journal of prosthodontic research 61 (2017) 8186

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Journal of Prosthodontic Research

journal homepage: www.elsevier.com/locate/jpor

Technical procedure

Duplication of complete dentures using

general-purpose handheld optical scanner and
3-dimensional printer: Introduction and clinical
considerations

Kosuke Kurahashi DDSa, Takashi Matsuda DDS, PhDa,

Takaharu Goto DDS, PhDa, Yuichi Ishida DDS, PhDa,*, Teruaki Ito PhDb,
Tetsuo Ichikawa DDS, PhDa
a
Department of Oral and Maxillofacial Prosthodontics, Tokushima University Graduate School of Biomedical Sciences,
Japan
b
Tokushima University Graduate School of Science and Technology, Japan

article info abstract

Article history: Purpose: To introduce a new clinical procedure for fabricating duplicates of complete
Received 18 April 2016 dentures by bite pressure impression using digital technology, and to discuss its clinical
Received in revised form significance.
20 May 2016 Methods: The denture is placed on a rotary table and the 3-dimensional form of the denture
Accepted 4 June 2016 is digitized using a general-purpose handheld optical scanner. The duplicate denture is
Available online 23 June 2016 made of polylactic acid by a 3-dimensional printer using the 3-dimensional data.
Conclusion: This procedure has the advantages of wasting less material, employing less
Keywords: human power, decreasing treatment time at the chair side, lowering the rates of contami-
Complete denture nation, and being readily fabricated at the time of the treatment visit.
Duplication # 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
CAD/CAM
3-Dimensional printer
Handheld optical scanner

satisfied with the duplicate complete denture after the post-

1. Introduction
As part of serial procedures for complete denture fabrication,
duplication of existing complete dentures has been an
alternative fabrication technique [1]. When the patient is
insertion observations and adjustments, the duplicate den-
tures are transferred to new complete dentures with dental
laboratory work [25]. The main advantage of the technique is
the reduction in the adaptation period to the new complete
dentures, which is particularly important for elderly patients.

* Corresponding author at: Department of Oral and Maxillofacial Prosthodontics, Tokushima University Graduate School of Biomedical
Sciences, 3-18-15 Kuramoto-cho, Tokushima 770-8504, Japan. Tel.: +81 88 633 7347; fax: +81 88 633 7461.
E-mail address: junchan@tokushima-u.ac.jp (Y. Ishida).
http://dx.doi.org/10.1016/j.jpor.2016.06.002
1883-1958/# 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
82 journal of prosthodontic research 61 (2017) 8186
[(Fig._1)TD$IG]
Fig. 1 Preoperative view of oral cavity (a and b) and existing complete dentures (c).
It is also useful in cases with severe bone resorption when the
new denture form is not predictable. The duplicate dentures
are occasionally used as a specialized tray of bite pressure
impression, in which both final impression and interocclusal
records are obtained at the same time [6].
Duplicate dentures are generally fabricated by the follow-
ing procedures: flasking of the complete denture with alginate
impression materials in a duplicating flask, opening it, pouring
auto-polymerizing resin into the mold, trimming, and polish-
ing [7]. Recently, the use of computer-aided design/computer-
aided manufacturing (CAD/CAM) has become widely accepted
in the field of dentistry [812]. In the field of complete denture
prosthodontics, impression and interocclusal records are sent
to dental laboratories, and new final dentures are commer-
cially fabricated using CAD/CAM technologies [1315]. How-
ever, there are few reports of the use of digital technology for
duplication of complete dentures in the dental clinic setting
[16].
This article introduces a clinical procedure for fabricating
duplicate complete dentures using a general-purpose hand-
held optical scanner and a 3-dimensional (3D) printer in the
dental clinic setting. The availability and advantages of this
procedure are discussed with a clinical case.
2. Materials and methods
A 66-year-old woman with fully edentulous jaws was enrolled
in this technical report (Fig. 1). The patient had the complete
dentures with hard resin teeth and acrylic denture base and
also had complaints concerning material degradation and
complete denture instability. The existing complete dentures
are improved to an appropriate form by using auto-polymer-
izing acrylic resin and tissue conditioner, if needed. The
clinical trial was conducted with the approval of the Ethics
Committee of the Tokushima University Hospital (No. 2413).
2.1. Digitalization of complete denture
The denture was fixed to a rotary table (Guru-ri kun Mini-AC,
Sigma Planning Corporation, Tokyo, Japan) by using a mixture
of utility wax and sticky wax. Before the image capturing, the
denture was coated with siccarol powder (Wakodo, Tokyo,
Japan) to facilitate the scanning. A handheld optical scanner
(Artec spider, Artec Group, Luxembourg) was equipped at the
focal point of the denture to digitize the surface topography of
the denture (Fig. 2). The rotary table was rotated at a speed of
68/s, and the denture topography was scanned every 1208. This
condition was determined through the scanning performance
of optical scanner and processing speed of the computer. In
cases with severe undercut areas, additional regional scan-
ning is needed by holding the scanner while detecting the area
that was not scanned from the monitor of the computer. The
3D data was integrated on the computer and the 3D denture
form was constructed using the specific software (Artec Studio
9, Artec Group, Luxembourg) (Fig. 3). A smoothing digital filter
is applied to the raw digital data. Texture mapping digital filter
was not performed because there was no need for denture
color. The 3D denture form can be designed with the aid of a
computer (Claytools, 3D Systems, SC, USA), if the dentist
needs to improve the denture form after scanning (Fig. 4).
2.2. Additive manufacturing of the duplicate denture by
using a general-purpose 3D printer
The duplicate denture was made of polylactic acid (PLA) using
a 3D printer (Makerbot Replicator 5th Generation Model,
Makerbot, NY, USA) using the 3D data of the denture form.
Thereafter, the denture forminternal and external surfaces,
peripheral or border of the denture base, and occlusal tables
was trimmed and finished using hand instruments (Fig. 5).
The duplicate denture was adjusted while evaluating the fit
of the duplicate denture base to the basal tissues using a
 journal of prosthodontic research 61 (2017) 8186 83
[(Fig._2)TD$IG]

