Shaping Dentistry with CAD/CAM Technology

Authored By: Lesley Ranft

CAD/CAM is an acronym that means computer-aided design/computer-aided manufacturing. CAD/CAM technology has been used in the manufacturing industry for many years. Today, CAD/CAM technology is used in dentistry to help dentists and dental lab technicians fabricate precise shapes and sizes for dental restorations, including inlays, onlays, crowns, and bridges. Dentists use CAD/CAM technology to provide their patients with durable, well-fitted single and multiple tooth restorations in a more efficient manner than traditional lab-fabricated restorations.

Another advantage of CAD/CAM technology is that it can allow a typical two-visit tooth restoration to be accomplished in one visit, provided that the dentist has the technology in the office (chairside CAD/CAM).

Dentists and dental lab technicians use CAD/CAM technology to design the anatomical features, size and shape of a tooth restoration on a computer. The CAD/CAM computer screen displays a 3-D custom image of your teeth and gums, allowing your dentist to use a cursor to draw the precise design of the tooth restoration. The CAD/CAM machine fabricates the restoration through a milling chamber that crafts the tooth-like ceramic material into a precise replica of the drawing.

The Advantages of CAD/CAM Technology

One of the advantages of CAD/CAM technology is that, provided the CAD/CAM equipment is located in the dental office, your dentist does not need to create a molded impression of your teeth. Secondly, there may be no need for a temporary restoration or a return visit to the office for a permanent restoration. If the technology is located at a dental lab rather than the dental office, then a two-visit restoration is necessary.

CAD/CAM technology cannot replace the dentist or dental lab technician who must be accurate in creating the initial tooth preparation and impression. For example, a high level of skill is crucial in fabricating and fitting crowns. An ill-fitted crown can leave space between the teeth or between the tooth preparation and the crown, which may be problematic in two ways:

• Increased risk of infection or disease because debris may lodge in the open space.
• Increased risk of teeth shifting because of the open space.

Previously, it has been difficult to offer high levels of tooth restoration strength without using metals, such as in an amalgam dental filling or gold restoration. However, today's porcelain ceramics work very well in the milling chamber, providing strength, durability, and a high esthetic value. Furthermore, today's materials such as zirconia may be more “fracture resistant” than those of the past. Although CAD/CAM is an exciting technology, it is not necessarily applicable to all procedures requiring porcelain.

Be aware that not all dentists have experience with CAD/CAM technology. In fact, some dentists may find it difficult to imagine why a wax molded impression that fills every tooth crevice should be replaced by CAD/CAM technology.

The Cost of CAD/CAM Technology

The cost of having a restoration fabricated with CAD/CAM technology depends on several factors, including:

• The type of restoration.
• The material choice for the tooth replica.
• The focus of the dentist.
• Cosmetic requirements.
• The location of the dentist.
• The type of dental insurance you have.

Dentists who use CAD/CAM technology in the office must make a significant investment in the CAD/CAM equipment, and this investment may drive procedure costs up. Of course, CAD/CAM used in a dental lab does not require an investment on the part of the dentist. However, the materials used in CAD/CAM restorations may also be more costly than traditional materials.

In the end, the use of CAD/CAM technology does not automatically mean that procedure costs will rise. To review average costs of tooth restorations such as inlays, onlays, crowns, bridges, and single and multiple tooth restorations, please visit those procedure pages on this website.

[Updated May 2009]

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