Though computer-aided design/computer-aided manufacturing (CAD/CAM) for dentistry has been available for the past 25-30 years, it’s only been within the past decade that the technology has moved from the lab to chairside. Much like radiovisiography technology, dental CAD/CAM technology got its start in Europe in the 1970s and 1980s. However, early versions of CAD/CAM systems were so cumbersome and complicated that they were considered more of a hindrance to practice workflow than an advantage, and were mostly confined to laboratories. Fortunately, advances in the technology over the past few years have made CAD/CAM a more viable option for dentists looking to do restorations in-house.
From the Lab to Chairside—What has Changed?
CAD/CAM systems allow users to scan, design, mill and place a crown in a single appointment. One reason that this system has become much more accessible has been the introduction to the market of intraoral scanners that eliminate both traditional impression materials and the powders and sprays associated with earlier scanners. These powder-free scanners save time and also create an overall more comfortable experience for the patient. Another advancement within the past few years have been scanners that don’t require trolley systems and can simply be unplugged and reconnected to a computer in each operatory.
Some CAD/CAM systems even allow dentists to take traditional impressions if they so choose and then use an existing CBCT unit to scan the mold. This kind of flexibility is a key factor in why more and more dentists are choosing to bring their restorations in-house. When you have the option to use equipment you’re already using anyway, why not?
New advancements in design software also give dentists more control over the outcome of their restorations—guaranteeing consistent results for patients. Some software design automated 3D models that require almost no manipulation from the doctor and the design can be completed in just minutes.
Finally, compact and vibration-free milling machines can mill crowns, inlays and onlays in as little as 15 minutes. Some machines are only the size of a desktop printer, meaning practices don’t have to sacrifice valuable real estate for new equipment. Also contributing to the recent uptick of in-house restorations has been an expansion in the kinds of materials that can be used to mill crowns, such as all-ceramic, hybrid ceramic or resin-based materials. This means doctors can work with their preferred materials and it’s easier than ever to create natural-looking results for patients.
The Future of CAD/CAM Technology
Having been used by dentists for a few years now, CAD/CAM is experiencing yet another evolution. Orthodontists are finding the intraoral scanners used to create restorations are perfect for orthodontic applications.
Powder-free scanners make it easy to create digital models and orthodontic-specific design software can take basic distance measurements including overjet, overbite, pressure map, arch length, tooth size, crowding measurement and more, to further improve doctors’ diagnostic capabilities. Digital models eliminate the need to make and store physical plaster models, saving valuable time and space for practices. This environmentally friendly solution also ensures that patients’ models are not damaged, lost or mixed-up over time. Plus, digital models can be easily shared with third-party labs to produce orthodontic appliances.
From heavy machinery hidden in the back of labs to scanners easily portable from operatory to operatory, CAD/CAM technology has come a long way, and different specialties are continuing to reappropriate it to meet their practices’ needs.
When was the first time you saw CAD/CAM in action? Where do you see CAD/CAM going in the future?