The Role of CAD/CAM Systems in Oral Rehabilitation: Literature Review and Case Report
In dentistry, CAD/CAM systems have been applied and developed in clinical practice since 1971. Nowadays, digital workflow systems which utilize a combination of digital oral scanner and computer programs have been developed to assist prosthesis designing and manufacturing. Thus, dental prostheses are automatically designed and manufactured by the systems. CAD/CAM systems have many advantages. Firstly, more precise restorations are made by elimination of human errors that cause higher risk of mechanical failure. Moreover, the use of CAD/CAM systems provides further selection of dental materials usage such as zirconia that served the need in esthetic and function aspects. Finally, this technology consumes less time in treatment procedures that is more convenient for patients and dentists. This report shows the history and workflow of CAD/CAM systems, a comparison of CAD/CAM technique to conventional procedure, and a case report that used CAD/CAM systems to design and produce fixed and removable prostheses for oral rehabilitation.
1. Ferro KJ. The glossary of prosthodontic terms. J Prosthet Dent 2017; 117(5): e1-e105.
2. Franks AS. The concept of oral rehabilitation. J Oral Rehabil 1976; 3(1): 1-8.
3. Christensen GJ. Defining oral rehabilitation. J Am Dent Assoc 2004; 135(2): 215-217.
4. Gill JR. Treatment planning for mouth rehabilitation. J Prosthet Dent 1952; 2(2): 230-245.
5. Abduo J, Lyons K, Bennamoun M. Trends in computer-aided manufacturing in prosthodontics: A Review of the Available Streams. Int J Dent 2014; 2014: 1-15.
6. Davidowitz G, Kotick PG. The use of CAD/CAM in dentistry. Dent Clin North Am 2011; 55(3): 559-570.
7. Miyazaki T, Hotta Y, Kunii J, Kuriyama S, Tamaki Y. A review of dental CAD/CAM: current status and future perspectives from 20 years of experience. Dent Mater J 2009; 28(1): 44-56.
8. Campbell SD, Cooper L, Craddock H, et al. Removable partial dentures: The clinical need for innovation. J Prosthet Dent 2017; 118(3): 273-280.
9. Kattadiyil MT, Mursic Z, AlRumaih H, Goodacre CJ. Intraoral scanning of hard and soft tissues for partial removable dental prosthesis fabrication. J Prosthet Dent 2014; 112(3): 444-448.
10. Parkash H. Digital dentistry: Unraveling the mysteries of computer-aided design computer-aided manufacturing in prosthodontic rehabilitation. Contemp Clin Dent 2016; 7(3): 289-290.
11. Beuer F, Schweiger J, Edelhoff D. Digital dentistry: an overview of recent developments for CAD/CAM generated restorations. Br Dent J 2008; 204: 505-511.
12. Mormann WH. The evolution of the CEREC system. J Am Dent Assoc 2006; 137: 7s-13s.
13. Miyazaki T, Hotta Y. CAD/CAM systems available for the fabrication of crown and bridge restorations. Aust Dent J 2011; 56(1): 97-106.
14. Richard VN. The future of dental devices is digital. Dent Mater J 2012; 28(1): 3-12.
15. Rekow ED, Erdman AG, Riley DR, Klamecki B. CAD/CAM for dental restorations-some of the curious challenges. IEEE Trans Biomed Eng 1991; 38(4): 314-318.
16. Kathuria YP. Microstructuring by selective laser sintering of metallic powder. Surf Coat Tech 1999; 116-119: 643–647.
17. Salmi M, Paloheimo KS, Tuomi J, Ingman T, Mäkitie A. A digital process for additive manufacturing of occlusal splints: a clinical pilot study. J R Soc Interface 2013; 10(84): 1-6.
18. Silva NRFA, Witek L, Coelho PG, Thompson VP, Rekow ED, Smay J. Additive CAD/CAM process for dental prostheses. J Prosthodont 2011; 20(2): 93-96.
19. Christensen GJ. The state of fixed prosthodontic impressions: room for improvement. J Am Dent Assoc 2005; 136(3): 343-346.
20. Touchstone A, Nieting T, Ulmer N. Digital transition: the collaboration between dentists and laboratory technicians on CAD/CAM restorations. J Am Dent Assoc 2010; 141(2): 15s-19s.
21. Lee JW, Park JM, Park EJ, Heo SJ, Koak JY, Kim SK. Accuracy of a digital removable partial denture fabricated by casting a rapid prototyped pattern: A clinical study. J Prosthodont 2017; 118(4): 468-474.
22. Bibb RJ, Eggbeer D, Williams RJ, Woodward A. Trial fitting of a removable partial denture framework made using computer-aided design and rapid prototyping techniques. Proc Inst Mech Eng H 2006; 220(7): 793-797.
