CDEN0109

I 29 industry report _ CAD/CAM I cosmeticdentistry 1_2009 aestheticrestorationsandinthespecialisedproduc- tion of partial and implant-supported prostheses. Another trend is the computerised fabrication of inlays, onlays, and partial and single crowns, either chairside or in the office’s own CAD/CAM-equipped laboratory. Biogeneric occlusal surface design en- ables the reconstruction of the missing occlusal surfacewithinlays,onlays,andpartialcrownsasnat- urally as possible (Fig. 7). The one-appointment treatment saves the patient time and removes the need for provisional restoration, which minimises the risk of cusp fracture, enamel-margin chipping, and weakening of the dentine bond. CAD/CAM and all-ceramics are frequently men- tionedtogether,whichfalselyimpliesthatCAD/CAM islimitedtoall-ceramics.Theenormouspotentialin- herent in the milling and, most recently, the laser sintering of metals is often completely overlooked. The fabrication of metal restorations (e.g. non- precious metals and titanium) will eventually be- come a domain of CAD/CAM technology. In the field of implantology, it is already possible to create long-term provisional restorations, abut- ments, and crowns using computer-assisted meth- ods, which also shorten treatment steps. Digital volume tomography (DVT) yields a 3-D image of the bone structure, thus enabling much higher quality diagnosis, including the exact localisation of the alveolar nerve. Particularly in dental arches bearing partial prostheses, the DVT image quality is better than that of CT images, and the X-ray dosage re- quiredismuchlower.TheDVTthusprovidesthebasis for the surgical planning of the implant. In the future, the implant site and adjacent teeth willbescannedwithanintra-oraldigitalcamera,and avirtualmodelwillbecalculated.The3-Dvolumeto- mogram will be superimposed on this model and the crownwillthenbeexactlypositionedintheX-rayim- age(Fig.8).Thepositionoftheendosseousabutment will be suggested in the centre of the crown’s basal surface and in its insertion pathway, and based on this the situation will be examined for its surgical feasibility. When selecting the implant system for a given case, the case will be able to be completely simulated in a three-dimensional radiograph. Using special software, it will soon be possible to construct a stereolithographically manufactured drilling template, which will guarantee that the holes drilled in the bone and the implants are exactly positioned (Fig. 9). The demands of CAD/CAM technology have in- spired topics in basic research and hence propelled progress in other areas of dentistry too. Universities and industry can collaborate and thereby promote and shape these exciting developments. Thus far, CAD/CAM or computerised dentistry has not been a central area of interest at universities. But as CAD/CAM technology is relatively new and its per- formance potential is significant, this is likely to change in the next few years. In turn, this develop- ment will influence dental education curricula and thereby influence treatment options in private prac- tices to the benefit of our patients._ Fig. 8_DVT image with superim- posed suprastructure to determine implant postion. (Image: Bindl/Sicat) Fig. 9_Special software will help construct a stereolithographically manufactured drilling template for exact positioning of drilling holes and implants. (Image:NobelBiocare/Geiselhöringer) Manfred Kern, Secretary Society for Dental Ceramic (SDC) can be contacted at info@ag-keramik.de. www.ag-keramik.eu cosmeticdentistry _author info Fig. 8 Fig. 9