CAD CAM - AN INTRODUCTION

 CAD is the use of computer systems to aid in the creation, modification, analysis, or
optimization of a design
 CAD output is often in the form of electronic files for print, machining, or other
manufacturing operation.
 CAM refers to the use of a computer to assist in all operations of a manufacturing plant,
including planning, management, transportation and storage.
 CAM primary purpose is to create a faster production process and components and tooling with
more precise dimensions and material consistency with the required amount of raw material (thus
minimizing waste) and simultaneously reducing energy consumption.

CAD CAM entered in the field of dentistry in the year 1980’s
earlier an inordinate amount of time required to produce a
viable product. This inefficiency prevented its use within
dental offices and limited it to lab side .
The recent developments in CAD
software's such as
CEREC,DELCAM,RENISHAW plc have enabled
the chairside use of CAD/CAM that’s in
dental offices.

CROWNS
ONLAY AND INLAY
BRIDGES
VENEERS
ORTHODONTIC
APPLIANCES
DENTURES

1. A digitalization tool/scanner that transforms geometry
into digital data that can be processed by the computer
2. Software that processes data and, depending on the
application, produces a data set for the product to be
fabricated
3. A production technology that transforms the data set
into the desired product.

Scanner is a data collection tools that measure three dimensional jaw and tooth structures and
transform them into digital data sets. Basically there are two different scanning possibilities
• optical scanner • mechanical scanner

 The basis of this type scanner is the collection of three-dimensional structures in a so-
called ‘triangulation procedure’.
 Here, the source of light (eg.laser)and the receptor unit are in a deﬁnite angle in their
relationship to one another.
 Through this angle the computer calculates a three-dimensional data set from the image
on the receptor unit.

 In this scanner, the master cast is read mechanically line-by-line by means of a ruby ball and the
three-dimensional structure measured.
 This type of scanner is distinguished by a high scanning accuracy.
 The drawbacks of this data measurement technique is long processing time.

:
 Design software assess the 3d data obtained from the scanners and helps to design the
restoration accurately and aesthetically.
 Based on the usage these software can be differentiated as chair side software and lab
software.
 Chair side software are present in the dental office itself and designed by the dentist
itself
Whereas lab software are present in the dental lab and used by the lab technicians.

The construction data produced with the CAD software are converted into milling strips
for the CAM-processing and ﬁnally loaded into the milling device. Processing devices are
distinguished by means of the number of milling axes:
3 AXIS MILLING DEVICE 4 AXIS MILLING DEVICE 5 AXIS MILLING DEVICE

These milling devices are short milling times and
simpliﬁed control by means of the three
axes(X,Y,Z)
These milling devices are usually less costly than
those with a higher number of axes.
Examples of 3-axis devices:
inLab (Sirona),
Lava (3M ESPE),
Cercon brain (DeguDent).
In addition to the three spatial axes, the tension
tension bridge for the component can also be
turned inﬁnitely variably.
As a result it is possible to adjust bridge
constructions with a large vertical height
displacement into the usual mould dimensions and
thus save material and milling time.
Example of 4 axis devices;
Zeno (Wieland-Imes).
In addition to the three spatial dimensions and the
the rotatable tension bridge (4th axis), the
possibility of rotating the milling spindle (5th axis).
This enables the milling of complex geometries
with subsections
Example in the Laboratory Area: Everest Engine
(KaVo).
Example in the Production Centre: HSC Milling
Device (etkon),
The quality of the restoration does not necessarily increase with the number of processing axes. It
results much more from the result of the digitalisation, data processing and production process.

Based the type of milling its divided into two types,
WET MILLING DRY MILLING

 Dry processing is applied mainly with respect to zirconium oxide blanks with a low degree of
pre-sintering.
 This offers several beneﬁts:
• Minimal investment costs for the milling device
• No moisture absorption by the die ZrO2 mould, as a result of which there are no
initial drying times for the ZrO2 frame prior to sintering.
 Disadvantages:
• The lower degree of pre-sintering results in higher shrinkage values for the
frameworks. Some manufacturers also offer the option of milling resin material in a dry milling
process.
 Zeno 4030 (WielandImes)
 Lava Form
 Cercon brain.

 In this process the milling diamond or carbide cutter is protected by a spray of cool liquid
against overheating of the milled material.
 This kind of processing is necessary for all metals and glass ceramic material in order to
avoid damage through heat development.
 A higher degree of pre-sintering results in a reduction of shrinkage factor and enables less
sinter distortion.
 Everest (KaVo)
 Zeno 8060
(WielandImes)
 inLab (Sirona)

MATERIALS USED: titanium,titanium alloys,chrome cobalt alloy.
USES: Crowns,
Copings,
Abutments.
DISADVANTAGE: High metal attrition,
High material cost.
 coron (etkon: non-
precious metal
alloy),
 Everest Bio
T-Blank (KaVo,
 pure titanium)

MATERIAL USED: Resin supplied as block.
USES: Temporary crowns,
Provisional FPD frameworks,
Full anatomical long term temporary prostheses.
 artegral imCrown,
 Merz Dental

MATERIALS USED: Monochromatic and multicoloured lithium silicate blocks.
USES: Crowns(partial and full)
FPD frame works,
veneers
Inlays,
onlays,
bridge.
ADCANTAGES: High mechanical stability(320 mpa),
Good aesthetics,
 Vitablocs TriLuxe
(Vita),
 IPS Empress CAD
Multi
(IvoclarVivadent)

