BACKGROUND: For edentulism, an implant supported removable complete overdenture (IOD) is an attractive solution to restore patients' chewing capacity, aesthetics, and self‐esteem, however, treatment is expensive and time consuming. PURPOSE/AIM: To estimate the decline in costs for digitally designed and CAD/CAM fabricated IODs (3D‐IODs) compared to conventionally fabricated IODs (C‐IODs) at comparable general health related quality of life (GHRQoL). MATERIALS AND METHOD: A randomized crossover study enrolled 36 fully edentulous patients, in whom six maxillary implants were placed together with two mandibular implants, if not already present. At the start of the study, a set of C‐IODs and 3D‐IODs was fabricated for each patient. All patients wore each IOD‐type for 1 year: first the 3D‐IOD and the second year a C‐IOD, or vice versa. At all three‐time points patients general QoL was assessed using the EQ‐5D‐5L questionnaire as well as the SF‐36 from which the SF‐6D was obtained, to research the anticipation of no significant difference. To enable cost consequence analysis (CCA), both costs made within healthcare and patient costs were assessed. Subsequently, a budget impact analysis (BIA) was performed to demonstrate the potential savings. RESULTS: No differences in general GHRQoL were seen between C‐IOD (M = 0.840, SD = 0.177) and 3D‐IOD (M = 0.837, SD = 0.156) (paired t‐test (N = 31): p = 0.880). With respect to the total costs for a complete IOD, however, the digital approach showed a reduction in initial total costs of 14.2% (€4700.33 vs. €4030.61: p <
0,001), in treatment time of 41.1% (309 vs. 182 min: p <
0.001), and in number of treatment sessions of 47.1% (5.68 vs. 3.0: p <
0.001). For repairs for an IOD in both the upper and lower jaw, the C‐IOD and 3D‐IOD scored similar for treatment time as well as additional costs. CONCLUSION: Implementing a 3D workflow in the production of IOD's supplies patients with a high‐quality 3D‐IOD at lower costs. TRIAL REGISTRATION: NL‐OMON44248 https://onderzoekmetmensen.nl/en/trial/44248.