Conventional, Milled, and 3D ‐Printed Complete Dentures: A Systematic Review and Meta‐Analysis of Clinical and Patient‐Centered Outcomes

OBJECTIVE: To compare conventional, milled, and 3D-printed complete dentures for clinical performance, patient-reported outcomes, and cost and time effectiveness across all comparisons. MATERIALS AND METHODS: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL were searched from inception to May 20, 2026, with no language or duration restrictions. Eligible randomized controlled trials enrolled edentulous adults receiving conventional, milled, or 3D-printed complete dentures (crossover and parallel-group designs). Primary outcomes were oral health-related quality of life, patient satisfaction, and complications. Secondary outcomes included denture retention, base adaptation, masticatory function, bite force, esthetics, biocompatibility/microbial count, patient preference, and cost and time. Data were pooled in random-effects meta-analyses. Certainty of evidence was assessed using GRADE. RESULTS: Twenty-five trials (27 publications) were included. No fabrication method demonstrated a clear advantage with respect to patient-important outcomes. The only statistically significant pooled difference was a small retention advantage of 3D-printed over milled dentures (mean difference -1.80 N, low certainty), with the remaining significant findings confined to single trials (very low certainty). 3D-printed dentures were associated with more mechanical complications and aftercare needs, whereas milled dentures were associated with better patient-rated esthetics and shorter processing time. CONCLUSIONS: Across all comparisons, no fabrication method showed a clear advantage for patient-important outcomes, and the certainty of evidence was mostly very low. CLINICAL SIGNIFICANCE: As no method has shown clinical superiority, the choice between conventional, milled, and 3D-printed dentures can be guided by workflow, cost, material durability, and patient factors.