As more and more dental procedures get performed in the US with implants and cosmetic dentistry, one of the main goals is to perform them in a single setting. Typically, different types of dental restorations, including veneers, crowns, orthodontic appliances, bridges, inlays and onlays take multiple stages to complete.
CAD is short for Computer Aided Design and CAM means Computer Aided Manufacturing. Prior to the mid 1980’s, neither existed for dentistry. As they began usage in the field of dental medicine in that decade, the technology was brand new, requiring way too much time to actually make something useful.
Because of this, it was relegated to the dental fabrication laboratory, rather than in the actual dental practice. As software and hardware improved over the next decade, utilization in the actual practice became a reality. Thus implants can be made in the office that are aesthetic, durable, and well fitting in a matter of hours instead of days.
Prior to CAD/CAM, a lot of dental restorations required temporary implants. Crowns for instance, necessitated placement of a temporary implant for several weeks. Then it was removed after the permanent crown was fabricated in a laboratory, shipped in, and then placed. The bonding material sets within hours, so the newest methods with CAD/CAM truly takes only one setting for the procedure.
So how does the CAD/CAM process work? The restorations are fabricated from solid blocks of white porcelain or composite resin. This is called milling and matches the shade of the restored tooth. So there are quite a few shades of white from which to choose. Once an image is take of the problem tooth, the computer uses the image with its software to create a fix for the “problem” which is a virtual restoration.
The software takes this data and sends it to the milling chamber where the restoration is carved from the selected shade of white block made out of either resin or porcelain. Once the implant is finalized, the backside of the restoration is etched with acid along with the front of the tooth. This makes for a microscopic increase of surface area on both opposing surfaces, and then bonding materials allow for the fusion between the milled restoration and the existing tooth.
CAD/CAM restorations have been a “disruptive” technology in dentistry for a few reasons. The first is the time factor for the patient not having to undergo multiple stages. The second is that the implants blend very well with the natural tooth structure, and metal is not required as it was in the past. In addition, without the additional stages cost has decreased overall.