CAD CAM Dentistry and

Digital Impression

Greetings from AECS Maaruti College of Dental

SciencesBangalore

Dentistry v/s CAD CAM Dentistry

“Lemon”

Dr. Werner Mörmann, Dr. Marco Brandestini, Dr. Alain Ferru

Applications of CAD CAM dentistry

ImpressionA negative likeness or copy in reverse of the surface of an object ; imprint of teeth and adjacent structures for use in dentistry. GPT – 8

Conventional v/s Digital• The digital impression cuts down turnaround time

• more comfortable for the patient

• gives more accurate fit and remakes are fewer

• improves dentist/lab communication

• gives a competitive advantage

Year, first author Test variability Conclusion

2014, Svanborg etal Marginal fit, Digital and conventional impression

The digital impression is more accurate and can generate a 3unit FDPs with significantly closer fit than VPS impression

2014, Yuzbasigolu etal

Patient comfort, effectiveness, clinical outcome

The digital impression is time effective and patient prefer digital impression method than the traditional one.

2014, Ender etal Accuracy of digital and conventional impression

The digital impression showed excellent clinical results within their indications and applying the right technique of scanning

2013, Lee etal Digital impression perception of student and clinician

The digital impression was most effective technique and students find difficulty in conducting traditional technique.

2012, Galhano etal Optical impression methods

The digital impression was speed, effective and less invasive than traditional methods.

2010,Poticny etal Predictability and esthetic out comes

The digital impression allows immediate evaluation of preparations and margins

Digital Impression

Basic components of CAD CAM involves:1. Digitalized Scanner

• Optical Scanner• Mechanical scanner

2. Design Software

3. Processing Device or Computer numeric control machine

“ Could cavities be scanned by ultrasound ? ”

Optical Scanner• Based on the principle of triangulation• The light source and the receptor unit are in a

definite angulation in relation to each other

Eg: Everest scan, Lava Scan, es1

Mechanical Scanner• The master cast is read mechanically line by line

by means of a ruby ball• The 3D structure is measured Eg: Procera scanner

Open v/s. Closed Architecture

Based on data files created :• Open-architecture files, typically termed STL files,

are not dependent on the manufacturer, and can be used virtually in any design software to fabricate a final restoration

• Closed-system software architecture collects and manipulates data modules by the same manufacturer, offering laboratory owners security and a one-stop for resolving problems

Based on the location of processing unit

• Chairside Production

• Laboratory Production

• Centralised fabrication in production

centre

Chairside digital impression systems with laboratory transfer capability

i-Tero Lava C.O.S CEREC AC

Features Candent i-Tero 3M Lava C.O.S Sirona CEREC AC

Optical technology

Parallel confocal / telecentric

Wavefront Sampling technology

LED / Laser sampling

Powder requirement

No Yes Yes (optispray)

Models Milled PU, removable dies, soft tissue profile

Additive / SLA blue resin one solid model & one working model

Additive / SLA; no tissue

Digital interface

Open Closed ( LAVA) Closed(CEREC In-Lab)

Articulators

All movements, attachment to Whipmix

full articulator for complex cases

Articulated;Centric and lateral

excursionsHinge only

Indications All Upto 4UB and singles

All

Recent Advances

Features CEREC Omnicam CEREC Bluecam

Imaging technique Continuous color imagingContinuous data acquisition

generates a 3D model

Single image acquisition

A few images are combined to create a 3Dmodel

Patient counseling mode

Yes -

3D scans in color Yes -

Powder usage - Yes

Area of application

Single tooth, quadrant, full mouth

Single tooth, quadrant (full mouth possible)

Advantages• Unrivalled handling• Powder free scanning• Precise 3D images in

natural color

• High precision• Ease of operation• Rapid acquisition of power-

coated surfaces

Clinic and laboratory relationship

• Adopting CAD/CAM technology into a practice, even at the highest level, does not have to mean an end to the doctor-laboratory relationship

• The integration of digital scanning technology can save time and reduce remake rates for the laboratory.

• Digital scanning and digital photography both offer the ability to convey accurate digital information between the clinician and the laboratory technician and vice versa

References• Mörmann WH, The evolution of the CEREC

systemJADA 2006;137(9 supplement):7S-13S.

• Abduo J, Lyons K, Bennamoun M, Trends in Computer-Aided Manufacturing in Prosthodontics: A Review of the available streams, International Journal of Dentistry Volume 2014, Article ID 783948, 15 pages

• Prajapati A etal, Dentistry Goes Digital: A Cad-Cam Way- A Review Article IOSR-JDMS.Vol13, Iss8 Ver. IV (Aug. 2014), PP 53-59

• Coppa A. et al. "Early Neolithic tradition of dentistry: Flint tips were surprisingly effective for drilling tooth enamel in a prehistoric population." Nature. Vol. 440. 6 April 2006.

• Lowe RA. CAD CAM dentistry and digital impression making.

• Baroudi K., and S. N. Ibraheem. "Assessment of Chair-side Computer-Aided Design and Computer-Aided Manufacturing Restorations: A Review of the Literature." Journal of international oral health: JIOH Vol 7 iss.4 (2015): 96-104.

• Harsono M etal. Evolution of Chairside CAD/CAM Dentistry. Inside Dentistry October 2012, Vol 8, Iss 10