Intro to Digital Dentistry Flashcards
What is Digital Dentistry?
*The use of dental technology or device
that incorporates digital or computer-
controlled components in contrast to
that of mechanical or electrical alone
CAD:
Computer Aided Design
The use of computer programs to create
two- or three-dimensional (2D or 3D)
graphical representations of physical
objects.
CAM :
Computer Aided
Manufacturing /Milling
The use of computer software to control
machine tools and related machinery in
the manufacturing of work pieces.
WHAT CAN WE DO WITH CAD/CAM?
(6)
*Single tooth restorations on natural teeth
* Multi-unit restorations on natural teeth
* 3-unit bridges
* Implant restorations
* RPD Frameworks
* Complete Dentures
*Single tooth restorations on natural teeth
(4)
ØCrowns
ØInlays
ØOnlays
ØVeneers
- Implant restorations
(4)
ØCustom abutments
ØCement retained crowns
ØTitanium milled bars for full arch restorations
ØMulti-unit frameworks for implant bridges
Why use CAD/CAM?
(8)
*Application of new materials
*Better cost effectiveness (some have estimated the savings in lab bills to range from 60%-70%)
*Reduction in labor
*Faster production process
*Precise dimensions
*Minimizing wastage of material
*Reducing energy consumption
* Better quality control
BENEFITS OF
DIGITAL
TECHNOLOGY
The multilevel quality
improvement afforded
through digital
technology is
recognized in workflow
and efficiency, record
keeping, data fidelity
and therapeutics.
LONGEVITY’OF’RESTORATIONS’
‘’Posterior’singleFtooth’restora4ons’fabricated’from’intraoral’scans’by’
using’CAD/CAM’technology’have’acceptable’results’for’
(4)
shade,’contour,’
marginal’adapta4on’and’occlusion’“
Survival rates:
—% after up to 17 years of clinical service
—% in 5.5 years vs —% for gold
—% in 5 years, —% in 10
—% in 9 years
88.7
88.8, 93.3
97, 90
98.4
Pre-requisite of Digital Imaging
(3)
*Digital Camera.
*Software.
*Production Unit.
CEREC® Bluecam System
(4)
*Inlays/ Onlays.
*Visible Blue Light (LEDs).
*Powder is required.
*Digital on-screen ArRculaRon.
CEREC Generation Comparison: CEREC Omnicam
Imaging Technique
3 D scan in color
Powder Usage
Area of Application
Advantages
Continuous data acquisition
Y
N
Single tooth, quadrant, and full
mouth
*Powder free.
*Easy handling
*Precise 3D image in natural
color.
CEREC Generation Comparison: CEREC Bluecam
Imaging Technique
3 D scan in color
Powder Usage
Area of Application
Advantages
Multiple shots joined together
N
Y
Single tooth, quadrant (full mouth
is possible)
*High precision.
*Rapid scan in powder coated
surfaces.
*Easy to use.
*Data Acquisition:
(2)
*Direct.
*Indirect.
*Accessibility to STL Files:
(2)
*Open.
*Close.
*Production of final restoration:
(3)
*Chair-side Production.
*Laboratory Production.
*Centralized Production Centers.
*DIRECT:
The data are directlyobtained from the patient’smouth via intra oral scanner.
*INDIRECT:
The data are indirectlyobtained in the lab either from an impression or a stone
cast.
*OPENFILES:
Are not dependent on the manufacturer, can be used with any
software to fabricate the final restoration.
*CLOSEFILES:
The data are controlled and manipulated by the owner
(manufacturer).
CAD / CAM Production Concepts In Dentistry
(3)
Chair-side Production
Laboratory Production
Centralized Production
CONVENTIONAL:
Initial Cost:
Additional Cost
- PVS + Registration Material ~
$17. - Trays, Dispensers, and Stone/
Shipping.
DIGITAL:
Ini$al Cost:
Addi$onal Cost:
*Scanner $20,000 -$30,000.
*Milling unit $110,000 -
$120,000.
- Electronic Lab
PrescripCons, Blocks, Burs,
and Maintenance.
Conventional Vs Digital
*Time
(2)
*Go Digital and Save
Time!!
*Time is $$.
Conventional Vs Digital Time
CONVENTIONAL:
(12)
*Tray Selection/ Custom Tray.
*Mixing Time.
*Setting Time.
*Remake.
*Opposing Arch.
*Inter-occlusal records.
*Disinfection/ Clean-up.
*Pour the impressions.
*Mont the casts.
*Ditch the dies.
*Shipping.
*Restoration.
Conventional Vs Digital Time
DIGITAL:
(9)
*Learning Curve.
*Lab Prescription.
*Scan (Prep, Opposing and
Buccal).
*Evaluate the scan.
*Rescan.
*Disinfection/ Clean-up.
*Send (Electronically).
*Cast (Printing/ Milling).
*Restoration.
Conventional Vs Digital
Tissue Displacement
(3)
*Tissue Displacement is a MUST for both
Techniques.
*Dry Field is a MUST for both Techniques.
*0.5 mm of tooth structure apical to the
finish line
Conventional Vs Digital Time
CONVENTIONAL
*~ min (Teeth)
*~ min (Implants)
41
43.12
Conventional Vs Digital Time
DIGITAL
*~ min (Teeth)
*~ min (Implants)
13
30.63
Digital Versus Conventional Impressions in Fixed
Prosthodontics: A Systematic Review
Ahlholm P, Sipilä K, Valli8u P, Jakonen M, Ko=ranta U J Prosthodont
2016 Aug 2 PMID: 27483210
*SystemaCc Review.
*Accuracy of ConvenConal Vs Digital impressions.
*In-vitro Studies.
*19 papers included.
*Same level of accuracy for Crowns and FPDs.
*Digital impressions showed a clinically accepted results,
shortened the treatment Cme.
*ConvenConal impressions are sCll recommended for full-arch
restoraCons.
Conventional Vs Digital Internal & Marginal Fit
Tsirogiannis P, Reissmann D, Heydecke G J Prosthet Dent 2016.
*Systematic Review.
*Marginal fit of single ceramic restoration ( CAD/CAM Vs CI).
*In-vitro & In-vivo.
*63 papers were included.
*In-vitro:
*Conventional: 58.9 μm (95% CI: 41.1-76.7 μm).
*Digital: 63.3 μm (95% CI: 50.5-76.0 μm).
*In-vivo:
*Conventional: 79.2 μm (95% CI: 59.6-98.9 μm).
*Digital: 56.1 μm (95% CI: 46.3-65.8 μm).
No significant difference was observed regarding the marginal gap of
single-unit ceramic restorations obtained from digital or conventional
impression techniques.
Digital versus conven@onal impressions for fixed
prosthodon@cs: A systema@c review and meta-analysis
Chochlidakis K, Papaspyridakos P, Geminiani A, Chen C, Feng I, Ercoli C J Prosthet Dent 2016;116:184-190
Systematic Review.
Marginal fit of fixed prosthesis.Conventional Vs Digital.Marginal and internal gaps with conventional technique were greater than the digital technique, (P-value <0.05).*Conclusion: Although conclusions were based mainly on in
vitro studies, the digital impression technique provided better marginal and internal fit of fixed restorations than conventional techniques did.
Conclusion
(2)
*Digital impression can produce clinical acceptable impressions.
*For Full-arch impressions, Conventional Impression techniques shows superior accuracy.
Some advantages of the Optical/Digital Technique:
(4)
*More comfortable to the patient.
*Better Marginal fit (both clinically accepted).
*Improve Dentist/Lab communication.
*Cut down the turn around time.
