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Dental Materials Supplemental Cards > Digital Impressions and CAD/CAM Restorations > Flashcards

Digital Impressions and CAD/CAM Restorations Flashcards

1
Q

what are 2 in vitro studies conducted by the dental advisor?

A
  • biomaterials
  • microbiology
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2
Q

what are 3 clinical marketing studies conducted by the dental advisor?

A
  • restorative materials - placement and long-term
  • infection control products
  • equipment
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3
Q

describe 4 of apex dental milling’s products

A
  • full-contour zirconia - anterior and posterior
  • zirconia frameworks and copings
  • pressed lithium disilicate
  • printed orthodontic and C&B models
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4
Q

what are the 6 main factors that need to be considered in selection of digital impression systems

A
  1. type of restoration - silica-based ceramic, zirconia, resin ceramic, metal, provisional, wax pattern
  2. in-office milling or milling center
  3. cost of equipment - $10,000 - $125,000
  4. powder required
  5. ortho and implant integration available
  6. special features
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5
Q

what is CEREC?

A
  • in-office milling system owned by DENTSPLY
  • 3 types: APOLLO DI, BLUECAM, OMNICAM
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6
Q

what are the major in-office milling systems?

A
  • CEREC
  • e4d Dentist (Planmeca)
  • PlanScan & PlanMill 40 (Planmeca)
  • TRIOS Pod and TRIOS Color (3Shape)
  • Galaxy BioMill (BIOLASE)
  • CS 3500 & 3600 intraoral scanners and Cs 3000 Mill (Carestream Dental)
  • 3M True Definition Scanner (3M)
  • TS 150 Mill (Glidewell Laboratories)
  • Whip Mix Corporation
  • DWX-50 Mill (Roland)
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7
Q

3M True Definition Scanners use open and trusted connections. what are those?

A

open connections:

  • send files directly to your lab
  • export files and send to any open CAD/CAM system
  • provides options for clean aligners and night guards

trusted connections:

  • in-office chairside mills
  • digital implant workflows
  • orthodontic appliances
  • access to digitally produced SLA working models
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8
Q

what are the 6 steps for using in-office CAD/CAM?

A
  1. prepare tooth (and soft tissue) - dentist
  2. scan - dentist
  3. design - assistant
  4. mill - assistant
  5. polish - stain & glaze - assistant
  6. seat - dentist
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9
Q

what are the training requirements for intra-oral scanning in-office?

A
  • initial scanning and “hole filling”
  • initial design if available (margin marking)
  • lab script completion
  • file transfer to laboratory
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10
Q

describe the 4 initial requirements of desktop scanning in-office

A
  • workstation dedicated to software (desktop or laptop)
  • WiFi or LAN network - shielded cable to send files
  • proper network specs to maintain speed of file transfer and storage of files
  • steady counter/cabinet to hold weight of scanner
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11
Q

describe infection control involved in in-office scanning/milling

A

disinfection of wands and keyboards

  • Plan Scan-Smart Tips, autoclaveable covers
  • ITero and Element: disposable covers
  • CS 3500&3600: autoclavable covers
  • Straumann Cares/DWIOS: disinfection with wipe
  • Tru Def - reportedly immersable in disinfectant
  • CEREC - dry heat or disinfection with wipe
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12
Q

describe the initial requirements (8) for in-office milling

A
  • workstation dedicated to software (desktop or laptop)
  • WiFi or LAN network - shielded cable to send files
  • proper network and memory to maintain speed of file transfer and storage of files
  • steady counter/cabinet to hold weight of mill and footprint
  • compressed air connection
  • water connection
  • distilled water
  • lubricant specific to mill
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13
Q

what are the use and maintenance requirements for in-office milling?

A
  • software updates applied
  • bur life and changes
  • chuck maintenance
  • filter changes for compressor
  • cleaning splindle and unit
  • lubricant specific to mill
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14
Q

what are the training requirements for in-office milling?

A
  • operation and maintenance of mill and furnace
  • file acquisition and initial design (margin marking)
  • restoration design
  • material selection and milling
  • firing, staining and glazing
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15
Q

describe maintaining and troubleshooting if something doesn’t scan or mill as expected

A
  • help lines
  • dial-in support
  • reviewing maintenance
  • network issues
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16
Q

which milling systems can use resin ceramic?

A

CEREC and PlanMill

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17
Q

which milling systems can use feldspathic porcelain?

A

CEREC will, PlanMill will not

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18
Q

which milling systems can use leucite-reinforced?

A

CEREC and PlanMill

19
Q

which milling systems can use lithium disilicate?

A

CEREC and PlanMill

20
Q

describe the lab workflow for CAD/CAM

A
  • dental office - impression, model, or digital scan
  • lab - pour model or scan impression, scan model, or import scan to design software
  • CAD (design center or lab) - design restoration
  • CAM (milling center or lab) - no model; mill restoration; sinter if necessary, finish and glaze. OR print model or wax pattern for investing, pressing or layering PFM or all-ceramic restorations; printed models are also used for orthodontic and prosthodontic appliances
21
Q

what is an SLA die?

A
  • fabricated using SLA (3-D) printing
22
Q

what are some examples of chairside oral scanners?

A
  • Lava Chairside Oral Scanner C.O.S. (3M)
  • iTero Imaging System (Align Technology, Inc.)
23
Q

what equipment is needed in a milling center?

A
  • scanners, design software, milling machines, and sintering ovens
  • proprietary and open architecture
  • 3-D printing - orthodontic and crown and bridge models
24
Q

T or F:

all shading must be done using shading liquids

A

false:

new ceramics are pre-shaded and layered

25
Q

what is sintering?

