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ePaper created 2016-10-04, 09:33:57 | version 1.38.0
| literature review CAD/CAM material and systems 14 CAD/CAM 3 2016 designs and enlarge the restoration or framework that is milled from a pre-sintered blank. Studies on marginal adaptation suggest that Lava restorations haveamarginalfitthatcanbeaslowas21microns.27 Some other systems that were able to mill zirconia were DCS Zirkon(DCS Dental) and Denzir.16 In the last decade, companies have decided to differ- entiatetheirproductsbyhavingafullCAD/CAMplat- form or by focusing on specific areas of expertise like CAD software and intraoral scanners; these compa- nies claim to be open platform because their systems allowtoexportuniversalfilessuchasSTLorOBJ(Fig.5) tobeusedwiththemajorityofnestingsoftwaresand milling machines that are able to import them. Defenders of closed platforms claim that the inte- grationofdifferentCAD/CAMsystemsdoesnotallow for a good integration between parts and probably leadstotheincorporationoffabricationerrors;atthis point no research about systems integration is avail- able. Table II shows some of the systems used for dentalCADwiththeirfileoutput;TableIIIshowssome of the most used CAM systems with their material recommendations and capabilities. Some of the main concerns from clinicians about all-ceramicCAD/CAMrestorationsaccuracyoffitare: scanning resolution, software designing limitations, and milling hardware limitations of accuracy. Clini- cians’andtechnicians’experiencewiththeCAM/CAM system integration is also a key factor for fabricating good restoration; the computer software per se will not allow an inexperienced operator to create an excellent dental restoration from scratch.18 Discussion Several advantages can be drawn from including CAD/CAM dental technology, 3-D scanning and the use of mill materials for all-ceramic restorations. Even though clinical studies have shown that mar- ginal fit of CAD/CAM restorations is compared to conventional restorations the fabrication of dental restorationsisstillacomplextaskthatrequiresexpe- rience, knowledge and skills. Theincorporationofnewsystemsandmaterialsbring a lot of concerns regarding system implementation, capabilities and mechanical properties of the differ- ent materials. One of the biggest problems that still remaininCAD/CAMdentalsystemsistheaccuracyof eachstepintheCAD/CAMchain,fromdigitalimpres- siontothemillingstep.Usingcomputeraidedmanu- facturingisdependentonthecalibrationofhardware with software in the workflow. Furthermore, the virtual configuration of the die spacer between the Table II: Most popular dental CAD systems available for 2015. Table III: Most popular dental CAM systems available for 2015. CAD System Manufacturer File output 3Shape 3Shape Propietary/STL ARTI / Modelliere Zirkonzahn STL CeraMill Amann Girrbach STL Cercon Eye/Art Dentsply Propietary CEREC Sirona Dentsply Propietary Delcam Delcam STL DentalWings DentalWings STL PlanCAD Planmeca STL Exocad Exocad STL InLab Sirona Dentsply Propietary Procera Nobel Biocare Propietary/STL CAM System Manufacturer Type Milling materials BruxZir Mill Glidewell Dry Zirconia,wax,PMMA CeraMill Motion Amann Girrbach Wet/dry Zirconia,Glass ceramic,ceramic resins,Lithium Disilicate,Chrome Cobalt,PMMA,wax,titanium Datron D5 Datron Wet/dry Zirconia,Glass ceramic,ceramic resins,Lithium Disilicate,Chrome Cobalt,PMMA,wax,titanium Denzir Ivoclar Dry Zirconia PlanMill Planmeca Wet Lithium disilicate,ceramic resin InLab MC XL Sirona Wet/dry Zirconia,Glass ceramic,ceramic resins,Lithium Disilicate,Chrome Cobalt,PMMA,wax,titanium LAVA 3M ESPE Dry Zirconia,wax,glass ceramic M1/M5 Zirkonzahn Wet/dry Zirconia,Glass ceramic,ceramic resins,Lithium Disilicate,Chrome Cobalt,PMMA,wax,titanium Procera Nobel Biocare Wet Aluminum oxide Zenotec Ivoclar Dry Zirconia,wax,PMMA 32016