is an area of dentistry utilizing CAD/CAM technologies to producedifferent types of dental restorations, including crowns, crownlays,veneers, inlays and onlays, fixed bridges, dental implant restorationsand orthodontic appliances.
History: CAD/CAM usage in dentistry began in the mid 1980s. Initially, this computerized technology was cumbersome and basically a novelty, requiring inordinate amounts of time to produce a viable product. This reality limited its practical usefulness to the dental laboratory setting, rather than the dental practice as time constraints precluded chair side (in the dental office) usage. As adjunctive techniques ,software, and available materials improved over time, CAD/CAM usage in the dental practice setting became a reality. Thus "chair side" CAD/CAM technology affords the practitioner the ability to produce tooth-colored prosthetic dental restorations on-site in a matter of hours
The concept of chairside CAD/CAM restoration differs fromconventional dentistry in that the prosthesis is typicallyluted or bonded in place the same day, whereasconventional dental prosthesis of larger size such ascrowns have temporaries placed for several weeks while adental laboratory produces the restoration off-site
The patient returns weeks later, the temporary is removed, and then thelaboratory made crown is then cemented or bonded in place. Because theCAD/CAM restoration is bonded the same day, the principles applied inpreparing the tooth for a crown or other prosthesis are typically moreconservative. Bonding is more effective on tooth enamel. As such, the teethneed to be prepared such that the enamel layer is not removed to expose thetooth dentin. Permanent bonding of the restoration is best achieved by bondingthe fitting surfaces of the restoration to the prepared enamel surfaces of thetooth. Consequently, less tooth surface removal is usually the normal.
Process:Typically CAD/CAM dental restorations are milled from solid blocks ofceramic or composite resin closely matching the basic shade of therestored tooth. Metal alloys may also be milled or otherwise digitallyproduced..
After decayed or broken areas of the tooth are corrected by thedentist, an image (scan) is taken of the prepared tooth and thesurrounding teeth. This image, called a digital impression, drawsthe data into a computer
Then proprietary software is used to create a replacement part for the missing areas ofthe tooth, essentially creating a virtual restoration. This is called reverse engineering.The software sends this virtual data to a milling machine where the replacement part forthe defect (the dental restoration) is carved out of a solid block of ceramic or compositeresin. Stains and glazes are fired to the surfaces of the milled ceramic crown or bridgeto correct the otherwise monochromatic appearance of the restoration. The resultingrestoration can then be adjusted in the patient’s mouth and cemented or bonded inplace
CAD/CAM dental softwareproductsCEREC, software for manufacturing crowns, veneers, onlays and inlays can beprepared, using different types of ceramicmaterial.Delcam dental solutions, for the design and manufacture of copings and bridgeframeworks, including fullcrowns, abutments, dental bars, inlays/onlaysand implant bridges
the components of the Cerecunit?1. The Acquisition Unit:The acquisition unit is made up of atower with a computer inside it, an lcdcomputer screen, camera unit forimaging teeth and program software forcreating dental restorations.
2. The Milling UnitThis is a box shaped chamberthat is separate from theacquisition unit. It wirelesslyreceives directions from theacquisition unit and mills(cuts)crowns, onlays, inlays and 2. The Milling Unitveneers from porcelain orcomposite(acrylic) blocks. Themilling unit featurs a selfcontained water supply and 2diamond coated burs that createthe specified shape of computerdesigned restorations.
Why Perform CEREC in Dentistry? Whatare its Benefits?1. Saves Time: Most restorations are completed in a single visit.That means NO return trips to the dentist.
2. No Temporaries: Receiving crowns or porcelain fillings in a single visitmeans not 2-3 week wait with temporary material on your tooth while alab makes the permanent restoration. ---That means NO temporaries tofall off or out inconveniencing the patient further by returning to theoffice to have it replaced.3. Less Novacaine: Because single visits for Cerec Dentistry are thestandard.
4. Less Tooth Drilling: Because Cerec restorations areplaced with extremely strong cement(glue), more toothstructure can generally be preserved during aprocedure. .5. Cerec Restorations are very Accurate: Theseprecisions restorations are performed under highmagnification on the computer screen, greatlyenhancing accuracy levels.6. Cerec Restorations are very strong havingpublished 10 year success rates exceeding 90%survival.
3DScannersThe most ComprehensiveOpen Platform within Digital Dentistry
Applications:Model scanning from single unit to fullarchFull arch scanning with palate for partialframeworksMulti – die scanning & designingcapabilitiesScanning occlusions using check-bites oron positive modelsusing our patented “axis-finder”techniqueImpression scanning up to full archReplication of wax-upsScanning implants for custom abutments
CROWN & BRIDGEDesign: single unit to full bridge,simple coping, clinical coping, dental band,¾ crown, full crown, veneer Managed byclinical parametersCustom anatomy kit creation toolAutomatic proposal of anatomyEditing tools with morphing and transformationAdvanced connector tools and shape editingHighly productive, easy to useVirtual Waxing tools – scaling & morphingDifferent output formats optimized with respecttomanufacturing solutionsFull anatomic veneer design for advancedsmile line
Special Considerations for CAD/CAM DentistryCAD/CAM technology is not a replacement for theaccuracy and talent provided by a dentist or dentallaboratory technician. Dentists must be precise increating the initial tooth CAD/CAM technology, tend tobe a more expensive restorative solution. However,even though the materials for CAD/CAM restorationsmight cost more, the expense incurred by the dentallaboratory and/or the dentist may not be passed ontothe patient.Also, there is no additional fee or cost to have arestoration placed in one visit as opposed to two.
preparation; both dentists and laboratory technicians must beaccurate when taking the digital impression and drawing therestoration.Equally important is the accuracy and skill with which they designa restoration, particularly since the fit of a restoration is critical topreventing future tooth damage. For example, an ill-fitted crown,veneer, inlay or onlay can leave space between the teeth, orbetween the tooth preparation and the restoration. This could leadto an increased risk of infection or disease.
When to Choose CAD/CAM DentistryIt is important to note that not every tooth can be treated with aCAD/CAM restoration. Your dentist will determine if a CAD/CAMrestoration is among the appropriate treatment options for yourcondition. Additionally, despite improvements in the esthetics ofCAD/CAM materials, patients may find that some CAD/CAMrestorations look too opaque and lack natural characterizations.Depending on the type of restoration thats needed (such asinlays/onlays), your dentist may prefer conventional laboratoryfabrication techniques that have a longer and more proven track recordfor accuracy of fit. Therefore, patients must discuss their particularsituation and desires with their dentist, who will make the final treatmentdecision based on a thorough examination.