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Table of Contents
REVIEW ARTICLE
Year : 2019  |  Volume : 7  |  Issue : 1  |  Page : 24-26

Computer-aided designing and computer-aided manufacturing in prosthodontics: The trendsetter


Department of Prosthodontics, Mahe Institute of Dental Sciences and Hospital, Mahe, Puducherry, India

Date of Web Publication26-Jun-2019

Correspondence Address:
Dr. Abdul Basith
Department of Prosthodontics, Mahe Institute of Dental Sciences and Hospital, Mahe, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_14_19

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  Abstract 

The advancement in digital technologies results in the betterment of final outcome. The digital technologies had also been into the field of dentistry. Computer-aided designing and computer-aided manufacturing (CAD/CAM) in dentistry was introduced in 1971. Dental CAD/CAM systems are used not only in crowns and bridges but also in removable prostheses, implants, and stents.

Keywords: Computer-aided designing and computer-aided milling, crowns and bridges, digitizing


How to cite this article:
Basith A, Bhojaraju N, Mathew M, Subash AK, Mohan A, Aboobacker F. Computer-aided designing and computer-aided manufacturing in prosthodontics: The trendsetter. Int J Oral Care Res 2019;7:24-6

How to cite this URL:
Basith A, Bhojaraju N, Mathew M, Subash AK, Mohan A, Aboobacker F. Computer-aided designing and computer-aided manufacturing in prosthodontics: The trendsetter. Int J Oral Care Res [serial online] 2019 [cited 2019 Jul 16];7:24-6. Available from: http://www.ijocr.org/text.asp?2019/7/1/24/261323




  Introduction Top


Computer-aided designing and computer-aided manufacturing (CAD/CAM) technology was introduced in dentistry in the year 1989, by Mormann and Brandestinni in Germany, and today it is widely used in all the branches of prosthodontics. Using these CAD/CAM technologies, various types of restorations and dental prostheses can not only be designed but also machined with accuracy and precision.[1],[2]

CAD/CAM technology refers to digital design and manufacture. CAD software recognizes the geometry of an object and designs, whereas CAM software is used for the manufacturing or milling.[3]

The CAD/CAM process can either include:

  • Additive rapid prototyping or subtractive manufacturing (computer numerical control machining; milling)



  •   Stages in Fabrication of Prosthesis Using CAD/CAM Technology Top


    There are various stages in fabrication of the prostheses with CAD/CAM technology, which are as follows:

    1. Computer surface digitization


    2. Computer-aided designing (CAD)


    3. Computer-assisted manufacturing (CAM)[2]


    The first stage is the computer surface digitization. This technique can be broadly divided into the following two categories:

    1. Mechanical scanning devices


    2. Optical scanning devices


    Various technologies used for computer surface digitization include optical camera, laser surface scanning device, three-dimensional (3D) scanning device (digitizer), photogrammetry, Moiré fringe displacement, computed tomography scan, magnetic resonance imaging, and 3D ultrasonography.

    The next stage in CAD/CAM is CAD. Once the 3D image is captured through any of the computer surface digitization techniques, 3D image processing is carried out and the digitized data are entered in the computer. Finally, designing of the restoration is performed using CAD software, which in turn sends commands to the CAM unit, for fabricating the restoration.

    Third and the final stage is CAM. It mainly includes additive and subtractive methods. Most common additive technique includes rapid prototyping or selective laser sintering, which enables less material wastage.

    In 3D printing, instead of wax, resin-type material is being used to fabricate patterns. Rapid prototyping can also be used to fabricate auricular prostheses.[4],[5]


      CAD/CAM in Removable Prosthodontics Top


    The success of CAD/CAM in fixed partial denture and implant resulted in an innovative idea of using it in removable prosthodontics. CAD/CAM dentures have lots of benefits, which include reduction in polymerization shrinkage, reduced patient visits, reduction in residual monomer, and also less chair time compared to normal dentures.