Fig. 2 (a) Layout of denture and scanning devices for digitalization (white arrow: rotary table, and black arrow: handheld
[(Fig._3)TD$IG]
optical scanner), (b) setting of lower denture, (c) setting of upper denture powdered with siccarol.

[(Fig._4)TD$IG] Fig. 3 3D images of the upper and lower complete dentures.

Fig. 4 Computer-aided modification of the denture form on the monitor.

silicone material (Fit Checker, GC Corporation, Tokyo, Japan) silicone material and interocclusal recording on wax was
according to a conventional procedure. After adjusting and performed according to a conventional technique; and the
improving the duplicate dentures, final impressions using midline was indicated on the duplicate denture (Fig. 6).
84 journal of prosthodontic research 61 (2017) 8186
[(Fig._5)TD$IG]
Fig. 5 The duplicate complete dentures made of PLA
material. The form was recontoured and finished using
hand instruments.
[(Fig._7)TD$IG]
Fig. 7 Dental laboratory work. Mounting of articulator (a), the buccal and lingual indicators for teeth arrangements (b), and
wax denture fabrication (c).
The duplicate dentures were mounted to an articulator and
a wax denture was made (Fig. 7), and then a final denture was
fabricated (Fig. 8).
3. Difference from conventional methods
The conventional fabrication procedure of duplicating a
denture has a series of technical steps: impression, mold-
made, injection of denture material, and re-contouring and
polishing according to a lost wax technique. The new method
consists of just two steps: digital impression of the existing
denture by using a handheld optical scanner, and fabrication
of duplicating PLA denture using a 3D printer.
By far, two methods to digitize the 3D form of denture have
been reported. One is that the denture is at once digitized by a
cone beam computed tomography (CBCT) [17,18], which has
high accuracy and automatic sampling. However, it is very
expensive and an ordinary dental clinic cannot afford this
equipment. Moreover, if the denture contains a metal, an
image metal artifact may be seen in the CBCT image. The other
is the impression surface and occlusal surface are separately
digitized by an optical scanner, and the images are integrated
on the computer [19]. It is also difficult to digitize a complete
denture form by using a commercial dental laboratory scanner
[(Fig._6)TD$IG]
Fig. 6 Final impressions and interocclusal records were
obtained using the duplicate complete dentures as a bite
pressure impression.
for crown and bridge use. These procedures need expensive
and permanent equipment. The procedure we are introducing
will enable clinicians to digitize the complete denture easily
using affordable equipment in a clinic.
However, if the duplicate denture is to be used as a
treatment denture, the teeth and gingival parts should be
reproduced with appropriate colors. In addition, the material
has to be approved for medical use. It is well known that the
PLA material is considered safe [20,21]. These are future
considerations for the general-purpose 3D printer.
4. Effect of performance
The conventional procedure used to fabricate the duplicate
denture needs much human power and uses more quantities of
various dental materials while the introduced procedure needs
less human power and uses less quantities of one dental
material, thus minimizing waste. Although the scanner and
printer requires an initial investment of about 2,000,000
Japanese yen (as of May 2016), this equipment will eventually
get cheaper as they become widely used and as technology
advances. In the conventional procedure, the dental materials
used are alginate impression material and the auto-polymeriz-
ing resin (about 2,0003,000 Japanese yen/denture) while in the
 journal of prosthodontic research 61 (2017) 8186
[(Fig._8)TD$IG]
Fig. 8 Completion of acrylic complete dentures.
introduced procedure, the material used is only the PLA material
(about 200300 Japanese yen/denture). The chair-side-treatment
time will be about 30 min for the conventional procedure,
whereas it will be about 5 min for scanning, 5 min for 3D
reconstruction, 15 min for digital processing, and 4 h for 3D
printing for the introduced procedure.
In addition, clinicians need to handle various dental
materials, which may come into contact with potentially
infectious body fluid in the conventional procedure. In the
introduced procedure, there is little contact of the existing
denture to other materials and equipment, except during its
placement on the rotary table.
The handheld optical scanner and rotary table are easy to
operate and the introduced procedure is also applicable in
home-visit dental care settings and at disaster areas.
5. Conclusion
The use of a general-purpose handheld optical scanner and a
3D printer in duplicating complete dentures has been proven
to be effective and of clinical significance through this study.
This procedure has the advantages of wasting less material,
employing less human power, decreasing treatment time at
the chair side, lowering the rates of contamination, and being
applicable readily fabricated at the time of the treatment visit.
The procedure will become more systematic and more
efficient following improvements in digital techniques in
the near future.
Conflict of interest
The authors report no conflict of interest.
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