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CAD/CAM - international magazine of digital dentistry, Italian Edition, No.2, 2017

literature review _ CAD/CAM material and systems CAD System Manufacturer File output 3Shape 3Shape Proprietary/STL ARTI / Modelliere Zirkonzahn CeraMill Amann Girrbach Cercon Eye/Art Dentsply CEREC Delcam Sirona Dentsply Delcam Dental Wings Dental Wings Planmeca Exocad STL STL Proprietary Proprietary STL STL STL STL PlanCAD Exocad InLab Procera Table II_Most popular dental CAD systems available for 2015. Table III_Most popular dental CAM systems available for 2015. Sirona Dentsply Proprietary Nobel Biocare Proprietary/STL (DENTSPLY Ceramco) was able to design and mill zirconia restorations out of a wax pattern.1 Almost at the same time that these compa- nies developed the first copy mill prototypes, Lava (3M ESPE) introduced in 2002 the fabri- cation of yttria-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 frame- work that is milled from a pre-sintered blank. Studies on marginal adaptation suggest that Lava restorations have a marginal 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 intra- oral scanners; 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 machines that are able to import them. Defenders of closed platforms claim that the inte gration of different CAD/CAM systems does not allow for a good integration between parts and probably leads to the incorporation of fab- rication 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 rec- ommendations and capabilities. Some of the main concerns from clinicians about all-ceramic CAD/CAM restorations ac- curacy of fit are: scanning resolution, software designing limitations, and milling hardware lim- itations of accuracy. Clinicians’ and technicians’ experience with the CAM/CAM system integra- tion is also a key factor for fabricating good res- toration; the computer software per se will not allow an inexperienced operator to create an ex- cellent dental restoration from scratch.18 _Discussion Several advantages can be drawn from in- cluding CAD/CAM dental technology, 3-D scan- ning and the use of mill materials for all-ceramic restorations. Even though clinical studies have shown that marginal fit of CAD/CAM resto- rations is compared to conventional restorations 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 PlanMill Planmeca 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 LAVA M1/M5 Procera 3M ESPE Dry Zirconia, wax, glass ceramic Zirkonzahn Wet/dry Zirconia, Glass ceramic, ceramic resins, Lithium Disilicate, Chrome Cobalt, PMMA, wax, titanium Nobel Biocare Wet Aluminum oxide Zenotec Ivoclar Dry Zirconia, wax, PMMA 20 2_2017

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