A
  • an oven used to allow zirconia to pass through certain phases
  • monoclinic to tetragonal, stopping short of cubic
26
Q

describe Lava C.O.S. vs Elastomeric Impressions with respect to perfect, high, and light occlusion

A

COS

  • perfect - 74%
  • high - 18%
  • light - 8%

Elastomeric Impressions

  • perfect - 48%
  • high - 46%
  • light 6%

overall, Lava C.O.S. provides better results

*perfect - dentist did not need to use a bur to correct the occlusion

*high - dentist did need to use a bur to correct occlusion

*light - no contact; this is bad

27
Q

describe Lava C.O.S. vs. Elastomeric Impressions with respect to mesial contacts

A

C.O.S.

  • perfect - 62%
  • tight - 38%

Elastomeric Impressions

  • perfect - 43%
  • tight - 57%

Lava C.O.S. - better results

28
Q

describe Lava C.O.S. vs. Elastomeric Impressions with respect to fit

A

C.O.S.

  • perfect - 92%
  • loose - 8%

Elastomeric Impression

  • perfect - 70%
  • loose - 30%

Lava C.O.S. - better results

29
Q

describe Lava C.O.S. vs. Elastomeric Impressions with respect to clinically acceptable cases

A

C.O.S.

  • Yes - 95%
  • No - 5%

Elastomeric Impression

  • Yes - 89%
  • No - 11%

Lava C.O.S. - better results

30
Q

describe Lava C.O.S. vs. Elastomeric Impressions with respect to patient preference

A
  • COS - 63%
  • elastomeric impression - 8%
  • no preference - 29%
31
Q

describe factors in selection of CAD/CAM ceramics

A
  • strength - 120-1200 MPa
  • esthetics - anterior vs. posterior
  • patient factors
32
Q

what are silica-based CAD/CAM ceramics?

A
  • feldspathic porcelain (CEREC blocs) - not very strong; can’t be used for posterior restorations
  • leucite-reinforced procelain (IPS Empress CAD)
  • lithium disilicate ceramics (IPS e.max CAD)
33
Q

describe flexural strength of silica-based ceramics

A
  • feldspathic porcelain - 100-120Mpa
  • leucite-reinforced porcelain - 120-140MPa
  • lithium disilicate ceramic - 375MPa

*gold is around 400MPa

34
Q

describe non-silica based CAD/CAM ceramics

A
  • zirconia (BruxZir Solid Zirconia, BruxZir Anterior, Lava Crowns and Bridges, Lava Plus, NexxZr)
  • flexural strength - 500-1500MPa
  • veneered core and framework and full-contour restorations
35
Q

what is zirconia?

A

yttrium-stabilized tetragonal zirconia (Y-TZP)

  • >90% zirconium oxide (ZrO2)
  • stabilized with 3.0-5.4% Y2O3, HfO2, Al2O3
  • small grains with no glassy phase
  • no silica - special primer for bonding
36
Q

what are the benefits of CAD/CAM zirconia ceramics?

A
  • esthetics - excellent
  • strength - very high
  • fit - excellent
  • metal-free
  • clinical track record
37
Q

describe the dental advisors clinical track record of zirconia ceramics

A
  • 10-yr Lava recall
  • 4-yr BruxZir recall
  • 1-yr NexxZr recall
  • 1-yr BruxZir anterior recall
38
Q

describe the dental advisors Lava recall at 10-yrs

A
  • over 1300 lava restoration placed since 2003
  • 1008 restorations recalled
  • molar crowns, pre-molar crowns, anteriors, bridges, and implant abutments

resistance to fracture and chipping:

  • fracture rate - 6% - required replacement; molar > premolar
  • chipping rate - 4.7% (roughly same as PFM)
  • no fracture/chipping - 89%
39
Q

what are some common reasons for Lava failures?

A
  • undersupported
  • underfired
40
Q

describe the recall of BruxZir solid zirconia crowns and bridges at 4-yrs

A
  • 913 restorations recalled at 4-yrs
  • single crowns (77%), bridges (16%), and implant crowns (7%)
  • most restorations had no chipping or fracture; one crown and two implant crowns failed
  • esthetics - excellent - great for patients who want B1 shade
  • five restorations exhibited slight marginal discoloration
  • minimal wear on restorations and on opposing dentition
  • 39 of 913 (2.8%) crowns debonded and were recemented
41
Q

describe the recall of NexxZr T full-contour restoraitons at 1-yr

A
  • 179 NexxZr T full-contour restorations recalled
  • 4% of restorations required minor occlusal adjustment at placement
  • single crowns (88%), bridges (11%), and implant crowns (1%)
  • one premolar crown exhibited chipping; no restorations required replacement
  • esthetics - excellent
  • excellent resistance to marginal discolorations with self-adhesive and adhesive resin cements
  • no wear observed on restorations or on opposing dentition
42
Q

describe the translucency parameters of zirconia, lithium disilicate, and resin ceramic

A
  • zirconia - 7.1-7.8
  • lithium disilicate - 13.8-15.8
  • resin ceramic - 14.9-17.7
  • higher numbers = more translucent
43
Q

describe surface roughness of zirconia, lithium disilicate, and resin ceramic

A
  • zirconia - 0.1-0.15um
  • lithium disilicate - 0.28-0.37um
  • resin ceramic - 0.34-0.46um
44
Q

what are milled resin ceramics?

A
  • laboratory composite filled with zirconia
  • has higher translucency but lower flexural strength
  • CeraSmart (GC America)
  • Enamic (Vident-VITA)
  • Lava Ultimate (3M)

Dental Materials Supplemental Cards (6 decks)

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