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Since Cerec (Chairside Economical Restoration of Esthetic Ceramics) was introduced as the first dental chairside computer-aided design/computer-aided manufacturing (CAD/CAM) system in the mid-1980s, this technology has enjoyed growing popularity, particularly in the recent past. There has been a considerable increase in the number of available chairside systems in only the last few years. One of the main reasons for this is that intraoral scanners have become increasingly better, smaller, and faster, while the design software has become more and more user-friendly. Many work steps are now automated, and a very large range of materials is now available for dental chairside applications. These advances have driven the rapid increase in the range of indications for chairside dentistry in the areas of prosthodontics, dental implantology, and orthodontics, and have paved the way for more novel treatment and treatment planning strategies. Another reason is that intraoral scanner-based digital impression techniques are already superior to conventional impression techniques in certain respects. Moreover, the quality of fit of digitally designed dental restorations is constantly improving because of advances in milling machine technology. Due to the sheer number of new possibilities, it is only a matter of time before chairside systems become a standard component of dental practice. This article reviews the actual advantages and limitations of the chairside workflow, and provides a summary of all the available chairside systems available today.
Keywords: chairside systems, digital impression taking, intraoral scanner, grinding/milling units, review
PubMed ID (PMID): 28630956Pages 151-164, Language: English, GermanMuallah, Jonas / Wesemann, Christian / Nowak, Roxana / Robben, Jan / Mah, James / Pospiech, Peter / Bumann, Axel
The aim of this study was to compare the accuracy of six intraoral scanners as regards clinically relevant distances using a new method of evaluation. An additional objective was to compare intraoral scanners with the indirect digitization of model scanners. A resin master model was created by 3D printing and drilled in five places to reflect the following distances: intermolar width (IMW), intercanine width (ICW), and arch length (AL). To determine a gold standard, the distances were measured with a coordinate measuring instrument (Zeiss O-Inspect 422). The master model was scanned 37 times with the following intraoral scanners: Apollo DI (Sirona), CS 3500 (Carestream Dental), iTero (Cadent), PlanScan (Planmeca), Trios (3Shape), and True Definition (3M Espe), and indirectly digitized with the OrthoX Scan (Dentaurum). The digital models were then measured, and deviations from the gold standard calculated. Significant differences were found between the devices. Among the intraoral scanners, Trios and iTero showed the most accurate results, although CS 3500, True Definition, and Apollo DI achieved comparable results. PlanScan demonstrated the highest deviations from the gold standard, and presented a high standard deviation (SD). Direct digitization revealed comparable (and, in fact, slightly higher) accuracy than indirect digitization. Both indirect digitization and most of the intraoral scanners were therefore demonstrated to be suitable for use in the orthodontic office, with the exception of PlanScan, which did not meet the demands of individual orthodontic treatment.
Keywords: intraoral scanner, indirect digitization, full-arch scan, digital impression, CAD/CAM, accuracy
Eine In-vitro-Machbarkeitsstudie zur vertikalen Verschleißmessung
Ziel: Das Ziel der vorliegenden Studie war es zu evaluieren, inwieweit maximale Höhenwerte bei simuliertem Verschleiß an einem Phantomzahn differieren, wenn sie auf Basis von 3-D-Daten berechnet wurden, welche mittels Intraoralscanner beziehungsweise Weißlichtprofilometrie generiert wurden. Zusätzlich wurden zwei verschiedene kommerziell verfügbare Analyseprogramme auf ihre Übereinstimmung getestet.
Material und Methode: An einem in eine Kobalt-Chrom-Legierung umgesetzten Phantomzahn wurden an zwei Lokalisationen Verschleißsimulationen durchgeführt. Nach jedem Verschleiß wurden die maximalen Höhenunterschiede im Verhältnis zur Ursprungsgeometrie gemessen. Die zur vertikalen Höhenmessung verfügbaren 3-D-Daten wurden einerseits mit der Weißlichtprofilometrie [WLP] und andererseits mit einem Intraoralscanner [IOS] generiert. Durch virtuelle Überlagerung der mit jedem System erfassten 3-D-Daten zu drei Zeitpunkten ([Verschleiß1] bis [Verschleiß3] im Verhältnis zum entsprechenden Baseline-Datensatz) konnten die maximalen vertikalen Höhenunterschiede gemessen und miteinander verglichen werden. Zur vertikalen Höhenbestimmung wurden zwei kommerziell verfügbare Programme, Geomagic Qualify und Oracheck, verwendet.
