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Computer-assisted dental prosthetics allows you to make a crown or a bridge even during one visit to the dentist. Saving time is not its only advantage. What is the CAD / CAM system and how is it used in Polish dental practice?

CAD / CAM technology in dentistryis used more and more often. Computer Aided Design (CAD) and Computer Aided Manufacturing (CAM), i.e. the CAD / CAM system, is a technology that is still being developed and improved. In the Polish dental practice, only permanent restorations can be made in the CAD / CAM system: crowns (also on implants), bridges, veneers, inlays and onlays, abutments.

- The techniques of digital preparation of removable dentures are already being developed in the world, but at the moment it is 3-4 times more expensive than in the case of traditional techniques, therefore in Poland digital design of removable dentures is not used yet - explains Dr. Krzysztof Sołtyk, specialist in dental prosthetics, pioneer of the CAD / CAM technique in Polish dentistry. - With time, when the technique of designing removable dentures is improved and becomes widely used, they will probably also become, just like currently made permanent restorations - adds the specialist.

CAD / CAM in dentistry: how does it work?

In the CAD / CAM technique, the dentist introduces a scanner into the patient's mouth - the camera placed on its tip takes a series of photos of the environment intended to recreate the tooth, i.e. the teeth adjacent to it and the teeth of the opposite dental arch, thus obtaining a three-dimensional image of the bite patient. The scan takes 2-3 minutes to download.

Then the dentist enters additional data into the program: he marks the contour of the crown on a virtual model, the angle of its insertion, its position in relation to the adjacent teeth, etc. Based on this information, the computer designs the shape of the restoration in three dimensions. The design is refined by the doctor, and the computer signals any inaccuracies and corrects any mistakes. It takes 15-20 minutes for an experienced specialist to prepare a project. The finished project, fitted into the virtual block, is sent to the numerical milling machine. The specialist selects a block of suitable material and places it inthe milling machine, which cuts and polishes the restoration in minutes. You can also correct the color of the crown or the bridge, matching it to the natural color of the patient's teeth, matting, better glazing, etc. Finally, the restoration is fixed in the patient's jaw.

CAD / CAM: longer durability of restorations

- A doctor who designs restorations in digital technology can choose from many more types of materials than in traditional technology. There are already available ones that can only be used in computer technology - explains Dr. Krzysztof Sołtyk. The blocks from which the milling machine cuts the restorations are manufactured on an industrial scale under optimal conditions, which is why these materials are increasingly durable, which ensures longer durability of restorations compared to hand-made ones.

CAD / CAM in dental diagnostics

The CAD / CAM technique is also used for diagnostics. - During the scan, the program analyzing the shape of the dental arches can detect bite irregularities, tooth displacements or wear and incorrect positioning of older crowns or bridges - emphasizes Dr. Sołtyk. - The program allows you to analyze the structure of the bite in the static, and also calculates, thanks to special sensors placed on the teeth, how the patient's teeth work during chewing. In this way, for example, excessive pressure on certain surfaces, which could lead to tooth damage over time, can be detected. This enables the bite to be corrected and the tangential and chewing surfaces to work perfectly, he adds. The computer programming technique also allows you to archive virtual models and document three-dimensional changes in the teeth and surrounding soft tissues in a given patient.

Advantages of digital prosthetics

In the traditional technique, first an impression was made to obtain a negative bite of the patient, in the laboratory a plaster cast was made on its basis, this in turn was used to model a metal crown, on which a porcelain crown was placed at the end. So it was a multi-stage work requiring the work of a team of people. It had to go on, and at every stage human error was possible; it was enough for the technician to add too much water when making the plaster cast, or the water was too hot to make the casting less accurate. In addition, the plaster shrinks when it dries - that is why the restorations made on the basis of castings were inevitably less precisely matched. Digital design allows you to bypass the plaster modeling phase of the dental arch and significantly reduce the time to complete restorations in the laboratory, eliminating the need to provide the patient with temporary restorations. Therefore, computer technology has two essentialsAdvantages for the patient: it saves time and allows you to precisely adjust the restoration. If the restoration does not require additional color correction and the then necessary kiln firing, the work can be done in one visit. What's more, at the stage of "characterization" of the restoration, the patient can participate in the correction of the color and, to some extent, the shape of the tooth, and on request, the doctor can send him a ready 3D project for approval by e-mail in pdf format.

Worth knowing

Comparable costs

Computer prosthetics has been used in Poland for 7 years and is developing at a rapid pace - over the last year the percentage of crowns made with this technique increased by 50%. Therefore, it is no longer a complete novelty and CAD / CAM restorations are comparable in price to those made using traditional techniques; in some clinics they are even cheaper - says Dr. Sołtyk. The equipment needed to work in the CAD / CAM system is quite expensive, but on the other hand, the specialist does not have to pay for the laboratory work, the cost of materials for impressions, casts and temporary restorations for the patient is also eliminated - in total, the costs of the office are equal , which has a positive effect on the price of supplements (crown from PLN 800 to PLN 1,800).

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