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38 Dental Tribune Middle East & Africa Edition | May-June 2015Anniversary < Page 37 > Page 39 whole working environment. Even just a couple of years ago, lab owners told me that they are still waiting for the right system to go for, unless there was the perfect system. I believe there is still no perfect digital solu- tion, but we are getting closer. We have to admit however that hand craft was neither perfect - but we adapted perfectly to the conditions. Rik Jacobs, The Netherlands: 10 years ago, the dental indus- try in terms of CAD/CAM was in an exploring stage, definitely in terms of economies of scale. It was the time that the first den- tal design software came on the market as far as I can remember it was transferred from the hear- ing aid market on the one hand and on the other 3D systems like CERE were just launched. How- ever the first serious milling ma- chine came shortly after in 2007. Dental Tribune MEA: Today, which aspects of dentistry have been altered most due to the rapid development of CAD/CAM? Dr. Julian Caplan, UK: In-sur- gery restorations, particularly for posterior indirect restora- tions, have become simplified and far less technique sensitive to finally make this technol- ogy a more mainstream option. Dentists can now visualize how they can integrate this technol- ogy into their everyday dental practice. The ability to morph CAD/CAM scans into CT scans is simplifying computer-guided surgery. Pre-planning for accu- rate implant placement utilizing CAD/CAM and CT scans will become the industries standard although the necessary surgical skills will still be a requirement - the computer has not replaced the surgeon – yet. Prof. Atef Shaker, Egypt: Well, development of CAD/CAM and its speed progress, have touched every dental field. Of course Restorative and Fixed Pros- thodontics fields have gained the highest advancement, but Orthodontic, Surgical, Remov- able Prosthodontics & Radiol- ogy branches of dentistry have been included in the CAD/CAM developments. In my opinion, within 5 years from now, CAD/ CAM & Digital Dentistry will be covering all specialties of the dental science. Dr. Munir Silwadi, Canada: Almost every single discipline of dentistry had its share of CAD/ CAM technology. Probably the fields of Aesthetic, Restorative and Prosthetic Dentistry got the lion’s share. Indirect Res- torations are more precise and predictable when fabricated through CAD/CAM systems. Guided Implant Surgery made the field of Implantology an eas- ier and safer procedure. CAD/ CAM driven orthodontics as well is getting more and more uti- lized. Dr. Mark Morin, USA: I feel that today the aspects of dentist- ry that has been altered the most in our profession by CAD/CAM is the implant and the lab world. The lab world is now almost all digital and connected to the of- fice through the internet. Den- tists have learned how to work with these labs differently than they did in the past. The implant world has now been simplified with cone beam technology. It has made it easier for the dentist to treatment plan, place, and re- store the implants. Lutz Ketelaar, Germany: I am often surprised how quick the old values of manual dentistry have been changed for the new solutions and how the markets adapt this opportunity world- wide. For me personally, the direction of monolithic restora- tions with the opportunity to go model-free and virtual adapta- tions, without losing esthetics out of the view, is a big change and can be seen on the materi- als that are being offered - sim- ple ZrO2 has been replaced for translucent variations in 16 shades, classical porcelain has a successor in high strength technical glass materials which natural opalescence and fluo- rescence. CAD/CAM is not limited by its opportunities, but of economic aspects - not everything that is possible makes sense. The trust into the investment of new tech- nologies with an open end is limited - The price for machines, materials and dental restora- tions is very much under pres- sure, knowledge and service are underestimated and almost ignorant behind the pricing poli- cies. Rik Jacobs, The Netherlands: So many aspects, it is based on imaginationwhathappenedonly 10 years ago. Certain treatments can be completely planned and executed by CAD CAM, con- sider Cone Beam CT, the suc- cess of CEREC at the practice of the Doctors, the transformation from a handicraft into a high tech virtual planned 3D work- ing environment, the start of the Milling centers, the overproduc- tion of the total number of mill- ing centers in certain countries, the total acceptance of Zirconia for Crown & Bridge applications and shortly 3D Printing which will become more and more ac- cepted in the profession. Dental Tribune MEA: What advantages do CAD/CAM sys- tems offer for the dental prac- tices versus conventional tech- nologies? Dr. Julian Caplan, UK: In-sur- gery CAD/CAM systems allow the dentist immediate evalua- tion of their preparations - spe- cifically clarity of their margins and occlusal clearance. In fact many universities are utiliz- ing this technology for their undergraduate teaching. The wonderful progression of this pre-manufacture assessment using digital scanners is that the preparation can be altered where there are deficiencies in the preparation, the altered parts removed from the original scan and only this part need be rescanned. This comes into a world of its own when a dentist is involved with multiple prepa- rations which previously would require a completely new im- pression if one of the prepara- tions did not fulfill the required criteria. CAD/CAM scanning is not only time efficient it also greatly reduces a dentist stress. Prof. Atef Shakar, Egypt: CAD/ CAM systems added many ad- vantages to the dentists as well to the dental patients. Speeding up the dental treatments was a recognitionwhichwasnotpossi- ble without CAD/CAM systems. High quality of precision has transferred the dental field to another spectrum of perfection. Technology-based treatments have increased our patients’ ex- pectations, which are now pos- sible, thanks to the versatility of Digital dental products. Dr. Munir Silwadi, Canada: CAD/CAM generated restora- tions are more precise and fit Rik Jacobs, The Netherlands, 6th CAD/CAM & Digital Dentistry Int’l Conference Dr. Mark Morin, USA, 7th CAD/CAM & Digital Dentistry Int’l Conference Dr. Julian Caplan, UK, 5th CAD/CAM & Digital Dentistry Int’l Conference better than conventionally pro- duced restorations. They can be manufactured in a faster and better reproducible way. CAD/ CAM technology saves time, of- fers safer treatment methods, and makes practicing dentistry less stressful and more enjoy- able. Dr. Mark Morin, USA: The ad- vantages that CAD/CAM offers to the dental practice over con- ventional technologies are nu- merous. The first one is efficien- cy. The ability to do crowns in one visit helps increase the prof- itability of the dental office. It al- lows us to participate in more of these PPO type insurance plans since it helps us control our cost by eliminating the lab expense and a second appointment. Stud- ies have also shown how the use of digital impressions are much more accurate and predictable than the traditional impression technique. It also benefits the patients because it makes the treatment predictable and con- venient. Lutz Ketelaar, Germany: CAD/ CAM allows a constant high quality of restorations, not only depending on manual skills in dental education - this is not the end of the classical dental technicians, otherwise we could also expect PC-gamers who play flight simulators to take over your next flight to Europe. Den- tal knowledge allows to use the instrument of CAD/CAM to be- come a perfect solution for an efficient workflow in high, mid and low price segment. Rik Jacobs, The Netherlands: Predictable output, workflow management, relieving the cli- ent & saving costs. Dental Tribune MEA: Given the proven positive results, what are the reasons why some dental practices are re- maining on the sidelines when it comes to CAD/CAM technol- ogy? Dr. Julian Caplan, UK: There are many reasons but the main reason is perceived cost of the systems to purchase. However this is only because the practi- tioner has not understood the savings that they would make in materials and laboratory costs.