Introduction to CAD/CAM Dentistry - CAD/CAM is a process that converts non-digital data into a digital format. - It is used to fabricate dental prostheses such as crowns, veneers, and orthodontic devices. - Traditional prosthesis fabrication involves making an impression, creating a wax model, and casting the final product. - CAD/CAM eliminates the need for physical techniques by recording impressions digitally and using additive or subtractive means for manufacturing. - Examples of dental prostheses that can be manufactured using CAD/CAM include study models, cuspal coverage restorations, and removable denture frameworks. - CAD/CAM dentistry was first used in the mid-1980s but was initially considered cumbersome and time-consuming. - The commercialization of Cerec by Sirona made CAD/CAM more accessible to dentists. - The first CAD/CAM system in dentistry was developed in the 1970s by Duret and colleagues. - Various digitizers, such as laser beams and contact probes, were developed to improve CAD/CAM systems. - CEREC and Procera are widely used CAD/CAM systems that have shown long-term clinical success.

CAD/CAM Process - CAD/CAM systems consist of CAD and CAM stages. - Optical or contact scanning captures the condition of the patient's teeth. - Software turns the captured images into a digital model for designing the prosthesis. - Devices such as 3D printers or milling machines are used to convert the design into a physical product. - The process involves correcting decayed or broken areas of the tooth, taking an optical impression, and designing the prosthesis.

Materials and Techniques in CAD/CAM Dentistry - CAD/CAM dentistry uses both subtractive processes (CNC milling) and additive processes (3D printing). - Before the 2010s, CAD/CAM-directed manufacturing was primarily CNC cutting, but now both methods are widely used. - CAD/CAM and milling technology are often treated as interchangeable terms, but CAD/CAM does not specify the method of production. - CAD/CAM materials include metals, porcelain, lithium disilicate, zirconia, and resin. - CAD/CAM restorations are milled from solid blocks. - Pre-sintered ceramic ingots require subsequent sintering. - Glass-based restorations can be manufactured using CAD-CAM. - Metals like CoCr and titanium can be manufactured using CAD-CAM. - Feldspathic and leucite-reinforced ceramics have good aesthetics but low flexural strength. - Lithium disilicate, zirconium oxide, and lithium silicate ceramics have high flexural strength and good aesthetics. - Zirconia has high flexural strength but weak optical properties and bonding ability. - Resin materials include resin composite, PMMA, and Nano-ceramics with weak flexural strength.

Advantages and Disadvantages of CAD/CAM Dentistry - Improved quality of prostheses in dentistry. - Standardised production process. - Increased productivity. - Ability to work with new materials with high accuracy. - Dentist's technique must be suited to CAD/CAM milling. - Allows use of materials otherwise unavailable in the laboratory. - Provides cheaper alternatives compared to conventional materials. - Decreases labor cost and time for dental technicians. - Standardizes the quality of restorations. - Reduces labor times for ceramic dental prostheses. - Rapid digitization of dental impressions. - Eliminates risk of distortion/damage to data. - Reduces discomfort for patients with strong gag reflex. - Saves time in post-processing compared to conventional impressions. - Enables instant emailing of 3D models to dental laboratories. - Steep learning curve for operators. - Requires a large financial investment. - Errors in occlusion assessment compared to conventional techniques. - Resin particles produced during milling contribute to plastic pollution. - Difficulty achieving balanced occlusion without human assessment.

Future of CAD/CAM Dentistry - Digital dentistry is growing at an accelerating rate. - CAD/CAM systems will continue to evolve and improve. - 20 new systems expected to become available by 2020. - Further research needed to evaluate CAD/CAM technology compared to other attachment systems. - Potential for advancements in materials and techniques in the future. - The use of 3D printing in dentistry is becoming more prominent. - Research is being conducted on the use of CAD/CAM technology for complete dentures. - Integration with digital workflows and intraoral scanners is being explored. - The future of CAD/CAM dentistry holds the potential for further advancements and innovations.