    Dentures fabricated using CAD/CAM are more accurate and are feasible.[6],[7] AlHelal et al.[8] showed that CAD/CAM dentures are more retentive compared to normal dentures, and the arch form had no influence on the retention of both conventional and CAD/CAM-milled dentures. Various systems available for fabrication of CAD/CAM dentures include the following:

    1. AvaDent (Global Dental Science, Scottsdale, Arizona, USA)


    2. Baltic Denture System Baltic denture system (Merz Dental, Waldenburg Germany)


    3. Ceramill full denture system (Amann Girrbach)


    4. DENTCA/Whole You (DENTCA, Whold you, Torrance, California, USA)


    5. Wieland digital denture (Stuggart, Germany)


    AvaDent system

    AvaDent dentures can be completed in two to three appointments. The AvaDent system offers two types of denture. In the monolithic prosthesis, the AvaDent XCL, the teeth and the base are a single unit. The XCL-1 denture has a single-layer tooth that has a dentin core. The XCL-2 denture has a multilayered tooth that has a dentin and enamel core with natural morphology.

    Baltic denture system

    The Baltic denture system allows the clinician to initiate the denture fabrication process utilizing functional impressions using the BDKEY Set components (Merz Dental). In this technique, denture is fabricated in two appointments.

    The Baltic system contains maxillary and mandibular adjustable record bases with teeth, and is available in three sizes (small, medium, or large) of the teeth. Intraoral adjustment of tray was carried out, and proprietary facebow that includes a vertical indicator is attached to the maxillary tray to register the facial midline and transfer the aesthetic and functional components from the patient to the designing software. A special device called the “BDKEY Lock” is provided to aid in jaw relation records.


      CAD/Computer Aided Milling in Maxillofacial Prosthesis Top


    Fabrication of a maxillofacial prosthesis is a challenging task because of its difficulty in shade matching and to record the defect bed more accurately.[9] CAD and Computer Aided Milling (CAM) systems simplify and drastically shorten the fabrication procedure, without unnecessary reliance on the artistic skills of the maxillofacial prosthodontist.[10]

    3D imaging is performed by using CAD software, which enables the fabrication of resin model with lithographic technique and then wax pattern is made and again 3D imaging is carried out and later, data are sent to the system and prosthesis is milled by computer-aided milling machine.


      CAD/CAM in Fixed Prosthodontics Top


    In fixed prosthesis, CEREC in lab system is most commonly used, where tooth preparation die is secured with scanning platform, and data captured using noncontact laser with two milling diamonds in milling chamber create precise restoration with excellent aesthetics and result in better fit of the restoration in patient’s mouth.


      CAD/CAM in Implant Dentistry Top


    CAD/CAM allows simplified production of precise implant components resulting in accurate implant designs. Even though the superiority of implant restorations by CAD/CAM is lacking the vision of CAD/CAM, the development of digital dentistry may improve the production of implant system and accuracy of design in the coming future.[11],[12]


      CAD/CAM in Temporomandibular Disorder Top


    Temporomandibular disorder (TMD) prevalence is a multifaceted problem mainly due to orofacial pain in addition to ear pain, headache, and neuralgia. The management of TMD mainly includes splint therapy, pharmacological management, and physiotherapy. However, conventional methods of splint fabrication are technique sensitive and require more chair time. But fabrication of splint enables less chair time and less effort.[13],[14]


      Discussion Top


    Dentistry has evolved from various old treatments such as crude restorations made of wires and wood to the new world of digital dentistry. CAD/CAM technology being one among them has resulted in precise fabrication of prostheses with less chance of error.[15]


      Conclusion Top


    Even though the CAD/CAM system is costly initially, it brings back lot of precise work and patient comfort. The advancement of CAD/CAM systems has developed to more precise levels. So we need to incorporate more of technology to the field of dentistry for better future.

    Financial support and sponsorship

    Nil.

