CAD/CAM in Dentistry

By: Ayah Al-Ani

Delivering esthetic results in a timely manner is a goal that is increasingly being reinforced in today’s dental clinics. Computer-Aided-Design (CAD)/Computer-Aided-Manufacture (CAM) is one of the many tools that have been developed to achieve this goal. Furthermore, the major advantages of CAD/CAM include the ability to achieve restorations that are more accurate in their resemblance of the natural tooth in a shorter time frame.

CAD/CAM is the dental computer that aids in the design and manufacturing of inlays, onlays, crowns, and bridges. Inlays and onlays are dental restorations that are transitory between crowns and fillings. They are primarily used when there is little tooth structure left due to caries’ resorption, but there is enough natural tooth structure that a full coverage crown is not needed. Dentists often prefer inlays when the tooth is resorbed by caries and the resulting cavity cannot be adequately addressed by classic restorations. Inlays are usually made of ceramic or metal and are made outside of the mouth. This is referred to as an indirect restoration. Inlays affect a maximum of two tooth surfaces whereas onlays affect three or more tooth surfaces. Hence, dentists may recommend different treatment plans based on the patient’s needs.

This technology is most often used in prosthetic dentistry. It allows the dentist to create 2D and 3D models and materialize them through numerically controlled machines. CAD/CAM has three components: a device that captures a digital image, a computer that plans the restoration, and a milling machine that converts a basic shape to the dental restoration.

There are eight steps that constitute producing a prosthetic restoration, for example a crown or a bridge. First, the dentist diagnoses the patient and explains the treatment options available to them. Then, the dentist contours the patient’s teeth and prepares them to place the prosthetic crown restoration. Next, one or more impressions of the prepared teeth are taken and a plaster model is casted. After that, a 3D oral camera is used to scan the teeth. During this step, the image is automatically transferred to the computer and is processed by the software.

The next step involves modeling, where the CAD/CAM software models the teeth based on the dentist’s requirements. After, the ceramic block is inserted into the milling machine. This machine develops the desired shape according to the standards set by the computer software and the dentist. Finally, the last step involves cementing the final crown bridge on the patient’s base tooth structure through aesthetic cement.

There are numerous advantages of using CAD/CAM technology in dentistry. Since this technology is usually used to provide patients with multiple restorations in the mouth, CAD/CAM provides a relatively simplistic procedure compared to the previous options. Previous options included taking impressions of the patients’ teeth, sending those impressions to the dental lab, receiving the crowns, and adjusting the fit of each crown for the patient. This included multiple visits to the dental clinic. Furthermore, the restorations made using this technology are long-term; one study revealed that 95-97% of CEREC’s brand crowns remained intact after five years of usage, while 90-95% of preserved inlays and onlays lasted ten years. Other advantages of CAD/CAM for dentists are: the patient spends less time in the office, increased productivity, easier production method, and the use of less materials.

Aspiring dentists will often benefit from learning about emerging technologies in their field. This will help them become more knowledgeable and empowers them to adopt such technologies in their future clinics. Technologies like CAD/CAM hold great promise for the future as they enable patients to achieve their aesthetic goals in a timely manner- both components are becoming increasingly important to today’s autonomic and appearance-conscious patients. Finally, this technology is more environmentally friendly as it uses less material to produce the desired product; this is also important as it encourages other companies to follow suit in their dental technological developments.

References:

Susic, I., Travar, M., & Susic, M. (2017). The application of CAD / CAM technology in Dentistry - iopscience. Iopscience, 200(012020): 1-12. DOI: 10.1088/1757-899X/200/1/012020