Digital Imaging and Processing for Restorations
Dental cad/Cam Systems
CAD/CAM, the abbreviation for computer-aided design/computer-aided manufacturing, describes a process in which digital images or models of objects are created and used for the design and fabrication of prototypes or final products using computer numerical control (CNC) or other fabrication methods such as stereolithography. This process has been used for decades in a variety of industries and has become a popular method in restorative dentistry for creating impressions, cast and dies, and provisional and final restorations. Reports of 10-year follow-up studies for one system have shown good outcomes that are improving with each technological enhancement.
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3. Fabrication technology that transforms the digital data of the restoration into a physical product. Different systems place the fabrication technology in the dental office, dental laboratory, or centralized facility.
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The two types of CAD/CAM systems for dental offices are acquisition (digital impression) only and scan and mill. Acquisition only systems create digital impressions by capturing images of the preparation and then sending the digital file to a center where a model is made upon which a laboratory technician can fabricate the final restoration. A scan and mill system adds an in-office restoration fabrication device to the digital impression instrument, enabling a restoration to be designed, fabricated, and delivered in one appointment. For the acquisition only system, multiple appointments are required as in conventional indirect restorative care, and a provisional restoration is placed in the interim while the restoration is being fabricated by a laboratory technician. Scan and mill systems offer the convenience of one appointment preparation, impression, fabrication, and delivery, but includes a waiting period while the restoration is milled and the additional cost of the milling machine.
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There are several dental CAD/CAM systems currently on the market (Table 14-1). Two of these systems (CEREC AC, Figure 14-1, A, and E4D Dentist, Figure 14-1, B) offer the option of in-office design and milling but also allow design and milling by dental technicians. Two other systems (iTero, Figure 14-2, A, and Lava Chairside Oral Scanner C.O.S., Figure 14-2, B) produce digital impressions that require design and milling at a dental laboratory or milling center. All of these systems can produce models from their digital files.
|Product||Manufacturer||Light Source||Number of Images Required||In-office Milling||Laboratory Milling|
|3M ESPE Lava Chairside Oral Scanner C.O.S.||3M ESPE (St. Paul, MN)||LED||Continuous video||No||Yes|
|CEREC AC||Sirona Dental Systems (Charlotte, NC)||Bluecam LED||1-3||Yes||Yes|
|E4D Dentist||D4D Technologies (Richardson, TX)||Laser||9+||Yes||Yes|
|iTero||Cadent, Inc. (Carlstadt, NJ)||Laser||21||No||Yes|
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