Clinical performance, accuracy, and physical-mechanical properties of 3D-printed removable partial denture metal frameworks compared with conventionally and partially digitally produced frameworks: A systematic review.
Clinical Snapshot
PICO Framework
| P — Population | Patients requiring removable partial denture (RPD) metal frameworks |
| I — Intervention | 3D-printed RPD frameworks using selective laser sintering (SLS), selective laser melting (SLM), and direct metal laser sintering (DMLS) |
| C — Comparator | Conventional casting methods and partial digital workflow methods |
| O — Outcomes | Clinical performance (retention, patient satisfaction), accuracy (fit), physical-mechanical properties (density, yield strength, surface roughness, microhardness) |
Bottom Line
This systematic review of 30 studies suggests that 3D-printed removable partial denture frameworks using selective laser melting and direct metal laser sintering technologies may offer comparable or superior clinical performance compared to conventional casting methods. The evidence indicates potential improvements in retention, patient satisfaction, and mechanical properties including density, yield strength, and microhardness. However, the findings should be interpreted cautiously due to significant methodological variability across studies and moderate risk of bias in many included studies. While the technology shows promise, clinicians should consider the current evidence limitations, equipment requirements, and cost-effectiveness when deciding whether to adopt 3D printing for RPD framework fabrication. Further high-quality randomized controlled trials with standardized protocols are needed to establish definitive clinical recommendations.
Key Findings
P Value: Not applicable - no meta-analysis performed
Effect Size: SLM and DMLS often outperformed conventional casting in mechanical properties
Primary Outcome: 3D-printed RPD frameworks showed comparable or superior clinical performance to conventional methods
Nnt Or Sensitivity: Improved retention and patient satisfaction with 3D-printed frameworks, higher density and better mechanical properties including yield strength and microhardness
Confidence Interval: Not reported - qualitative synthesis only
Clinical Application
Requires access to 3D printing technology (SLS, SLM, DMLS) and trained technicians, may have higher initial equipment costs Relevant to Australian prosthodontic practice, though TGA approval status of specific 3D printing materials and PBS coverage for advanced fabrication methods should be considered Patients requiring removable partial dentures, particularly those needing improved retention and mechanical durability
Abstract
PURPOSE: This systematic review evaluated the clinical performance, physical-mechanical properties, and accuracy of removable partial denture (RPD) frameworks fabricated using three-dimensional (3D) printing technologies-specifically, selective laser sintering (SLS), selective laser melting (SLM), and direct metal laser sintering (DMLS)-compared to those produced by conventional casting or methods using a partial digital workflow. STUDY SELECTION: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, a literature search was conducted in the PubMed, Scopus, Web of Science, and Cochrane databases in October 2024. Studies were included if they compared the fit, accuracy, mechanical and physical properties, and clinical outcomes of metal RPD frameworks made using 3D printing technologies with those produced using conventional casting or partial digital methods. The risk of bias was assessed using appropriate tools (modified CONSORT, ROB2, and ROBINS-I) based on the study design and a qualitative analysis was conducted. This study received no funding and was registered with PROSPERO (#CRD42024597225). RESULTS: Thirty studies were included: 12 compared 3D printing technologies with conventional casting, eight with partial digital methods, and 10 with both. Clinically, 3D-printed frameworks could improve retention and patient satisfaction. The laboratory results showed higher density, better mechanical properties (yield strength, surface roughness, and microhardness), and varied accuracy by component and method, with SLM and DMLS often outperforming conventional casting. The evidence was limited by methodological variability, a moderate risk of bias in many studies, and inconsistencies across the study designs and parameters. CONCLUSIONS: 3D-printed RPD metal frameworks demonstrated clinical accuracy and mechanical-physical performance comparable or superior to those of conventional and partially digital methods for RPD frameworks, with ongoing advances expected to further enhance their precision and clinical applicability.
References
- 1.Alqutaibi, A. Y., Al-Gabri, R. S., Al-Zaghruri, A. S., Farghal, A. E., Alnazzawi, A. A., & Alghauli, M. A. (2026). Clinical performance, accuracy, and physical-mechanical properties of 3D-printed removable partial denture metal frameworks compared with conventionally and partially digitally produced frameworks: A systematic review. Journal of Prosthodontic Research. https://doi.org/10.2186/jpr.JPR_D_25_00028
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