State of Libya

Ministry of higher Education and scientific research

Elmergib University
Faculty of medical technology – Maselata
Department: Dental technology

Title of the research: CAD/CAM in dentistry

By the student:
Esraa Mohamed Aljaly Ahmed Milad Abu Ghalia
Hania joma Farhat Mohamed Almabrouk Altalisi

Supervised by: Dr. Sanaa Al-Rifai.

The academic year: fall 2023.

Abstract:
Objective: The CAD/CAM process in Dentistry describes an indirect restoration
designed by a computer (Computer Aided Design) and milled by a computer
assisted machine (Computer Aided Machined). It can be divided into three
different steps: data acquisition, indirect restoration design and construction of
the prosthesis itself. This paper relates the state of art of the CAD/CAM systems
in dentistry and some of the concerns and special cares that can interphase to
optimize their results. Yet, it stablishes some considerations about the role of
CAD/CAM systems in the present and near future of the dental practice.
Introduction:
The CAD/CAM process in Dentistry describes an indirect restoration
designed by a computer (Computer Aided Design) and milled by a
computer-assisted machine (Computer Aided Machined). The first system
introduced was developed by Duret and colleagues in 1971, but was not
widely used, mostly because of the lack of accuracy of digitizing, computer
power and materials, etc.. Thus, in the next decade, Mormann and Bran
Destini developed the CEREC system in Zurich, Switzerland. The name
CEREC means Ceramic Reconstruction.
The definition of the term:
CAD/CAM dentistry is a field of dentistry and prosthodontics using
CAD/CAM (computer-aided-design and computer-aided-manufacturing) to
improve the design and creation of dental restorations, especially dental
prostheses, including crowns, crown lays, veneers, inlays and on lays, fixed
dental prostheses (bridges), dental implant supported restorations, dentures
(removable or fixed), and orthodontic appliances. CAD/CAM technology
allows the delivery of a well-fitting, aesthetic, and a durable prosthesis for
the patient.
The parts of the device:

1.Intraoral cameras (IOCs) are cameras used by dentists or doctors to

show a patient the interior of their mouth, as an alternative to using a mirror.
They were first introduced in 1989 and are now widely used in dental offices.
IOCs allow the patient to see a clear picture of the inside of their mouth,
aiding the dentist in consulting with them on various treatment options.
Images can be saved to a patient's file for future reference
2.CAD Software:
Computer-aided design (CAD) software is used by dental professionals to
design dental restorations digitally. It allows for precise customization of
crowns, bridges, inlays, onlays, and other prosthetic devices based on the
digital impressions.
3.CAM Software:

Computer-Aided Manufacturing (CAM) software translates the digital designs

created in CAD into instructions for the milling machine. It specifies the tool
paths and milling parameters needed to produce the physical restoration from
various materials.

4.Milling Machines:

Dental milling machines use CAM data to precisely carve or mill dental
restorations from materials such as ceramics, zirconia, or resin. These
machines can create crowns, bridges, and other prosthetic components with
high accuracy.
5.3D Printers:

While milling machines are common, 3D printers are also increasingly being
used in CAD/CAM dentistry. They can create dental models, surgical guides,
and other components layer by layer using materials like resins.
6.Materials:
Various materials are used in CAD/CAM dentistry, depending on the specific
application. Common materials include ceramics (such as lithium disilicate
and zirconia), resins, and metals. These materials are selected based on
factors like strength, aesthetics, and biocompatibility.
7.Sintering Furnaces:
In cases where zirconia is used as the material, a sintering furnace is
employed to complete the manufacturing process. The restoration is placed
in the furnace to undergo a sintering process, which strengthens and
solidifies the material.
8.Digitally Guided Implant Surgery:

CAD/CAM technology is also utilized in implant dentistry for planning and

executing guided implant surgery. This involves digitally planning the optimal
placement of dental implants and creating surgical guides to ensure precision
during the implant placement process.

The integration of CAD/CAM technology in dentistry allows for more efficient

and accurate dental procedures, reduces the need for traditional dental
impressions, and enables the creation of high-quality, customized dental
restorations.
History
Although CAD/CAM dentistry was used in the mid-1980s, early efforts were
considered a cumbersome novelty, requiring an inordinate amount of time to
produce a viable product. This inefficiency prevented its use within dental
offices and limited it to labside use (that is, used within dental laboratories). As
adjunctive techniques, software, and materials improved, the chairside use of
CAD/CAM (use within dental offices/surgeries) increased. For example, the
commercialization of Cerec by Sirona made CAD/CAM available to dentists
who formerly would not have had avenues for using it.
 Advantages of CAD/CAM:
The advantages CAD/CAM provides when compared with the traditional laboratory
and chairside led techniques are that it 1- allows for use of materials otherwise
unavailable in the laboratory

CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) technology

enables the use of materials that might be otherwise difficult to work with or
unavailable in traditional laboratory settings. Some of these materials include:
High-performance polymers: CAD/CAM systems can utilize various high-
performance polymers like PEEK (polyether ether ketone) or PEKK
(polyether ketone ketone), which offer excellent mechanical properties,
biocompatibility, and resistance to chemicals and high temperatures.

Ceramics: CAD/CAM systems can work with ceramics like zirconia, lithium
disilicate, or alumina. These materials offer high strength, durability, and
excellent aesthetics, making them suitable for dental restorations and other
precision components.
Composite materials: CAD/CAM technology can process composite materials
composed of resin matrices reinforced with fibers such as glass, carbon, or
aramid. These materials offer a combination of strength, lightness, and versatility
for various applications in engineering, aerospace, and automotive industries.

