Clinical evaluation of computer-aided design and manufacturing versus three-dimensional printed crowns for restoring badly destructed primary molars

Abstract Introduction The rising demand for cosmetic treatments and parents’ expectations for the aesthetic restoration of their children’s teeth have led to a growing interest in alternative esthetic crowns with lower cost. Aim This study aimed to evaluate the clinical performance of computer-aided design and manufacturing (CAD/CAM) versus three-dimensional (3D) printed polymethyl methacrylate (PMMA) resin-based crowns for restoring badly destructed primary molars. Patients and methods A randomized split-mouth clinical trial was designed using 30 primary molars from 15 children aged 4 to 8, divided into two groups. Group I: 15 primary molars were crowned with PMMA-based crowns fabricated using CAD/CAM system. Group II: 15 primary molars were crowned using 3D printable PMMA fabricated via a 3D dental printer. All crowns were evaluated at baseline and third, sixth, and ninth months using the modified U.S. Public Health Service criteria for marginal integrity, proximal contact, color match, restoration failure, gingival health, tooth wear index for opposing teeth, and parent satisfaction questionnaire for both groups. Results There was no statistically significant difference in marginal integrity, proximal contact, tooth wear of opposing teeth, and gingival health between the CAD/CAM and 3D printer groups. There was a statistically significantly higher color match in the CAD/CAM group compared with the 3D printer group after 6 and 9 months follow-up. There was a statistically significant higher restoration failure in the 3D printer group compared to the CAD/CAM group after 9 months of follow-up. There was higher parent overall satisfaction in the CAD/CAM group compared with the 3D Printer group after 9 months of follow-up. Conclusion CAD/CAM milled, and 3D printed PMMA crown materials can serve as viable esthetic alternative crowns for restoring badly destructed primary molars.