Ergebnisse: Bis auf einen Ausreißerwert von 16,7 % Unterschied waren die Differenzen der Höhenverschleißmessungen auf Basis von [IOS] beziehungsweise [WLP] in einem metrischen Differenzbereich von maximal 15 µm, was 12,6 % entsprach. Maximale Höhenwerte, die an identischen Verschleißarealen mit [Oracheck] und mit [Geomagic] ermittelt wurden, wiesen maximale Unterschiede von +7 beziehungsweise -6,7 % auf.
Schlussfolgerung: Die Verschleißmessung auf der Basis von [IOS] erscheint im Rahmen der vorliegenden In-vitro-Untersuchung als eine praktikable Methode, um schnell, einfach und kostengünstig ein klinisches Verschleißscreening durchführen zu können. Die beiden Programme [Geomagic] und [Oracheck] erweisen sich hinsichtlich ihrer Analysefähigkeit als ebenbürtig.
Keywords: Profilometrie, Verschleiß, digital, intraoral, Abformung, in vitro, Analyse
Since February 2010, intraoral scanning (Lava COS system, 3M ESPE, Seefeld, Germany) has been integrated into the preclinical curriculum at the Department of Prosthodontics of the Justus Liebig University. All students were given a lecture and were trained using a guided scan exercise. After preparing three teeth (mandibular first premolars and mandibular first molar in the 4th quadrant) for cast crowns, the students were asked to scan the maxillary and mandibular teeth. Their acceptance of the new module, "Scanning," was analyzed with the use of a questionnaire (n = 108). The evaluation showed that 63.9% of the students perceived the digital impression to be informative, and had an overall positive opinion of this new digital technology. Concerning the difficulty of the scanning process, approximately 60.2% considered it to be manageable, while 55.6% reported that the magnified view of their preparations improved their understanding of preparing chamfer finish lines. Altogether, the majority of students appreciated this intraoral scanning device as an enhancement of their education. They indicated that this method contributes to a better understanding of crown preparations. In conclusion, the implementation of intraoral scanning seems promising in preclinical education and will be continued in the curriculum.
Keywords: digital denture impression, intraoral scanner, Lava COS system, preclinical education in dentistry, learning effect by 3D technology, CAD/CAM
The connection of a device for the registration of mandibular movements depends on the coupling of the teeth with a paraocclusal adapter. This is normally done by individualizing a prefabricated metal support, either directly on the patient or in the dental laboratory. The goal was to create an individual paraocclusal adapter by means of additive computer-assisted design/computer-assisted manufacturing (CAD/CAM) procedures, and to test it clinically. Starting from intraoral scans of the maxillary and mandibular teeth, an individual paraocclusal adapter was constructed by combining an adapter piece adapted to the tooth and jaw shape with a prefabricated standard part. This article describes step by step the design using the 3D CAD software, up until production by means of 3D printing. Initial clinical experience is also discussed.
Keywords: CAD/CAM, 3D printing, transfer tray, electronic movement recording, virtual articulation
Chairside computer-aided design/computer-aided manufacturing (CAD/CAM) technology requires an effective technical basis to obtain dental restorations with optimal marginal accuracy, esthetics, and longevity in as short a timeframe as possible. This article describes a compact, 5-axis milling machine based on an innovative milling technology (5XT - five-axis turn-milling technique), which is capable of achieving high-precision milling results within a very short processing time. Furthermore, the device's compact dimensioning and state-of-the-art mode of operation facilitate its use in the dental office. This model is also an option to be considered for use in smaller dental laboratories, especially as the open input format enables it to be quickly and simply integrated into digital processing systems already in use. The possibility of using ceramic and polymer materials with varying properties enables the manufacture of restorations covering all conceivable indications in the field of fixed dental prosthetics.
Keywords: CAD/CAM, milling unit, software, dental materials