UNIVERSITY OF KUFA

FACULTY OF ENGINEERING
Department of Material Engineering
Fourth stage - Morning
2023-2024

CAD/CAM Implant

By:
Zainab Basim Hussein
Zahraa Faiq Abdel Hussein

Supervisor
Dr. Muhammad Saad
2024/4/2
 Objectives
1 Introduction to CAD/CAM Implant

What is the CAD/CAM System? 2

3 Materials and Methods

Advantage and limitations of CAD/CAM Implant 4

5 The difference between the traditional method and the CAD/CAM
 Introduction

Dental implants are artificial tooth roots surgically placed in the

jawbone to replace missing teeth. They provide a strong
foundation for permanent restorations like crowns, bridges, or
dentures. CAD/CAM technology has revolutionized various
fields, including dentistry. In the context of dental implants,
CAD/CAM plays a pivotal role in designing and manufacturing
precise implant restorations (to create certain parts of dental
implants) tailored to individual patient needs. Implant-supported
prostheses are comfortable and aesthetic. The prosthetic abutment
has also faced a rapid design evolution.
What do we mean by (CAD)?
CAD stands for Computer-Aided
Design. It refers to the use of
computer software and systems to
assist in the creation, modification,
analysis, or optimization of
designs for products.
 Computer Aided Design (CAD)
There are several CAD (Computer-Aided Design) programs commonly used in the field of
dental. Some of the popular CAD software programs include:

❑ 3Shape Dental System: 3Shape offers a comprehensive CAD/CAM solution specifically

tailored for dental professionals.

CAD
❑ Exocad: is another leading CAD software
Computer Aided usedDesign
in dental implantology.
(CAD) It offers a user-
friendly interface and advanced functionalities for designing implant restorations with
precision and efficiency.
There are several CAD (Computer-Aided Design) programs commonly used in the field of
dental. Some of the popular CAD software programs include:

❑ 3Shape Dental System: 3Shape offers a comprehensive CAD/CAM solution specifically

tailored for dental professionals.

CAD
CAD
❑ Dental
Exocad:CAD is another
Wings:leading
Offers
ComputerCAD
a dedicated
software
Aided CAD
usedDesign
in
software
dental implantology.
specifically designed
(CAD) It offers for
a user-
friendlyapplications.
dental interface and advanced functionalities for designing implant restorations with
precision and efficiency.
There are several CAD (Computer-Aided Design) programs commonly used in the field of
dental. Some of the popular CAD software programs include:

❑ 3Shape Dental System: 3Shape offers a comprehensive CAD/CAM solution specifically

tailored for dental professionals.

CAD
CAD
CAD
What do we mean by (CAM)?
CAM stands for Computer-Aided
Manufacturing. It refers to the
use of computer software and
systems to control manufacturing
processes, including machining,
milling, 3D printing, and other
fabrication techniques.
 Computer Aided Manufacturing (CAM)
In the field of dental implantology, several CAM programs are commonly used for
manufacturing implant restorations and related components. Here are some examples:

❑ Hyper DENT: is a CAM software widely used in dental laboratories and milling
centers for manufacturing dental prostheses, including implant restorations.
❑ CIMSystem-Millbox: is a CAM software specifically designed for dental applications,
including the fabrication of dental restorations such as crowns, bridges, and implant
components.
❑ Work NC: is software developed by Hexagon's Manufacturing Intelligence division.
While it's not specifically tailored for dental applications like some other CAM software.
 How it works?
❖ Scanning: The process begins with capturing digital impressions of the
patient's oral anatomy using intraoral scanners or desktop scanners.

❖ Design: Using specialized CAD software, professionals design the implant

abutments and restorations based on the digital impressions. This allows for
precise customization according to the patient's specific needs.
scanning accurate to dental
Figure (1) (a) Scanning of the scanning abutment to allow the virtual transfer of the
implant position, taking the information from the scanning software and loading it
into the Exocad design software; (b) the design of the prosthetic abutment.
❖ Manufacturing: Once the design is finalized, CAM technology is employed to
fabricate the implant components. This can involve milling from blocks of
materials such as ceramics or metals, or 3D printing using various biocompatible
materials.

