Clinical evaluation of laboratory-made and CAD-CAM-fabricated occlusal devices to treat oral parafunction.

STATEMENT OF PROBLEM: The demand for occlusal devices to treat oral parafunction is rising. Conventionally, these occlusal devices are produced in the dental laboratory, which requires impressions and gypsum casts. Computer-aided design and computer-aided manufacturing (CAD-CAM) require fewer production steps and may offer greater comfort. Whether this is an improvement on conventional procedures is unclear.

PURPOSE: The purpose of this crossover clinical study was to examine whether a digital workflow is feasible for fabricating occlusal devices to treat oral parafunction and to compare CAD-CAM-fabricated occlusal devices with conventionally produced ones to determine whether the digital method provides better results.

MATERIAL AND METHODS: Thirty participants wore digitally fabricated occlusal devices for 3 months and then conventionally produced occlusal devices for another 3 months or vice versa. The main target parameter was the participant's preference for 1 of the device types.

RESULTS: Both types had specific advantages and disadvantages, but the differences in participants' preference were not statistically significant. After completing the 2 testing periods, 16 participants preferred the laboratory-made device, whereas 12 participants preferred the digital occlusal device. Two participants dropped out during the study.

CONCLUSIONS: Given the absence of statistically significant differences, the digitally fabricated device can be considered a suitable alternative to laboratory-made devices. Laboratory-made occlusal devices are now the gold standard. However, given the savings in terms of cost and treatment time, they may be replaced, particularly if the production process can be improved.