Dental News - CAD/CAM innovation: a pathway to better implant restorative dentistry

Carl Drago, DDS, MS

Thu. 1 March 2012

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WAUKESHA, Wis., USA: Functionally and esthetically optimal dental restorations traditionally have been fabricated by restorative clinicians and dental laboratory technicians using impressions, casts and articulator mountings prior to waxing and casting metal frameworks. These procedures are labor-intensive, and the accuracy of the casts depends on many factors, including the water/powder ratio, type of dental stone employed, and impression materials and techniques.

Each step introduces the potential for human and/or material error. And yet the success of implant prosthodontic treatment depends to a large extent on the accuracy of transferring implant positions intraorally to master casts.

Moreover, the traditional impression-making process requires the placement and removal of impression copings from implant-restorative platforms. Minimizing the frequency of tissue disruption could prove beneficial in maintaining both peri-implant bone height and peri-implant soft tissue adjacent to implant restorations.

The use of computer-aided design and computer-aided manufacturing (CAD/CAM) technology offers a pathway to reduced tissue disruption and greater framework accuracy. CAD/CAM tools for diagnosis, treatment planning, surgery, prosthetic treatment and laboratory procedures have become an intimate part of implant dentistry.

CAD/CAM abutments and frameworks are now routinely fabricated from commercially pure titanium, titanium alloy and zirconia by various implant companies and milling centers. Such frameworks have proven to be more accurate than traditional cast restorations.

Laser and tactile scanning are enabling better and less invasive diagnostics, and other CAD/CAM tools are making it possible to create restorations that fit more precisely, take less time to fabricate and may result in decreased costs.

An excellent opportunity for dental laboratory technicians to stay abreast of this rapidly evolving technology will be at AO’s upcoming annual meeting in Phoenix. It will include a special day-long program of technical and scientific-based lectures for dental lab technicians.

The AO program will present protocols and instrumentation for using scanned images of the natural dentition (prepared teeth) and implants. Scanning may be acccomplished intraorally, thereby eliminating the errors associated with impressions and casts. Vertical gap measurements of scanned wax copings have been reported to be significantly larger than those noted in copings designed virtually in a computer.

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