23. Turner KA, Missirlian DM. Restoration of the extremely worn dentition. J Prosthet Dent 1984; 52(4): 467-474.
24. Moon JE, Kim SH, Lee JB, Han JS, Yeo IS, Ha SR. Effects of airborne-particle abrasion protocol choice on the surface characteristics of monolithic zirconia materials and the shear bond strength of resin cement. Ceram Int 2016; 42(1, Part B): 1552-1562.
25. Abd El-Ghany OS, Sherief AH. Zirconia based ceramics, some clinical and biological aspects: review. Future Dent J 2016; 2(2): 55-64.
26. Harada K, Raigrodski AJ, Chung KH, Flinn BD, Dogan S, Mancl LA. A comparative evaluation of the translucency of zirconias and lithium disilicate for monolithic restorations. J Prosthet Dent 2016; 116(2): 257-263.
27. Amer R, Kürklü D, Kateeb E, Seghi RR. Three-body wear potential of dental yttrium-stabilized zirconia ceramic after grinding, polishing, and glazing treatments. J Prosthet Dent 2014; 112(5): 1151-1155.
28. Zhang Y, Lee JJ, Srikanth R, Lawn BR. Edge chipping and flexural resistance of monolithic ceramics. Dent Mater 2013; 29(12): 1201-1208.
29. Venezia P, Torsello F, Cavalcanti R, D'Amato S. Retrospective analysis of 26 complete-arch implant-supported monolithic zirconia prostheses with feldspathic porcelain veneering limited to the facial surface. J Prosthet Dent 2015; 114(4): 506-512.
30. Bomicke W, Rammelsberg P, Stober T, Schmitter M. Short-term prospective clinical evaluation of monolithic and partially veneered zirconia single crowns. J Esthet Restor Dent 2017; 29(1): 22-30.
31. Silva NR, Thompson VP, Valverde GB, et al. Comparative reliability analyses of zirconium oxide and lithium disilicate restorations in vitro and in vivo. J Am Dent Assoc. 2011; 142: 4s-9s.
32. Johansson C, Kmet G, Rivera J, Larsson C, Vult von Steyern P. Fracture strength of monolithic all-ceramic crowns made of high translucent yttrium oxide-stabilized zirconium dioxide compared to porcelain-veneered crowns and lithium disilicate crowns. Acta Odontol Scand 2014; 72(2): 145-153.
33. Amir Rad FA, Succaria FG, Morgano SM. Fracture resistance of porcelain veneered zirconia crowns with exposed lingual zirconia for anterior teeth after thermal cycling: An in vitro study. Saudi Dent J 2015; 27(2): 63-69.
34. Galhano GA, Pellizzer EP, Mazaro JV. Optical impression systems for CAD-CAM restorations. J Craniofac Surg 2012; 23(6): e575-e579.
35. Guth JF, Keul C, Stimmelmayr M, Beuer F, Edelhoff D. Accuracy of digital models obtained by direct and indirect data capturing. Clin Oral Investig 2013; 17(4): 1201-1208.
36. Ender A, Attin T, Mehl A. In vivo precision of conventional and digital methods of obtaining complete-arch dental impressions. J Prosthet Dent 2016; 115(3): 313-320.
37. Patzelt SB, Emmanouilidi A, Stampf S, Strub JR, Att W. Accuracy of full-arch scans using intraoral scanners. Clin Oral Investig 2014; 18(6): 1687-1694.
38. Flugge TV, Schlager S, Nelson K, Nahles S, Metzger MC. Precision of intraoral digital dental impressions with iTero and extraoral digitization with the iTero and a model scanner. Am J Orthod Dentofacial Orthop 2013; 144(3): 471-478.
39. Santosh YD, Nikhil R, Sumit JD, Jitendra JM. In vitro Comparison of marginal fit of Cad-Cam zirconia, SMLS Co-Cr, pressable lithium disilicate, and cast Ni-Cr copings. Adv Dent & Oral Health 2016; 2(2): 1-6.
40. Batson ER, Cooper LF, Duqum I, Mendonca G. Clinical outcomes of three different crown systems with CAD/CAM technology. J Prosthet Dent 2014; 112(4): 770-777.
41. Boitelle P, Mawussi B, Tapie L, Fromentin O. A systematic review of CAD/CAM fit restoration evaluations. J Oral Rehabil 2014; 41(11): 853-874.
42. Jiang W, Xiaobo W, Xianghui Z, Chunbao Z, Bo G. A study on the fabrication method of removable partial denture framework by computer-aided design and rapid prototyping. Rapid Prototyping J 2012; 18(4): 318-323.
43. Kim HR, Jang SH, Kim YK, et al. Microstructures and Mechanical Properties of Co-Cr Dental Alloys Fabricated by Three CAD/CAM-Based Processing Techniques. Materials 2016; 9(7): 596.
44. Arnold C, Hey J, Schweyen R, Setz JM. Accuracy of CAD-CAM-fabricated removable partial dentures. J Prosthet Dent 2018; 119(4): 586-592.