The application of CAD / CAM technology in the manufacture of all-ceramic restorations

Brzi razvoj dentalne medicine, kao kliničko – stručne i znanstvene discipline podrazumijeva uvođenje računalne tehnologije i digitalizaciju u dentalnoj medicini. U tom smislu, na tržištu se pojavljuje sve veći broj CAD/CAM (eng. Computer-Aided Design / Computer-Aided Manufacturing) sustava. Kako im samo ime kaže, sustav se sastoji od jedinice kojom se skenira ispreparirani zub ili kavitet, računalnog programa pomoću kojega se oblikuje budući nadomjestak te, završno, CAM jedinice kojom se izrađuje nadomjestak prema zadanom obliku i veličini. CAD/CAM sustavi se razlikuju s obzirom na način izrade protetičkog nadomjeska. Tijekom izrade protetičkog nadomjeska izravno u ordinaciji (in office sustav), liječnik skenira zub intraoralnom kamerom u ustima pacijenta, a u slučajevima kada se protetički nadomjestak izrađuje u dentalnom laboratoriju (in lab sustav, proizvodnja u centraliziranim centrima) u ordinaciji se uzima konvencionalni otisak koji se potom šalje u dentalni laboratorij te skenira ili se pak izlijeva radni model koji se potom skenira u laboratoriju. Moguće je, također, uzeti intraoralni digitalni otisak te sken poslati u dentalni laboratorij. Bez obzira na vrstu primjenjenog CAD/CAM sustava, važna je prednost CAD/CAM tehnologije u kraćem vremenu potrebnom za izradu nadomjeska. Uz razvoj same tehnologije dolazi i do razvoja novih estetskih keramičkih materijala rilagođenih strojnoj izradi. S druge strane, veliki je nedostatak visoka cijena sustava kao i manjak informiranosti o sustavima i radu s njima. Spomenute prednosti idu u korak sa sve većim estetskim i funkcionalnim zahtjevima pacijenata, a na liječniku dentalne medicine je da u skladu sa svojim mogućnostima izabere CAD/CAM sustav i o njemu se educira kako bi gotovi protetički nadomjesci bili što precizniji i kvalitetniji, a postupak izrade trajao što kraće.Rapid development of dental medicine as a clinical, professional and scientific discipline involves introduction of computer technology and digitization in the profession. In this respect, there is an increasing number of CAD/CAM (Computer-Aided Design / Computer-Aided Manufacturing) systems on the market. As the name itself suggests, the system consists of an unit which scans an embedded tooth or cavity, a computer program by which the future restoration is formed and, finally, a CAM unit by which the restoration is made according to the default format and size. CAD/CAM systems differ with respect to the method of prosthetic restoration. During a prosthetic restoration done directly at the office (in office system), the physician scans the tooth with an intraoral camera directly in the mouth of a patient, and when the prosthetic restoration is made in a dental laboratory (in lab system, production in centralized centers), a conventional impression is taken at the office, then sent to a dental laboratory and scanned, or a working model is molded and then scanned in the lab afterwards. Moreover, it is also possible to take an intraoral digital print and send the scans to a dental laboratory. Regardless of the type of CAD/CAM system used, the important advantage of CAD/CAM technology is the shortest time needed to make the restoration. Along with the development of the technology itself, the development of new esthetic ceramic materials adapted to machine processing is being developed as well. On the other hand, there is a huge disadvantage of high cost of the system as well as the lack of system information and of the necessary work experience. The aforementioned advantages go hand in hand with the increasing esthetic and functional requirements of patients, while the dental ractitioner is the one to choose the CAD/CAM system in accordance with their capabilities, to educate themselves about it so that the finished prosthetic restorations can be as precise and as good quality as possible, and also to make the production process as short as possible