Whitepaper Sample
The Expanding Indications for CAD/CAM Technology:
Custom Prosthetics via NobelProcera
Dr. Barry Decided*
Abstract
Numerous factors influence the clinician’s ability to achieve successful outcomes
in prosthetic dentistry. The knowledge and skill of the practitioner are critical
for this objective, as are the restorative materials and clinical procedures used
in a patient’s care. The adoption of computer-aided design / computer-assisted
machining (CAD/CAM) and the digital workflow enables dental professionals
to predictably scan, design, fabricate, and deliver high-strength, esthetic
restorations for indications that include crowns, bridges, implant abutments,
and more. Dental innovators are now developing fully integrated digital
solutions designed to provide seamless workflows for dental laboratories and
practitioners. This presentation will outline the use of the NobelProcera system
in pursuit of these clinical objectives.
Learning Objectives:
•
Improved ability to identify classification of today’s ceramic materials
•
Understand historical context in development of contemporary digital-ceramic
restorations
•
Review the material benefits of NobelProcera restorations
Key Words
CAD/CAM, prosthetics, digital, zirconia, customized, Nobel Biocare
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Figure 1
The NobelProcera copings can be fabricated in shades that mask underlying
biological substructures.
Figure 2
Thin (0.4mm, 0.6mm, and 0.7mm pictured) copings allows NobelProcera to
achieve seamless esthetic integration.
M
odern ceramic materials have a critical role
in dentistry and can be generally classified
according to their material composition as either
silica-based or non–silica-based [Table 1]. Silicabased materials can be further categorized as
1) conventional feldspathic porcelains, which are
most often fabricated on refractory dies, and 2)
reinforced, pressed ceramics. In non–silica-based
materials, the subgroups consist of 1) sintered and
infiltrated ceramics that are created according to the
slip-cast technique, and 2) densely sintered, highpurity aluminum and zirconium oxides ceramics that
are fabricated through CAD/CAM processes.1-4
biocompatibility, CAD/CAM-generated restorations
have gained broad acceptance in the restorative
community. These restorations are the result of the
digital age and represent the integration of precision
technology in dentistry (Figures 1 and 2). As a result,
NobelProcera restorations (Nobel Biocare, Yorba Linda,
CA) have established the new standard for restorative
dentistry, providing natural esthetics and individualized
prosthetics as well as proven biocompatibility for
dental professionals seeking to provide quality care for
their patients (Figures 3 and 4).
At this time, there are multiple CAD/CAM systems
available in the market.5,6 For discerning clinicians,
the NobelProcera system can provide an optional
restorative approach for reasons that include long-term
performance, mechanical properties, and esthetic
capabilities, each of which has been well-documented
The CAD/CAM process was introduced to dentistry
by Duret, whose work was subsequently applied to
the fabrication of all-ceramic crowns. Due to their
mechanical and esthetic qualities as well as their
Table 1. Classification of Ceramic Materials
Silica-based materials
Non–silica-based materials
Conventional feldspathic
ceramics
Reinforced pressed
ceramics
Sintered and infiltrated
aluminum oxide
Densely sintered, highpurity aluminum or
zirconium oxide
Amorphous phase and
crystalline phase (i.e.,
feldspar, quartz)
Vitreous phase and
increased crystalline
phase
Alumina core and glass
CAD/CAM-generated,
milled copings,
abutments, and C&B
infrastructures
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The Expanding Indications for CAD/CAM Technology:
Custom Prosthetics via NobelProcera
Figure 3
Mandibular preparations shown on the model.
Figure 4
Facial view of definitive mandibular NobelProcera crowns upon seating and
cementation.
in the literature. The versatility of NobelProcera,
which provides restorative solutions for veneers, and
zirconia crowns, abutments, and fixed dentures, gives
and reproducibility of digital manufacturing with dense,
durable restorative materials.
Various advantages are provided by a CAD/CAM-based
dental professionals the confidence to use these
restorations to predictably treat a broad range of
clinical conditions.7
approach. This technology enables dental professionals
to produce two or more identical restorations.4 For
example, one electronic file can be used to generate
two implant abutments (i.e., for provisional and final
restorations) initially and then, should it be necessary
in the future, to be recalled from archived patient files
so that an exact duplicate abutment or coping can
be fabricated. This CAD/CAM process represents
not an evolution but a revolution in esthetic dentistry.4
Combined with high-strength ceramics, CAD/CAM is
responsible for significant changes in dentistry.9,10
The Evolution of CAD/CAM Technology
For decades, dental laboratories have depended on
the experience and manual craftsmanship of human
workers in order to fabricate esthetic restorations
(Figures 5 through 8).8 Thanks to CAD/CAM technology,
the dental industry has continued to evolve from this
dynamic. The CAD/CAM process introduces the
digital age to the customization of dental prostheses
and involves the effective communication of case
information among the restorative team members.8
"Clinical applications
With CAD/CAM technology, digital files are used to
partially or entirely replace the traditional sequences
of prosthesis fabrication. CAD/CAM systems can
be used to create the entire restoration, such as a
single-unit crown milled from zirconia, or just a part
of the restoration (i.e., screw-retained CAD/CAM
provisionals, implant coping, or similar framework).
By using CAD/CAM to fabricate the substructure
of a given restoration, today’s dental professionals
are able to combine innovative technology and
conventional prosthetic principles, fusing the reliability
of CAD/CAM
technology and digital
communication are
expanding at an
unprecedented rate."
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