Abstract
Objective: compare the trueness and precision of obturator frameworks fabricated using conventional, digital-analogue, and digital workflows based on a standardized maxillary model with a palatal defect. Methods: A master model with a unilateral palatal defect was used to fabricate 30 obturator frameworks (n = 10/group). Group 1 (conventional) used two-stage PVS impressions, stone casts, and conventional Co/Cr casting. Group 2 (digital-analogue) used CBCT–intraoral scan composites to generate 3D-printed models for conventional casting. Group 3 (fully digital) involved digital design and metal SLS printing. All frameworks and models were desktop-scanned. Precision was assessed by within-group superimposition of framework scans, and trueness by superimposition onto the reference model using surface-matching software. Results: Statistically significant differences in trueness were observed between groups (p < 0.001). The digital workflow exhibited the highest overall trueness (mean deviation: 0.05 ± 0.16 mm), followed by the digital-analogue (0.08 ± 0.15 mm) and conventional methods (0.11 ± 0.17 mm). Tooth-level trueness was significantly better in digital workflows (p < 0.001), while soft-tissue level comparisons showed no significant difference between digital-analogue and conventional techniques. Conclusion: Fully digital workflows demonstrated superior trueness and precision compared to conventional and digital-analogue methods. Digital obturator fabrication offers a promising alternative to traditional techniques for improved fit and clinical predictability. Clinical implications: Fully digital workflows enhance the trueness and precision of obturator frameworks, potentially providing a reliable and efficient alternative to conventional and hybrid fabrication techniques in the rehabilitation of maxillary defects. Within the limitations of this in vitro investigation, fully digital methods exhibited superior accuracy, supporting their potential role in contemporary maxillofacial rehabilitation.