Patient-Reported Outcomes of Digitally vs. Conventionally Fabricated Frameworks in Removable Partial Dentures: A Systematic Review and Meta-Analysis

Objective: Digital workflows are increasingly used for fabricating metal frameworks of removable partial dentures (RPDs), offering advantages in clinical efficiency and reproducibility. This systematic review aimed to compare patient-reported outcomes (PROMs) between conventionally and digitally fabricated RPDs. Methods: An electronic and manual search was conducted up to January 1, 2025, to identify clinical trials and cohort studies evaluating PROMs for conventional and digital RPD frameworks. Studies using validated tools, including visual analogue scales (VAS) and oral health-related quality of life (OHRQoL) questionnaires, were included. Two reviewers independently performed study selection, data extraction, and quality assessment. Meta-analyses were conducted using weighted mean differences (WMD) or standardized mean differences (SMD) with 95% confidence intervals (CIs), applying a random-effects model. Results: Out of 942 identified studies, four met the inclusion criteria (59 patients, 118 RPDs), with three eligible for meta-analyses. Digitally fabricated RPDs showed significant improvements in speech (WMD = 1.01; 95% CI: 0.03 to 1.99; p = 0.04), cleanability (WMD = 0.66; 95% CI: 0.00 to 1.31; p = 0.05), and prosthesis stability (WMD = 1.24; 95% CI: 0.01 to 2.46; p = 0.05). No significant differences were found in esthetic perception, overall satisfaction, or OHRQoL. Conclusion: Digital workflows may improve specific aspects of patient comfort, particularly speech, hygiene, and stability, but offer similar outcomes to conventional methods in terms of satisfaction and esthetic perception. Clinical significance: Digitally fabricated RPD frameworks may improve patient comfort by enhancing speech clarity, hygiene maintenance, and prosthesis stability. These benefits can support better long-term outcomes and reduced clinical chair time, suggesting that digital workflows represent a reliable and efficient alternative to conventional fabrication methods.