
without
endangering the
upper jaw or
being interfere
with the tongue
• connecting two points at the apices of the retromolar pads of
both sides of the arch.LINE 1
•passing through the incisal edge of lower central incisors of
the anterior ridge and parallel to the line (1)LINE 2
•passing through the mid line of the cast and perpendicular to
both lines (1) and (2).On line 3, the midpoint between line (1)
and (2) was determined and marked, (point a)LINE 3
•Line (4) passing through point (a) and running parallel to lines
(1) and (2).LINE 4
This center was located on the duplicate mandibular cast by drawing four
lines on the cast and extending them to the cast base in the following
sequence

67. Preparation of the mandibular denture
for the retention test
 The finished mandibular denture
was placed on duplicate cast after
determination of its geographic
center
 The three wire lopes was engaged
by three metallic wires and the
wires extended upwards to meet
and joined in the geographic center
of the denture, at the bur projecting
from the cast base.
 A metallic loop was then used to
join the three wires on the top of
the bur.
Three 18 gauge orthodontic wire lopes was
attached to lingual aspect of the denture
one at its midline
two posterior at line (4)

68. Measuring the denture retention
 patient sitting in an upright
position with his head rested on
the head rest and the lower
occlusal plane parallel to the floor.
 The metallic probe of the digital
force gauge was attached to the
metallic hook which is attached to
the geometrical center of the
mandibular partial denture
 The force gauge pulls the
mandibular denture vertically
upward until denture movement
occurs.Force at which the denture
dislodges was recorded in Newton.

69. The mean retention
values for digitally
fabricated partial
dentures recorded
higher values than
those of
conventional
dentures

70. CONCLUSION
Within the limitations of this short-term clinical study the retention of
digital RPD fabricated with digital impression, digital designing and
casting a 3D printed pattern was higher than conventional RPD as it
was associated with less human intervention.

71. REFERENCES
 Waleed Hamed Maryod and Eatemad Rekaby Taha (2019), Comparison of the retention of
conventional versus digitally fabricated removable partial dentures. A cross over study. Int J Dent
& Oral Heal. 5:2, 13-19
 Tregerman I, Renne W, Kelly A, Wilson D. Evaluation of removable partial denture frameworks
fabricated using 3 different techniques. The Journal of Prosthetic Dentistry. 2019 Apr 1.
 Lee JW, Park JM, Park EJ, Heo SJ, Koak JY, Kim SK. Accuracy of a digital removable partial
denture fabricated by casting a rapid prototyped pattern: A clinical study. The Journal of
prosthetic dentistry. 2017 Oct 1;118(4):468-74.
 Arnold C, Hey J, Schweyen R, Setz JM. Accuracy of CAD-CAM-fabricated removable partial
dentures. The Journal of prosthetic dentistry. 2018 Apr 1;119(4):586-92.
 Soltanzadeh P, Suprono MS, Kattadiyil MT, Goodacre C, Gregorius W. An in vitro investigation of
accuracy and fit of conventional and CAD/CAM removable partial denture frameworks. Journal of
Prosthodontics. 2018 Nov 1.