CAD/CAM in modern orthopedic dentistry

Abstract

Introduction. CAD/CAM (Computer - aided Design, Computer - aided manufacturing) is a perspective branch of digital dentistry. The whole СAD/CAM technological process from taking impressions until fixation is performed by chairside and can take only one visit. According to polls (2016), 89% of dentists consider that CAD/CAM technology has to replace conventional process of modelling and manufacturing of prosthetic constructions in the nearest future. Aim of the study. to analyze technological possibilities of СAD/CAM in orthopedic dentistry, to reveal advantages and disadvantages of CAD/CAM technology on the example of a clinical case. Materials and methods. Was carried out a review of the publications of the last 10 years on the selected theme using PubMed system. According to a key phrase "CAD/CAM" 1862 publications were found, 80 publications were selected and analyzed. Research includes data from 20 publications. Examination of a patient at the age of 32 years with partial defect of solid tissues of lateral teeth of the maxilla was performed. Defect was treated with the help of zirconium crowns manufactured by means of CAD/CAM technology. Results.The analysis of literature allowed to define the main advantages of CAD/CAM technology: 1) accuracy of marginal fit and occlusal contacts; 2) high esthetics; 3) concept of one-visit dentistry; 4) decrease of human factor; 5) stability and predictability of treatment. Presented clinical case confirms mentioned advantages of CAD/CAM technology. According to five sources, marginal discrepancy of the CAD/CAM crowns varies from 30 to 60 microns. At the same time traditional full ceramic crowns have an average discrepancy 90 microns. Researches demonstrate maintaining of 95-98% of CAD/CAM crowns for the 6-year period of clinical observation (R. Van Noort, 2012, M. Fages, 2017, Alqahtani, 2017). The analysis of literature revealed fact that rather small significance is attached to applying of CAD/CAM digital workflow in treatment of handicapped people and other categories. Possibility to minimize the number of visits for this group of patients is the greatest advantage. Were defined the following shortcomings of CAD/CAM technology: 1) high cost; 2) increased material consumption; 3) limitations in several types of prosthetic constructions. Conclusions. 1. The analysis of literature showed that CAD/CAM the technology has large prospects in modern dentistry due to constant perfecting. 2. The quality of CAD/CAM crowns and bridges surpasses the quality of conventional constructions of the same type. However, partial and complete CAD/CAM dentures, as well as some other constructions, still have lack of precision.