Technologies:

CAD/CAM

2013
Metal-Ceramic vs All-Ceramic
Improved Materials
 Improved Technology
 CAD/CAM  Procera
 Cerec
Computer Aided  Everest
Design/  Lava
 Celay
Computer Aided  Wol-Ceram Epc-CAM
Manufacturing  Cercon
etc.
 Application of science to dentistry
CAD/CAM made it possible to work with a new generation
of hard ceramics in dentistry. These materials cannot be
cast so therefore must be machined. In order to machine
something a cutting path is required. The cutting path is
generated from digital scanned data.

 SCAN THE OBJECT

 CREATE DIGITAL DATA POINTS

 GENERATE CUTTING PATH

 MACHINE REPLICA OBJECT

 CAD/CAM
What is dental CAD/CAM?
Dental CAD/CAM is the process by which the model of a
prepared tooth is scanned. This data is then used to
generate the coping design (CAD) which in turn is used
to generate a cutting path for manufacturing the coping
(CAM).
Computer Aided Design (CAD) and Computer Aided
Manufacture (CAM) in restorative dentistry can be used
to:
 Reduce production time for copings and frameworks;
increasing overall productivity
 Introduce consistent and measurable accuracy
 Provide evidence of product quality
CAD/CAM technology
 Scanner
- digital impression of the
prepared teeth
 Software – CAD
- digital cast on the screen

- virtual design of the model

 Milling unit – CAM
- computer aided milling unit
(cnc)
- grinding process
 Non-contact sensor:  Contact sensor:
optical: laser point, mechanical
laser stripe, white
light, fotogrammetry
Elements – Presintered, yttrium-stabilised,
HIP zircon
material  Copings and bridges

versatility Non- shrinkage zircon silicat

 Full crowns in the posterior
region

Industrial manufactured titanium

blanks
 Copings, crowns and bridges

Leucite-reinforced glass ceramics

 Inlays, Onlays, Veneers as well
as anterior and posterior copings
 Green processing
 Millingof presintered ceramic blocks
 advantage: easy to process, grinding instruments do not
have to be replaced that often
 disadvantage: porous presintered zirconia shape shrinks
during final sintering- enlarged substructures= software
calculated
 Hard processing
 Milling
of dense sintered ceramic blocks
 Takes more time, grinding instruments wear off
 HIP= Hot Isostatic Press : special sintering
technique
 Hightemperature and pressure applied to densify the
material, gaining 20% more in strength
Frameworks zirconium oxide
 CAD/CAM methods

 In clinic - the dentist purchases an intra-oral scanner, the

cutting machine and the consumable materials. All the
work is done by the dentist at the clinic. Mainly suitable
for full crowns, inlays and onlays.

 In lab - the laboratory purchases a scanner, cutting

machine and consumables. The dentist sends the
patient's impressions and prescription to the lab. The lab
scans models of the prepared teeth, designs the
restoration and machines the restoration.
 CAD/CAM methods
 Centralised machining - in this situation the lab
purchases or leases a scanner only. Again, the dentist
sends the patient's impressions and prescription to the
lab. The lab scans models of the prepared teeth and
designs the coping and then sends this data off to an
external machining centre. The machined coping is
returned to the lab for veneerig.

 Centralised scanners and machining - the laboratory

sends the model away to the external centre to be
scanned. The coping is also designed and machined at
the external centre. The model and coping are sent back
to the lab for veneering.
Procera-
Centralised machining

Stockholm/ Sweeden
 Making a sectioned cast in
the lab
 Scanning the die and the cast
 CAD-data sent to central
machining center (checking)
 Milling starts in 19 minutes
 Copings (hand) packed and
mailed
 delivered within 5 days
 First patient 1985 (1994)
Katana-Centralised machining

Semmelweis Laboratory
Everest-in lab
• Scan-
Measuring
unit

• Engine-
Milling and
grinding
unit

• Therm-
Sintering
unit

• Elements-
Materials
Software User interface
Light beam projection

 15 projection
sequences

 The rotary plate

moves on its vertical
and horizontal axis
during this process
CAD- Software

 The
preparation
limit is
automatically
detected
Design
Decision guidance

Form of margins

Juncture region
Metal margin
Framework thickness
 3-D virtual view of the occlusion on the screen
 The distances between occlusion and framework
construcion are shown with different colours.
 Easy, quick and safe design of frameworks in
connection with the virtual wax knife.
Design
Virtual wax knife
- Can be used to process the virtual framrwork in three dimensions on
the screen
- Precise addition or removal of virtual material enables quick and
precise waxing
Design

Cantilever bridge Bridge for veneering

CAM Engine
 5-axis technology
 Ensures secure milling of
undercuts
• The wide degree of
freedom during the
milling process
enables complex
geometry
• Engine speed
5.000 – 80.000 min-1
Engine
 Simultaneously controlled 5-axis
technology
 Thin crown margins and best
marginal fit
 The wide degree of freedom during
the milling process enables complex
geometry
 Engine speed
5.000 – 80.000 min-1
Engine

 The 5-axis milling strategy

5-axis technology Milling of titanium

Cerec-in clinic
 Intraoral scanning-no impression
 Digaital images of tooth and opposing arch
CAD and CAM
Milling the crown
20 minutes chairside
Milling titanium
Thank You for
Your Attention!