MATERIALS USED: Vita In-Ceram Alumina (Al2O3)
Vita In-Ceram Zirconia (70% Al2O3, 30% ZrO2
VITA In-Ceram Spinell (MgAl2O4)
USES:Vita In-Ceram Alumina: Crown copings,
FPD frameworks.
Vita In-Ceram Zirconia: crown copings,
FPD frameworks.
VITA In-Ceram Spinell: Anterior aesthetic crowns
ADVANTAGES: High translucency,
Superior masking ability,
 Vita In-Ceram

MATERIALS USED: Aluminium oxide
yutrium stabilized zirconium.
USES: Crowns,
FPD frame works,
Implant abutments.
ADVANTAGES: High mechanical strength,
High flexural strength,
High fracture toughness,
transformation strengthening.
 In-Ceram AL Block (Vita)
 inCoris Al (Sirona)
 Lava Frame (3M ESPE),
 Cercon Smart Ceramics
(DeguDent),
 Everest ZS und ZH (KaVo),
 inCoris Zr (Sirona), In-
Ceram YZ (Vita),
 zerion (etkon) Zeno Zr
(Wieland-Imes)

GREEN STAGE
PROCESSING
blank without heat treatment,
ie an object pressed from
ceramic powder and binding
agents.
Easy processing
WHITE STAGE
PROCESSING
Pre sintered blocks
Adequate stability
Hot isostate pressed condition
No sinter shrinkage,
No sinter furnace necessary,
PROCESSING IN
HOT ISOSTATIC
PRESSING
CONDITION
Open porosity,
Linear shrinkage
expected.(25%)
Linear shrinkage(20%)
Long milling times,
High wear cutters,
Devices with high
stability and rigidity required.
carbide metal
grinders without
liquid cooling
carbide metal grinders
without water cooling
or with diamond
grinders with liquid
cooling
diamond tools and
water cooling

VARIOUS CAD CAM SYSTEMS
With increase in manufacturers there is an increase in CAD CAM system,
some of them are,
 CEREC SYSTEM,
 CELAY SYSTEM,
 PROCERA ALL CERAM SYSYTEM,
 COMET SYSTEM,
 CICERO SYSTEM.

It’s the only chair side system available in market.
TOOTH
PREPARATION
OPTICAL
IMPRESSION
COMPUTER
GENERATED
DESIGNING
COMPUTER
AIDED
MILLING
CLINICAL
PLACEMENT
 Single appointment,
 Excellent polishing,
 Less reduction of tooth structure,
 Improved aesthetics.
 VITA MARK
II
 PROCAD
 DicorMGC

This system is mostly used for inlay and onlay preparation
• CAVITY
PREPARTION DONE
CAVITY SEPARATED BY SOFT
STEEL MATRIX BAND
• A THREE COMPONENT
COMPOSITE IS USED TO TAKE
IMPRESSION OF THE CAVITY
OCCLUSAL CONTACTS ARE
CHECKED DURING
MAXIMUM
INTERCUSPARTION
• A MANIPULATIVE DEVICE IS
LUTED TO THE SUFACE OF
PATTERN TO FACILITATE
REMOVAL AND LEFT
ATTACHED UNTIL FINAL
POLYMERIZATION
PATTERN MOUNTED IN
WORKING CAST AND
OCCLUSAL & PROXIMAL
CONTACTS CORRECTED
PATTERN IS
LIGHT
ACTIVATED AND
MILLING IS DONE
CLINICAL PLACEMENT
 A precise ceramic restoration done in one
session.
 Processing time very low,
 A inlay can be milled in 3 min and onlay in 12
to 13 min.
 VITA CELA
BLANK

5.COMPUTER AIDED
MILLING.
6.CLINICAL
PLACEMENT..
3.SCANNING DONE.
4.DATA TRANSFERRED
AND DESIGNED IN
COMPUTER.
1.TOOTH
PREPARATION DONE.
2.CAST DITCHED TO
ENHANCE SCANNING
EFFICIENTLY.
 Can be used for anteriors,posteriors and
implant abutments.
 Precision fit.
 Bio compatible and homogeneity.
 Innovating colouring technique.
 Zirconia
 Alumina
 titanium

DIGITIZING DATA FROM
WAX PATTERN OR DIE
SURFACE
MATHEMATICAL
PROCESSING OF DATA
MILLING WITH THE HELP OF
COMPUTER
COORDINATE MEASURING TECHNIQUE
CLINICAL
PLACEMENT
 Precise fit.
 Good aesthetics

Computer Integrated CEramic RecOnstruction
PREPARATION OF SCAN
MODEL
•CENTRAL OCLUSSION AND
ARTICULATION
•DESIGN OF CROWN LAYER
BUILD UP
•CLINICAL PLACEMENT
TOOTH
PREPARATION
AND
IMPRESSION
OPTICAL
SCANNING
COMPUTER AIDED
MILLING
 Good static relationship,
 Dynamic occlusal contact relationship.

ADVANTAGES:
 Accuracy.
 Reduced marginal gap.
 No need for time consuming impressions.
 Short time consuming.
 Better fitting.
 More durable.
 More natural looking.
 Less reduction of tooth structure ,hence better periodontal
health.
 Excellent polishing characteristics.
 Wear hardness similar to enamel.
 Less fracture of inlay, because because it is milled from a
solid homogenous block.

CAD CAM - AN INTRODUCTION

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CAD CAM - AN INTRODUCTION