Metal alloys: Some CAD/CAM systems are capable of machining metal alloys
such as titanium, cobalt-chrome, or stainless steel. These materials are essential
in industries like aerospace, medical implants, and automotive manufacturing
due to their high strength, corrosion resistance, and biocompatibility.
Exotic materials: CAD/CAM technology allows for the machining of exotic
materials like carbon fiber composites, nickel-based super alloys, or
advanced ceramics used in specialized applications such as aerospace
components, high-performance racing parts, or cutting-edge medical devices.

Bio-compatible materials: CAD/CAM systems can work with bio-compatible

materials specifically designed for medical applications, such as
biodegradable polymers, bioactive glasses, or tissue-engineering scaffolds.
These materials are crucial for producing implants, prosthetics, and medical
devices that interact safely with the human body.
Nano-materials: While not as common, some CAD/CAM systems can work
with nano-materials for specialized applications in nanotechnology, such as
nanostructured metals, nanoparticles, or nanocomposites. These materials
offer unique properties at the nanoscale, including enhanced strength,
conductivity, or catalytic activity.

By leveraging CAD/CAM technology, researchers, engineers, and

manufacturers can access a broader range of materials and unleash
innovative solutions across various industries, pushing the boundaries of
what's possible in material science and engineering.
; 2) Time efficiency: With CAD/CAM technology, dental restorations can be
designed and fabricated in a single appointment, eliminating the need for multiple
visits and temporary restorations. This saves time for both the patient and the
dentist, resulting in a more efficient and convenient treatment process.

Polymeric materials: CAD/CAM systems can utilize polymers such as PMMA

(polymethyl methacrylate) or composite resins as alternatives to more expensive
materials like metals or ceramics. These materials are often more affordable while
still offering adequate strength and aesthetics for applications such as dental crowns,
temporary restorations, or prototyping.
Wood and wood composites: CAD/CAM systems can work with wood
materials or wood composites as cost-effective alternatives to metals or
plastics in applications such as furniture manufacturing, cabinetry, or
decorative elements. Wood offers a natural and aesthetically pleasing finish
at a relatively lower cost compared to other materials.

Foams and foam composites: CAD/CAM technology can process foam

materials such as polyurethane foam or foam composites, which are
lightweight, inexpensive, and suitable for applications like packaging,
insulation, cushioning, and architectural elements.
Recycled materials: CAD/CAM systems can utilize recycled plastics,
metals, or other materials as cost-effective alternatives to virgin materials.
Recycling reduces raw material costs and environmental impact while still
providing functional and durable components for various applications.

Low-cost alloys: Some CAD/CAM systems can work with low-cost metal
alloys like aluminum alloys or certain stainless steels, which offer a balance
between affordability and performance for applications such as automotive
parts, consumer electronics, or structural components.
Paper-based materials: CAD/CAM technology can process paper-based
materials such as cardboard, corrugated board, or paper pulp composites,
which are lightweight, readily available, and inexpensive. These materials
are commonly used in packaging, signage, displays, and disposable
products.

By utilizing these cheaper alternatives with CAD/CAM technology,

manufacturers can reduce material costs, streamline production processes,
and offer more affordable products without compromising quality or
performance.
3) decreases labor cost and time for dental technicians and 4) standardizes the
quality of restorations.

Ceramic materials in particular, can be highly time-consuming to work with. To

make a ceramic dental prosthesis by hand, the technician has to meticulously build
up porcelain powder and sinter it onto the surface of a coping. With CAD/CAM,
labor times are significantly reduced, with CAD systems with some reviews
reporting that only 5–6 minutes of technician input is required to produce a dental
prosthesis. In this way, the cost of production is reduced because labour costs are
lower.
3) decreases labor cost and time for dental technicians and

4) Digital records: CAD/CAM technology allows for the creation of digital records of the
patient's dental anatomy and restoration history. This enables easier communication
and collaboration between dental professionals and facilitates efficient follow-up care
and maintenance.

Ceramic materials in particular, can be highly time-consuming to work with. To make a

ceramic dental prosthesis by hand, the technician has to meticulously build up porcelain
powder and sinter it onto the surface of a coping. With CAD/CAM, labor times are
significantly reduced, with CAD systems with some reviews reporting that only 5–6
minutes of technician input is required to produce a dental prosthesis. In this way, the
cost of production is reduced because labour costs are lower.
Disadvantages of CAD/CAM
• Learning curve: With any new technology there is a steep learning
curve. With time and experience operators will need to understand how to
work the equipment and software used for CAD/CAM technology. Initially it
can be difficult to adopt a new digital workflow when operators were
comfortable with using their long-standing process in dentistry. This would
also mean staff would need to be trained to feel comfortable using
CAD/CAM systems.

• Cost: digital dentistry requires a large financial investment, including

buying and maintaining equipment as well as software updates. However, in
the long run the investment will pay off as it can save money on expenses
such as laboratory fees and single use impression equipment
 CONCLUSIONS:
Irrespective of the clinical application, the CAD/CAM technology has been
shown to have better mechanical performance, because preconceived
structures are involved. There are advantages to using CAD⁄CAM in Dentistry:
the new materials are aesthetically pleasing and durable; there is increased
efficiency in laboratory processing; quick fabrication of the restoration; and
quality control of restorations such as fit, mechanical durability and predictability
. These advantages will ultimately benefit our patients . There are new materials
and techniques launched on market on a daily basis, most of them adding
something new to restorative procedures. The future is digital, but in this
“technological era” we, professionals of dentistry, must be aware of the
developments,
 Thank
You
All
For listening