Abstract
PURPOSE: To compare the cost-efficiency of digitally designed and manufactured removable complete dentures (RCDs) with conventionally fabricated RCDs through a systematic review and meta-analysis. METHODS: A comprehensive electronic and manual search was performed in PubMed, Embase, Web of Science, and Scopus up to February 10, 2025. Eligible studies included clinical trials and cohort studies comparing cost-related outcomes of digital and conventional RCD workflows. Primary outcomes were laboratory, clinical, and total costs; secondary outcomes included the number of treatment sessions. Meta-analyses were conducted using random-effects models. Risk of bias was evaluated using standardized tools. RESULTS: Four retrospective studies and one prospective study, including 184 patients, met the inclusion criteria. No statistically significant differences were observed between digital and conventional workflows in laboratory costs (mean difference [MD]: -239.77 (2025 USD); p = 0.1063), clinical costs (MD: 74.39 (2025 USD); p = 0.4514), total costs (MD: -357.76 (2025 USD); p = 0.2577), or treatment sessions (MD: -1.47; p = 0.3514). Operator experience significantly influenced clinical costs (p < 0.0001) and the number of sessions (p = 0.0001). CONCLUSION: Within the limitations of the available evidence, digital and conventional workflows for RCD fabrication demonstrated comparable cost-efficiency. Although digital workflows may reduce the number of sessions when performed by experienced clinicians, the current evidence is insufficient to establish a clear cost-efficiency advantage.