Clinical Effectiveness and Methodological Quality of CAD/CAM and Conventional Prosthetic Rehabilitation in Edentulous Patients: A Systematic Review and Meta-Analysis

Abstract

Introduction: Edentulism is still considered one of the most serious problems regarding oral health worldwide. It makes mastication and speaking difficult, compromising overall quality of life. Conventional dentures usually differ a lot in terms of how accurately and comfortably they are, since manufacturing depends heavily on the artistry. Computer-Aided Design and Manufacturing (CAD/CAM) and 3D printing technologies have been positively influencing dentistry, particularly prosthetic rehabilitation, by enabling greater precision and faster production; however, their true impact in clinical settings remains uncertain. Objective: The current systematic review aimed to assess the methodological quality and clinical outcomes of CAD/CAM-based prosthetic rehabilitation in both partially and fully edentulous patients, without direct comparison to conventional fabrication methods. Methods: In accordance with the PRISMA 2020 guidelines, all relevant studies published from 1^st January 2015 to October 2025 were retrieved from the databases PubMed, Embase, Cochrane CENTRAL, and Web of Science. Clinical or comparative studies concerning digital prostheses (PMMA(polymethyl methacrylate.), zirconia, or titanium) for complete and partial prosthetic rehabilitations were eligible for inclusion. Methodological rigor was assessed using the CASP checklist, and quantitative data were analyzed using meta-analytic methods. Results: All included studies demonstrated high methodological quality (Mean CASP = 19.1 ± 0.67). Despite strong reporting standards, the clinical evidence remains limited. Only a small proportion of studies (approximately 5–10%) reported outcomes favoring CAD/CAM over conventional fabrication in domains such as prosthesis fit, patient satisfaction, esthetics, or retention. However, due to substantial heterogeneity in outcome measures and incomplete reporting of effect estimates (e.g., odds ratios, risk ratios, and confidence intervals), quantitative pooling was not feasible. Therefore, the statistical analyses presented represent an exploratory quantitative synthesis rather than a confirmatory meta-analysis, and the findings should be interpreted cautiously. Conclusion: Reviews and comparative studies received higher quality ratings, but this did not result in corresponding clinical benefits. CAD/CAM prosthetic rehabilitation offers the highest fabrication accuracy, but its clinical superiority is still being proven.