Intro to Digital Dentistry

Question 1

What is Digital Dentistry?

Answer 1

*The use of dental technology or device
that incorporates digital or computer-
controlled components in contrast to
that of mechanical or electrical alone

Question 2

CAD:

Answer 2

Computer Aided Design
The use of computer programs to create
two- or three-dimensional (2D or 3D)
graphical representations of physical
objects.

Question 3

CAM :

Answer 3

Computer Aided
Manufacturing /Milling
The use of computer software to control
machine tools and related machinery in
the manufacturing of work pieces.

Question 4

WHAT CAN WE DO WITH CAD/CAM?
(6)

Answer 4

*Single tooth restorations on natural teeth
* Multi-unit restorations on natural teeth
* 3-unit bridges
* Implant restorations
* RPD Frameworks
* Complete Dentures

Question 5

*Single tooth restorations on natural teeth
(4)

Answer 5

ØCrowns
ØInlays
ØOnlays
ØVeneers

Question 6

• Implant restorations
  (4)

Answer 6

ØCustom abutments
ØCement retained crowns
ØTitanium milled bars for full arch restorations
ØMulti-unit frameworks for implant bridges

Question 7

Why use CAD/CAM?
(8)

Answer 7

*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

Question 8

BENEFITS OF
DIGITAL
TECHNOLOGY

Answer 8

The multilevel quality
improvement afforded
through digital
technology is
recognized in workflow
and efficiency, record
keeping, data fidelity
and therapeutics.

Question 9

LONGEVITY’OF’RESTORATIONS’
‘’Posterior’singleFtooth’restora4ons’fabricated’from’intraoral’scans’by’
using’CAD/CAM’technology’have’acceptable’results’for’
(4)

Answer 9

shade,’contour,’
marginal’adapta4on’and’occlusion’“

Question 10

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

Answer 10

88.7
88.8, 93.3
97, 90
98.4

Question 11

Pre-requisite of Digital Imaging
(3)

Answer 11

*Digital Camera.
*Software.
*Production Unit.

Question 12

CEREC® Bluecam System
(4)

Answer 12

*Inlays/ Onlays.
*Visible Blue Light (LEDs).
*Powder is required.
*Digital on-screen ArRculaRon.

Question 13

CEREC Generation Comparison: CEREC Omnicam
Imaging Technique
3 D scan in color
Powder Usage
Area of Application
Advantages

Answer 13

Continuous data acquisition
Y
N
Single tooth, quadrant, and full
mouth

*Powder free.
*Easy handling
*Precise 3D image in natural
color.

Question 14

CEREC Generation Comparison: CEREC Bluecam
Imaging Technique
3 D scan in color
Powder Usage
Area of Application
Advantages

Answer 14

Multiple shots joined together
N
Y
Single tooth, quadrant (full mouth
is possible)

*High precision.
*Rapid scan in powder coated
surfaces.
*Easy to use.

Question 15

*Data Acquisition:
(2)

Answer 15

*Direct.
*Indirect.

Question 16

*Accessibility to STL Files:
(2)

Answer 16

*Open.
*Close.

Question 17

*Production of final restoration:
(3)

Answer 17

*Chair-side Production.
*Laboratory Production.
*Centralized Production Centers.

Question 18

*DIRECT:

Answer 18

The data are directlyobtained from the patient’smouth via intra oral scanner.

Question 19

*INDIRECT:

Answer 19

The data are indirectlyobtained in the lab either from an impression or a stone
cast.

Question 20

*OPENFILES:

Answer 20

Are not dependent on the manufacturer, can be used with any
software to fabricate the final restoration.

Question 21

*CLOSEFILES:

Answer 21

The data are controlled and manipulated by the owner
(manufacturer).

Question 22

CAD / CAM Production Concepts In Dentistry
(3)

Answer 22

Chair-side Production
Laboratory Production
Centralized Production

Question 23

CONVENTIONAL:
Initial Cost:

Additional Cost

Answer 23

• PVS + Registration Material ~
  $17.
• Trays, Dispensers, and Stone/
  Shipping.

Question 24

DIGITAL:
Ini$al Cost:

Addi$onal Cost:

Answer 24

*Scanner $20,000 -$30,000.
*Milling unit $110,000 -
$120,000.

• Electronic Lab
  PrescripCons, Blocks, Burs,
  and Maintenance.

Question 25

Conventional Vs Digital
*Time
(2)

Answer 25

*Go Digital and Save
Time!!
*Time is $$.

Question 26

Conventional Vs Digital Time
CONVENTIONAL:
(12)

Answer 26

*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.

Question 27

Conventional Vs Digital Time
DIGITAL:
(9)

Answer 27

*Learning Curve.
*Lab Prescription.
*Scan (Prep, Opposing and
Buccal).
*Evaluate the scan.
*Rescan.
*Disinfection/ Clean-up.
*Send (Electronically).
*Cast (Printing/ Milling).
*Restoration.

Question 28

Conventional Vs Digital
Tissue Displacement
(3)

Answer 28

*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

Question 29

Conventional Vs Digital Time
CONVENTIONAL
*~ min (Teeth)
*~ min (Implants)

Answer 29

41
43.12

Question 30

Conventional Vs Digital Time
DIGITAL
*~ min (Teeth)
*~ min (Implants)

Answer 30

13
30.63

Question 31

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

Answer 31

*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.

Question 32

Conventional Vs Digital Internal & Marginal Fit
Tsirogiannis P, Reissmann D, Heydecke G J Prosthet Dent 2016.

Answer 32

*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.

Question 33

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

Answer 33

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.

Question 34

Conclusion
(2)

Answer 34

*Digital impression can produce clinical acceptable impressions.
*For Full-arch impressions, Conventional Impression techniques shows superior accuracy.

Question 35

Some advantages of the Optical/Digital Technique:
(4)

Answer 35

*More comfortable to the patient.
*Better Marginal fit (both clinically accepted).
*Improve Dentist/Lab communication.
*Cut down the turn around time.