    Conflicts of interest

    There are no conflicts of interest.



     
      References Top

    1.
    Davidowitz G, Kotick PG. The use of CAD/CAM in dentistry. Dent Clin North Am 2011;55:559-70, ix.  Back to cited text no. 1
        
    2.
    Tamrakar AK, Rathee M, Mallick R, Dabas S. CAD/CAM in prosthodontics—A futuristic overview. Ann Dent Spec 2014;2:14-5.  Back to cited text no. 2
        
    3.
    Bilgin MS, Baytaroğlu EN, Erdem A, Dilber E. Fabricating removable dentures with CAD/CAM—A review. Eur J Dent 2016;10:286-91.  Back to cited text no. 3
      [Full text]  
    4.
    Uzun G. An overview of dental CAD/CAM systems. Biotechnol Biotechnol Equip 2008;22:530-5.  Back to cited text no. 4
        
    5.
    Sykes LM, Parrott AM, Owen CP, Snaddon DR. Applications of rapid prototyping technology in maxillofacial prosthetics. Int J Prosthodont 2004;17:454-9.  Back to cited text no. 5
        
    6.
    Baba NZ, Goodacre CJ, Kattadiyil MT. CADCAM removable prosthodontics. In: Clinical Applications of Digital Technology. Hoboken, NJ: John Wiley; 2015. p. 107-38.  Back to cited text no. 6
        
    7.
    Dwivedi T, Jakhanwal I, Anupama T, Gill GS. CADCAM in prosthetic dentistry: A comprehensive review. Int J Com Health Med Res 2017;3:56-9.  Back to cited text no. 7
        
    8.
    AlHelal A. Comparison of retention between milled and conventional denture bases: A clinical study. In: Loma Linda University Electronic Theses, Dissertations, and Projects. 323. 2016.  Back to cited text no. 8
        
    9.
    Agrawal KK, Singh SV. CAD-CAM system: A road for pragmatic maxillofacial prosthesis. Dentistry 2015;5:5.  Back to cited text no. 9
        
    10.
    Tsuji M, Noguchi N, Ihara K, Yamashita Y, Shikimori M, Goto M. Fabrication of a maxillofacial prosthesis using a computer-aided design and manufacturing system. J Prosthodont 2004;13: 179-83.  Back to cited text no. 10
        
    11.
    Tan PL, Gratton DG, Diaz-Arnold AM, Holmes DC. An in vitro comparison of vertical marginal gaps of CAD/CAM titanium and conventional cast restorations. J Prosthodont 2008;17:378-83.  Back to cited text no. 11
        
    12.
    Thompson WB, Owen JC, De SG, Stark SR, Henderson TC. Feature based reverse engineering of mechanical parts. IEEE Trans Rob Autom 1999;15:57-66.  Back to cited text no. 12
        
    13.
    Dunn DB, Lewis MB. CAD/CAM occlusal splints. A new paradigm. Aust Dent Pract 2011;22:131.  Back to cited text no. 13
        
    14.
    Algabri RS, Alqutaibi AY, Abo-Alrejal H, Al-Adashi O, Abdulrahman F. Effect of computer-aided design/computer-assisted manufacture versus conventional occlusal splints on the management of temporomandibular disorders: A systemic review and meta-analysis. Int Dent Med J Adv Res 2017;3:1-9.  Back to cited text no. 14
        
    15.
    Aeran H, Kumar V, Seth J, Sharma A. Computer aided designing–computer aided milling in prosthodontics: A promising technology for future. IJSS Case Reports Reviews 2014;1:23-7.  Back to cited text no. 15
        




     

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      In this article
       Abstract
      Introduction
       Stages in Fabric...
       CAD/CAM in Remov...
       CAD/Computer Aid...
       CAD/CAM in Fixed...
       CAD/CAM in Impla...
       CAD/CAM in Tempo...
      Discussion
      Conclusion
       References

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