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implants international magazine of oral implantology

I overview Figs. 4 & 5_Fitting accuracy below 50 µm seems to be possible for full-arch reconstructions. will control the implant positioning and type of re- construction of the operation virtually in advance. _CAD/CAM technologies in implant prosthetics Closely connected to computer-assisted im- plant planning is the CAD/CAM technology (Com- puter-Aided Designing/Computer-Assisted Manu- facturing), which has significantly changed the dental medicine in the course of the past twenty years.7 The more parallel dental implants can be planned and clinically placed, the easier and more stable the design (Fig. 2) of CAD/CAM frame- works/FDPs (Fixed Dental Prostheses) and bars madeoftitaniumorzirconiacanbekept.Thesema- terialsarealsocharacterisedbyimprovedtechnical and biological features. Consequently, technical andbiologicalcomplicationsaretobeexpectedless often.8, 9 Depending on the connection type of implant systems, also full-ceramic reconstructions can be screwed together directly on the implant’s level (Fig. 3). The fitting accuracy of implant-borne CAD/ CAM-titanium and -zirconia reconstructions are significantly higher than the conventionally pro- ducedbridgeswithcastalloys.10 Bynow,mostofthe major manufacturers offer their own CAD/CAM systems and have centralised production facilities formanufactureofframeworksandbridgesattheir disposal. Thus, a fitting accuracy below 50 µm (Fig. 4 & 5) seems routinely possible for full-arch recon- structionswiththerequiredcareandknow-howof the production process.11-13 The CAD/CAM production is specific for metals like titanium and ceramics, as for example zirconia. For milling with CNC-machines, especially suited milling cutters are used. After the milling of zirco- niaintheoverdimensionedgreen-/white-body,the final crystallisation (sintering and HIP) of the work piece is made. Despite of automated and mechani- calprocesses,theCAMsteprequirestheexperience ofspecialisedengineerswhoareabletooverseethe processes and step in if problems occur. The current development efforts and advance- ments take place in the area of software possibili- ties and the connection of individual digital sub- areas.Thereby,auniversaldataformat(STL)enables the forwarding of data by intra- or extraoral scan- ners via CAD- and CAM software. However, it prob- ably might take some time until the various providers will open their systems completely and thusenableuserstofreelychoosebetweenthedig- ital work steps._ Editorial note: A list of references is available from the publisher. 20 I implants4_2014 PD Dr med.dent.Joannis Katsoulis,MAS Department of Reconstructive Dentistry and Gerodontology School of Dental Medicine University of Bern Freiburgstrasse 7 3010 Bern Switzerland joannis.katsoulis@zmk.unibe.ch _contact implants Fig. 4 Fig. 5

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