Digital Roadmap IN DENTAL IMPLANTOLOGY

Digital roadmap IN DENTAL IMPLANTOLOGY

 

Modern CAD-CAM technologies allow improving the quality of design and manufacturing of implant-supported structures, as well as conventional prosthetic restorations. The possibilities provided expand the choice of treatment and provide great speed and precision. The use of CAD-CAM technology began in the 1970s. Dr. François Dure formulated the hypothesis of transmitting an optical image from the prosthetic field. In 1983, he was the first to produce a single crown using CAD-CAM software – Computer Aided Design.

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This technology received an additional boost in the mid-1980s with the work of Moman and Brandestini. The technology is based on digital impressions, which transmit digital data from the prosthetic field. They are registered using an intraoral scanner. It directly builds a 3D image of hard dental tissues and adjacent soft tissues. It sequentially builds a virtual 3D model of the upper jaw, the lower jaw and both jaws in central occlusion. The comparison of the three models in a common project is done by selecting common points. The composite model is sent directly to the design computer for modeling in the form of an STL file.

The advantages of the intraoral scanner are speed and the ability to take the digital impression in the dental office and directly assess the quality of the resulting model.

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Digital Roadmap IN DENTAL IMPLANTOLOGY Another option for digital transmission of information is to take a preliminary silicone impression and scan it with a laboratory scanner. The laboratory scanner allows for scanning plaster models or printed models. Occlusal relationships can be transferred from an occlusal device, articulator or from a taken occlusal record. The combination of the three models (upper jaw, lower jaw and in central occlusion) is again done by fixing common points. The models are adjusted to a match, which is registered by the homogeneity of the two different-colored models.

Its advantages are high scanning accuracy and no risk of shifting the focus from the model.

The resulting 3D models allow for inspection and assessment of their quality under magnification. With the "With missing elements" correction function, elements that are not in the modeling field can be cut out or supplemented. They can also be illuminated and their surface appearance can be changed, enlarged and inspected in detail in all three planes of space.

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The models thus formed are sent in the form of an STL file to the CAD-CAM design computer.

The 3D models obtained from the scan are opened in CAD-CAM design software on the computer.

There are different design softwares – Exocad, 3 shape dental, Dental wings, Romexis, Cerec. They provide different design solutions with similar general steps for its implementation. After modeling the prosthetic construction, a separate STL file of the construction is created, which is sent to the CAD-CAM computer via an internet connection.

The computer's CAD-CAM software allows the positioning of the structure in the material from which it will be made and the driving of the milling machine.

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In modern dental implantology, some authors apply a digital work protocol or a combined approach with elements of the classical method of implant prosthetics. The aim is to find the optimal option for the manufacture of a maximally precise construction. Other authors present and develop a completely digital work protocol, which begins with digital planning, guided surgery, intraoral scanning of the implant, through a digital impression transfer Scan body.

This is followed by 3D modeling of the virtual prosthetic structure using CAD-CAM software. The information is sent in the form of an STL file to the milling machine, which creates the real prosthetic structure (CAD-CAM – 1). The technology of machine milling allows for the development of new materials for the manufacture of implant superstructures. They must meet the mechanical, functional and aesthetic requirements for dental materials.

• Digital roadmap
• IN DENTAL IMPLANTOLOGY