❖ Implantation: After fabrication, the custom implant components are attached to

the dental implant fixtures surgically placed in the patient's jawbone.
❖ Manufacturing: Once the design is finalized, CAM technology is employed to
fabricate the implant components. This can involve milling from blocks of
materials such as ceramics or metals, or 3D printing using various biocompatible
materials.

❖ Implantation: After fabrication, the custom implant components are attached to

the dental implant fixtures surgically placed in the patient's jawbone.

Figure (2) shows us Manufacturing

(abutments) for implant
CAD/CAM implants can be fabricated from a variety of materials, including zirconia,
titanium, and various ceramics. The choice of material depends on factors such as
strength requirements, aesthetics, and biocompatibility.

A. Titanium: is a biocompatible metal. In CAD/CAM implant, titanium blocks may

also be used for milling custom abutments and implant-supported frameworks.

B. Zirconia: is a ceramic material known for its biocompatibility, aesthetic appeal,

and mechanical properties similar to natural teeth.

In addition to PMMA (Polymethyl Methacrylate),Composite Resins and Metal

Alloys.
Titanium implant
zirconia implant abutment
 The methods
Abutments are essential components in dental implant restorations, serving as the
connection between the implant fixture and the final prosthetic restoration.
CAD/CAM technology offers several methods for manufacturing implant
abutments with precision and customization. Here are the primary methods
used:

1) Milling (CNC) from Prefabricated Blanks:

One common method involves milling abutments from prefabricated blanks of
materials such as titanium or zirconia. These blanks are available in various
shapes, sizes, and colors to accommodate different implant systems and aesthetic
preferences.
CAD software is used to design the abutment based on the digital impression
or scan of the implant site. The design is then sent to a CNC (computer
numerical control) milling machine, which carves the abutment from the blank
according to the specified dimensions and contours.

This method offers precise customization and allows for the fabrication of
anatomically shaped abutments tailored to the patient's soft tissue architecture
and occlusal requirements.
2) Direct Milling from Solid Blocks:
Some CAD/CAM systems allow for the direct milling of abutments from solid
blocks of material, such as titanium or zirconia. This method eliminates the need
for prefabricated blanks and offers greater flexibility in design and customization.

Using CAD software, dental professionals design the abutment directly based on
the digital impression or scan of the implant site. The design is then sent to a
CNC milling machine equipped with appropriate milling tools to fabricate the
abutment from the solid block of material.

Direct milling allows for the creation of highly customized abutments with
precise contours, emergence profiles, and screw access channels.
Direct Milling from Solid
Blocks in implant
3) Selective Laser Melting (SLM):
Selective laser melting is an additive manufacturing technique that can be used to
fabricate metal abutments, particularly those made from titanium alloys. In this
method, a laser selectively melts layers of metal powder to build up the abutment
structure layer by layer.

CAD software is used to design the abutment, specifying the desired dimensions,
features, and surface finish. The design is then converted into a series of digital
slices, which are used to control the laser melting process.

SLM offers excellent precision and allows for the fabrication of complex
geometries not achievable with traditional milling methods. However, it may
require specialized equipment and expertise, making it less commonly used for
abutment manufacturing in dental laboratories.
Selective laser melting
(SLM)
4) Hybrid Methods:
Some CAD/CAM systems combine milling and additive manufacturing
techniques to fabricate hybrid abutments. For example, a titanium base may be
milled, and a zirconia or ceramic overlay may be added using 3D printing
technology to achieve optimal aesthetics and strength.

Hybrid methods offer the benefits of both milling and additive manufacturing,
allowing for customized designs with enhanced aesthetics and mechanical
properties.
Advantages:
1) Precision (Improved accuracy and fit): CAD/CAM technology ensures
precise fitting of implant components, leading to better aesthetics and
functionality.

2) Customization: Each implant restoration can be tailored to the patient's

unique oral anatomy, enhancing comfort and performance.

3) Enhanced aesthetics: CAD/CAM software allows dentists to design

restorations that perfectly match the color and shape of the surrounding teeth.

