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ePaper created 2017-02-21, 16:08:16 | version 1.38.0
literature review _ CAD/CAM material and systems CAD System 3Shape ARTI/Modelliere CeraMill Cercon Eye/Art CEREC Delcam Dental Wings PlanCAD Exocad InLab Procera Table II_Most popular dental CAD systems available for 2015. Table III_Most popular dental CAM systems available for 2015. Manufacturer 3Shape Zirkonzahn Amann Girrbach Dentsply Sirona Dentsply Delcam Dental Wings Planmeca Exocad Sirona Dentsply Nobel Biocare File output Propietary/STL STL STL Propietary Propietary STL STL STL STL Propietary Propietary/STL rations out of a replica of the restoration. Some years after, the Cercon system (DENTSPLY Cer- amco) was able to design and mill zirconia resto- rations out of a wax pattern.1 Almost at the same time that these companies developed the first copy mill prototypes, Lava (3M ESPE) introduced in 2002 the fabrication of yt- tria-tetragonal zirconia polycrystal (Y-TZP) cores and frameworks for all ceramic restorations. With the Lava system, the die is scanned by an optical process, the CAD software designs and enlarge the restoration or framework that is milled from a pre-sintered blank. Studies on marginal adap- tation suggest that Lava restorations have a mar- ginal fit that can be as low as 21 microns.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 differentiate their products by having a full CAD/ CAM platform or by focusing on specific areas of expertise like CAD software and intraoral scan- ners; these companies claim to be open platform because their systems allow to export universal files such as STL or OBJ (Fig. 5) to be used with the majority of nesting softwares and milling ma- chines that are able to import them. Defenders of closed platforms claim that the integration of different CAD/CAM systems does not allow for a good integration between parts and probably leads to the incorporation of fabrication errors; at this point no research about systems integration is available. Table II shows some of the systems used for dental CAD with their file output; Table III shows some of the most used CAM systems with their material recommendations and capabilities. Some of the main concerns from clinicians about all-ceramic CAD/CAM restorations accuracy of fit are: scanning resolution, software designing limitations, and milling hardware limitations of accuracy. Clinicians’ and technicians’ experience with the CAM/CAM system integration is also a key factor for fabricating good restoration; the computer software per se will not allow an inex- perienced operator to create an excellent dental restoration from scratch.18 _Discussion Several advantages can be drawn from includ- ing CAD/CAM dental technology, 3-D scanning and the use of mill materials for all-ceramic resto- rations. Even though clinical studies have shown that marginal fit of CAD/CAM restorations is com- pared to conventional restorations the fabrication of dental restorations is still a complex task that requires experience, knowledge and skills. The in- corporation of new systems and materials bring a lot of concerns regarding system implementa- tion, capabilities and mechanical properties of the different materials. One of the biggest problems that still remain in CAD/CAM dental systems is the accuracy of each step in the CAD/CAM chain, from digital impression to the milling step. Using CAM System Manufacturer BruxZir Mill Glidewell Type Dry Milling materials Zirconia, wax, PMMA CeraMill Motion Amann Girrbach Wet/dry Zirconia, Glass ceramic, ceramic resins, Lithium Disilicate, Chrome Cobalt, PMMA, wax, titanium Datron D5 Denzir PlanMill Datron Ivoclar Planmeca Wet/dry Zirconia, Glass ceramic, ceramic resins, Lithium Disilicate, Chrome Cobalt, PMMA, wax, titanium Dry Wet Zirconia Lithium disilicate, ceramic resin InLab MC XL Sirona Wet/dry Zirconia, Glass ceramic, ceramic resins, Lithium Disilicate, Chrome Cobalt, PMMA, wax, titanium 3M ESPE Zirkonzahn Dry Zirconia, wax, glass ceramic Wet/dry Zirconia, Glass ceramic, ceramic resins, Lithium Disilicate, Chrome Cobalt, PMMA, wax, titanium Nobel Biocare Ivoclar Wet Dry Aluminum oxide Zirconia, wax, PMMA LAVA M1/M5 Procera Zenotec 20 dentistry1_2017cosmetic