This systematic review and network meta-analysis aimed to compare different PMMA (polymethyl
methacrylate) complete denture base manufacturing techniques by evaluating their mechanical
properties. The objective was to determine which method-compression molding, injection
molding, milling, or 3D printing-offers the best performance.In vitro studies investigating
mechanical properties of PMMA denture base resins.Four electronic databases such as
PubMed, Embase, Web of Science, and the Cochrane Library were screened for English
language articles. Two independent researchers selected studies, extracted data, assessed
risk of bias, and evaluated evidence certainty.A total of 17152 articles were found
by electronic databases. Finally, 63 studies were analyzed, using random-effects model
for network meta-analysis. The outcomes investigated were flexural strength, flexural
modulus, surface roughness, impact strength, and Vickers hardness. Milling consistently
ranked first or second across outcomes, excelling in flexural strength, modulus, and
surface roughness. In contrast, 3D-printed denture bases demonstrated the lowest mechanical
performance, highlighting the limitations of this technique at present.Milling is
generally recommended for PMMA denture bases due to its superior mechanical properties
across most outcomes, supporting its use in clinical settings. However, while promising,
3D-printed PMMA denture bases require further improvement to meet clinical performance
standards.