4) Faster turnaround time (Efficiency): CAD/CAM allows dentists to create

these components in their office, often within a single visit.
Limitations:

1) Accuracy: The accuracy of the final restoration highly depends on the

quality of the initial digital scans. Any errors during scanning can translate
into minor discrepancies in the final product.

2) Cost: The technology and materials used in CAD/CAM can add to the
overall cost of the implant procedure compared to traditional methods.

3) Availability: Not all dental offices have invested in in-house CAD/CAM

technology, potentially leading to longer turnaround times or the need for
outsourcing.
 Applications
Abutment: This is the small connector piece that screws onto the top of the
dental implant and serves as the base for the artificial tooth (crown).
 Applications
Superstructure
Abutment: This (Crown):
is the smallThis
connector
is the visible,
piece thattooth-shaped
screws ontorestoration
the top of that
the
dental implant
replaces the missing
and serves
tooth.as the base for the artificial tooth (crown).
 The difference between traditional and (CAD/AM) implants
The primary difference between traditional implants and implants fabricated
using CAD/CAM technology lies in the design, manufacturing process, and
customization options:

➢ Design Process:

Traditional Implants: In traditional implant dentistry, the design of implant

components, such as abutments and prosthetic restorations, often involves
manual techniques, such as waxing, casting, and hand-finishing. This process
may rely heavily on the skills and experience of the dental technician.
 The difference between traditional and (CAD/AM) implants

CAD/CAM Implants: With CAD/CAM technology, the design process is

digitalized. Dental professionals use specialized CAD software to design
implant components based on digital impressions or scans of the patient's oral
anatomy. This allows for precise customization and the creation of highly
accurate digital models.
 Figure (3) Digital workflow of the CAD/CAM crown. (A) Digital impression of
the prepared tooth. (B) Digital design of proposed restoration. (C) Swirl marks on
the internal surface indicating overmilling. (D, E, F, G, H, and I) Cross-sectional
views of the prepared tooth, proposed restoration and overmilled areas.
 The difference between traditional and (CAD/AM) implants

➢ Manufacturing Process:
Traditional Implants: In traditional implant dentistry, implant components are
typically manufactured using conventional methods, such as casting,
machining, or hand-fabrication. This process may involve multiple manual
steps and may be subject to variations in accuracy and consistency.

CAD/CAM Implants: CAD/CAM technology enables the automated

manufacturing of implant components using computer-controlled milling
machines or 3D printers. These machines fabricate components directly from
digital designs, ensuring high precision, consistency, and reproducibility.
 The difference between traditional and (CAD/AM) implants

➢ Customization Options:
Traditional Implants: While traditional methods allow for some degree of
customization, such as manual shaping and contouring of implant components,
the options may be limited compared to CAD/CAM technology.

CAD/CAM Implants: CAD/CAM technology offers extensive customization

options for implant components. Dental professionals can digitally design
components with precise dimensions, contours, and surface textures tailored to
the patient's specific anatomy and clinical needs. This allows for optimal fit,
aesthetics, and functionality.
 The difference between traditional and (CAD/AM) implants

➢ Efficiency and Accuracy:

Traditional Implants: Traditional methods may be time-consuming and labor-
intensive, with the potential for human error in the fabrication process. The
accuracy and consistency of the final implant components may vary depending
on the skill level of the technician and the quality of materials and equipment
used.

CAD/CAM Implants: CAD/CAM technology streamlines the design and

manufacturing process, reducing turnaround times and minimizing the risk of
errors. The digital workflow ensures high accuracy and consistency in the
fabrication of implant components, leading to superior clinical outcomes.
 The difference between traditional and (CAD/AM) implants
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 Future Directions
Advancements in CAD/CAM technology continue to refine the precision
and efficiency of implant workflows.

Integration with other digital technologies such as cone-beam computed

tomography (CBCT) and virtual planning software enhances treatment
planning and outcomes.

In summary, CAD/CAM implants represent a sophisticated approach to

dental implantology, leveraging computer technology to achieve precise,
customized, and predictable treatment outcomes for patients requiring tooth
replacement.