Cadcam in Dentistry

A short and brief introduction to the benefits of CAD/CAM technology in Dentistry

1. CAD/CAM in Dentistry

2. What is CAD/CAM? CAD/CAM stands for Computer-Aided Design –Computer-Aided Milling. It makes use of scanning technology, 3D modeling and computer design applications to create a virtual plan of the proposed crowns, veneers, inlays, onlays and even bridges. 2

3. 3 1971 Dr. Francois Duret Father of dental CAD/CAM technology (SOPHA System) 1985 Dr. Werner H. Mörmann CEREC System 1980s Dr. Matts Andersson Procera System Brief History on CAD/CAM in dentistry:

4. 4 1994 Siemens CEREC team CEREC 2 system 2000 Sirona Dental Systems GmbH, Bensheim , Germany CEREC 3 system Brief History on CAD/CAM in dentistry:

5. Work flow of CAD/CAM technology 5

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7. 1. Tooth Preparation

8. Tooth preparation I s the physical alteration of the remaing tooth structure, in which the alterations made can accommodate the restoration material without worry of mechanical or biologic failure. 8

9. 9 INLAY ONLAY POSTERIOR CROWNS ANTERIOR CROWNS BRIDGE SPAN VENEER

10. Guidelines in tooth prep: P rior to applying tooth prep, one must decide the design of the preparation. A lways remember the conservation of enamel is the most vital component. O cclusal reduction is the first step in preparing the tooth, in order to avoid excessive reduction. 10

11. Guidelines in tooth prep: Reduction of the functional cusps is also prioritized when prepping the tooth. This is to avoid thin spots in the porcelain and fracture of the restoration when under stress. Overall, one must study the process of milling using a machine in order to carefully prepare your porcelain restorations. 11

12. Guidelines in tooth prep: According to Dr. Herbert T. Shillingburg , these are the 5 principles in tooth preparation. 12 Preservation of tooth structure Retention and Resistance Structural durability Marginal Integrity Preservation of the Periodontium

13. 2. Material Selection

14. Common materials in CAD/CAM Feldspathic Ceramics (Glassy Phase Ceramics) 14

15. Common materials in CAD/CAM Nano-Ceramics combines the resilience of resins with the strength of ceramic. Inlays and onlays are the best indications for this material, because thin margins are less prone to chipping and there is less flexion and debonding of the restoration. advantages are fast fabrication, clean milling, and easy polishing. 15

16. Common materials in CAD/CAM Lithium Disilicate Glass-ceramic 16

17. Common materials in CAD/CAM Zirconia Blocks 17

18. 3. Scanning/Digital Impression

19. Take note while scanning: Scanning is the final impression in the procedure, so all old rules apply: use of packing cord, hemostatic agents, or use of laser surgery in order to make sure the margins are clear and can be visualized. 19

20. Take note while scanning: Make sure there is proper isolation of the tooth prep. Check for undercuts, occlusal clearance, and sharp edges. 20

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26. 4. Design and Milling

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36. 5. Glazing and Crystallizing

37. For adding shine and realistic esthetics to the milled crown, glazing the finished product with glaze spray and initiating crystallization process by baking in high heat. When using spray: coat the product until it appears frosty. If glaze spray is not optional, you can shine the restorative crown with a rubber polisher after it is baked 37

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39. 6. Bonding of CAD/CAM Restoration

40. Cements usually used for temporary or permanent cementation of prosthesis/restorative material: Zinc Phosphate Zinc Oxide-eugenol Zinc Oxide-non-eugenol Zinc Polycarboxylate Glass Ionomer Type 1 Resin composite cements or compomers Resin-modified glass ionomer or hybrid ionomers 40

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42. 7. Other forms of restorations using CAD/CAM

43. Crownlays Endocrowns Replacing missing laterals Implant Crowns Zirconia Restorations 3D printing in Dentistry 43

44. References: Jain, R., Takkar , R., Jain, G., & Deora , N. (1970, January 01). CAD-CAM the future of digital dentistry: A review. Retrieved October 14, 2020, from https://www.semanticscholar.org/paper/CAD-CAM-the-future-of-digital-dentistry:-a-review-Jain-Takkar/620f5cc557f48b274733767a3d96a4dfc7449016 AEGIS Communications, B. (2015, November 01). CAD/CAM Materials in Dentistry. Retrieved October 14, 2020, from https://www.aegisdentalnetwork.com/id/2015/11/cad-cam-materials-in-dentistry Jpda . (2018, May 07). A Review On Cad Cam In Dentistry. Retrieved October 14, 2020, from http://www.jpda.com.pk/a-review-on-cad-cam-in-dentistry/ Geraldine M.W., & Mitchell T.Z. (2017). The Dental Reference Manual: A Daily Guide for Students and Practitioners. Springer International Publishing Switzerland. Indirect Restorations with CAD/CAM Technology pp162-175. Youtube video: The Basics of CAD/CAM Dentistry. (March 10, 2017). Channel Name: asdanet . Link: shorturl.at/ nrxUZ 44