Technologies: CAD/CAM

2013

Metal-Ceramic vs All-Ceramic

Improved Materials

Improved Technology

CAD/CAM

Computer Aided

Design/

Computer Aided

Manufacturing

Procera

Cerec

Everest

Lava

Celay

Wol-Ceram Epc-CAM

Cercon

etc.

CAD/CAM made it possible to work with a new generation of hard ceramics in dentistry. These materials cannot be cast so therefore must be machined. In order to machine something a cutting path is required. The cutting path is generated from digital scanned data.

SCAN THE OBJECT

CREATE DIGITAL DATA POINTS

GENERATE CUTTING PATH

MACHINE REPLICA OBJECT

Application of science to dentistry

CAD/CAM

What is dental CAD/CAM? Dental CAD/CAM is the process by which the model of a prepared tooth is scanned. This data is then used to generate the coping design (CAD) which in turn is used to generate a cutting path for manufacturing the coping (CAM). Computer Aided Design (CAD) and Computer Aided Manufacture (CAM) in restorative dentistry can be used to:

Reduce production time for copings and frameworks; increasing overall productivity

Introduce consistent and measurable accuracy

Provide evidence of product quality

CAD/CAM technology

Scanner - digital impression of the prepared teeth

Software – CAD - digital cast on the screen

- virtual design of the model

Milling unit – CAM - computer aided milling unit (cnc) - grinding process

Non-contact sensor:

optical: laser point,

laser stripe, white

light, fotogrammetry

Contact sensor:

mechanical

Presintered, yttrium-stabilised,

HIP zircon

Copings and bridges

Non- shrinkage zircon silicat

Full crowns in the posterior

region

Industrial manufactured titanium

blanks

Copings, crowns and bridges

Leucite-reinforced glass ceramics

Inlays, Onlays, Veneers as well

as anterior and posterior copings

Elements –

material

versatility

Green processing Milling of presintered ceramic blocks

advantage: easy to process, grinding instruments do not have to be replaced that often

disadvantage: porous presintered zirconia shape shrinks during final sintering- enlarged substructures= software calculated

Hard processing Milling of dense sintered ceramic blocks

Takes more time, grinding instruments wear off

HIP= Hot Isostatic Press : special sintering technique High temperature and pressure applied to densify the

material, gaining 20% more in strength

Frameworks zirconium oxide

In clinic - the dentist purchases an intra-oral scanner, the cutting machine and the consumable materials. All the work is done by the dentist at the clinic. Mainly suitable for full crowns, inlays and onlays.

In lab - the laboratory purchases a scanner, cutting machine and consumables. The dentist sends the patient's impressions and prescription to the lab. The lab scans models of the prepared teeth, designs the restoration and machines the restoration.

CAD/CAM methods

Centralised machining - in this situation the lab purchases or leases a scanner only. Again, the dentist sends the patient's impressions and prescription to the lab. The lab scans models of the prepared teeth and designs the coping and then sends this data off to an external machining centre. The machined coping is returned to the lab for veneerig.

Centralised scanners and machining - the laboratory sends the model away to the external centre to be scanned. The coping is also designed and machined at the external centre. The model and coping are sent back to the lab for veneering.

CAD/CAM methods

Procera-

Centralised machining

Stockholm/ Sweeden

Making a sectioned cast in the lab

Scanning the die and the cast

CAD-data sent to central machining center (checking)

Milling starts in 19 minutes

Copings (hand) packed and mailed

delivered within 5 days

First patient 1985 (1994)

Katana-Centralised machining

Semmelweis Laboratory

• Scan-

Measuring

unit

• Engine-

Milling and

grinding

unit

• Therm-

Sintering

unit

• Elements-

Materials

Everest-in lab

Software User interface

Light beam projection

15 projection

sequences

The rotary plate

moves on its vertical

and horizontal axis

during this process

CAD- Software

The

preparation

limit is

automatically

detected

Design

Decision guidance

Form of margins

Juncture region

Metal margin

Framework thickness

3-D virtual view of the occlusion on the screen

The distances between occlusion and framework construcion are shown with different colours.

Easy, quick and safe design of frameworks in connection with the virtual wax knife.

Virtual wax knife - Can be used to process the virtual framrwork in three dimensions on

the screen

- Precise addition or removal of virtual material enables quick and

precise waxing

Design

Design

Cantilever bridge Bridge for veneering

CAM Engine 5-axis technology

Ensures secure milling of

undercuts

• The wide degree of

freedom during the

milling process

enables complex

geometry

• Engine speed

5.000 – 80.000 min-1

Engine

Simultaneously controlled 5-axis

technology

Thin crown margins and best

marginal fit

The wide degree of freedom during

the milling process enables complex

geometry

Engine speed

5.000 – 80.000 min-1

Engine

The 5-axis milling strategy

5-axis technology Milling of titanium

Cerec-in clinic

Intraoral scanning-no impression

Digaital images of tooth and opposing arch

CAD and CAM

Milling the crown

20 minutes chairside

Milling titanium

Thank You for Your Attention!