ISSN : 0376-4672
Dental computer-aided design (CAD) and computer-aided manufacturing (CAM) technology have rapidly progressed over the past 30 years. The technology, which can be used in the dental laboratory, the dental office and the form of production centers, has become more common in recent years. This technology is now applied to inlays, onlays, crowns, fixed partial dentures, removable partial denture frameworks, complete dentures, templates for implant installation, implant abutments, and even maxillofacial prostheses. Dentists and dental technicians, who want to use these techniques, should have certain basic knowledge about that. This article gives an overview of CAD/CAM technologies, histories and how it applies in prosthetic dentistry.
CAD/CAM systems (computer-aided design / computer-aided manufacturing) used for decades in restorative dentistry have its application to implant dentistry. This study aimed to overview CAD/CAM systems used implant dentistry, especially emphasizing custom implant abutments manufacturing. CAD/CAM custom abutments present the advantages of being specific to each patient and providing a better fit than the stock and cast custom abutments. This cutting edge technology of virtual-designed and computer-milled implant abutments will likely replace traditional implant restorative protocols and become the standard for implant dentistry in the foreseeable future.
Loss of dentition can lead to not only compromised esthetics and functions of the patient, but also alveolar bone resorption. Bone grafting with prosthetic reconstruction of the gingiva can be selected for the treatment, and it provides many benefits as prosthetic gingival reconstruction does not require a complicated surgical process and is available within a short period of time, with stable clinical results. However, conventional porcelain fused to metal prosthesis has certain limits due to its size, and deformation after several firing procedures. In this clinical report, the author would like to introduce a patient with severe alveolar resorption who was treated with gingiva-shaped zirconia/titanium CAD/CAM implant fixed prosthesis for esthetic and functional rehabilitation. Clinical reports Clinical report 1, 2 : A case of loss of anterior dentition with atrophied alveolar bone. Implant retained zirconia bridge applied with Procera implant bridge system to simulate the gingiva. Upper structure was fabricated with zirconia all ceramic crown. Clinical report 3, 4 : A case of atrophied maxillary alveolus was reconstructed with fixed implant prosthesis, a CAD/CAM designed titanium structure covered with resin on its surface. Anterior dentition was reconstructed with zirconia crown. Conclusion and clinical uses All patients were satisfied with the outcome, and maintained good oral hygiene. Zirconia/titanium implant fixed prosthesis fabricated by CAD/CAM system was highly accurate and showed adequate histological response. No critical failure was seen on the implant fixture and abutment overall. Sites of severe alveolar bone loss can be rehabilitated by implant fixed prosthesis with CAD/CAM system. This type of prosthesis can offer artificial gingival structure and can give more satisfying esthetics and functions, and as a result the patients were able to accept the outcome more fondly, which makes us less than hard to think that it can be a more convenient treatment for the practitioners.
Recently, the digital solution of fabricating removable prosthesis by applying haptic input device, electronic surveying, and rapid prototyping was introduced. This review article covers the concept of electronic surveying, computer-aided denture framework designing procedure, discussions after several digital denture cases, directions of future development, such as digital tooth arrangement and RP flasking.
Mineral trioxide aggregate (MTA) is mainly composed of lime and silica. Its four major phases are tricalcium silicate, dicalcium silicate, tricalcium aluminate, and tetracaclcium aluminoferrite. MTA has relatively long initial setting time (2h 45m)and various additives can be added to reduce setting time. Compressive strength of MTA increases with time and reaches 100 MPa after 28 days. MTA has high pH of 9-12.5 because of the formation of calcium hydroxide during its hydration reaction. MTA has superior sealing ability to amalgam and IRM when it is used in perforation repair or root end filling. MTA is safe in cytotoxicity and genotoxicity and have potential to promote pulpal and periapical hard tissue formation.
