DESIGN AND FABRICATION OF COMPLETE DENTURES USING CAD/CAM
TECHNOLOGY
DESIGN AND FABRICATION OF COMPLETE DENTURES USING CAD/CAM
TECHNOLOGYHan W, Li Y, Zhang Y, Zhang Y, Hu P, Liu H, Ma Z, Shen
Y.
Medicine. 2017 Jan 1;96(1):e5435AAMIR ZAHID GODILFIRST YEAR
P.G.DEPARTMENT OF PROSTHODONTICSM.A.R.D.C.
1
OUTLINEINTRODUCTIONCONVENTIONAL DENTURES: ADVANTAGES AND
DISADVANTAGESCAM PROCESSINGREVIEW OF LITERATUREFABRICATION
PROCESSCAD/CAM DENTURES: ADVANTAGESCRITIQUE AND CONCLUSION
INTRODUCTIONComputer-aided design and computer-aided
manufacturing (CAD/CAM) has emerged as a new approach for the
design and fabrication of complete dentures.
Infante L, Yilmaz B, McGlumphy E, et al. Fabricating complete
dentureswith CAD/CAM technology. J Prosthet Dentistry
2014;111:3515.
Several commercial CAD software systems, including 3Shape Dental
System and AvaDent digital dentures, have recently become available
for designing complete dentures.
With this CAD/CAM technology, only 2 appointments are needed for
patients to get their complete dentures.
Kattadiyil MT, Goodacre CJ. CAD/CAM technology: application to
complete dentures. Loma Linda University Dentistry 2012;
23:1623.
Yamamoto S, Kanazawa M, Iwaki M, et al. Effects of offset values
for artificial teeth positions in CAD/CAM complete denture. Comput
Biol Med 2014;52:17
CONVENTIONAL METHOD OF DENTURE FABRICATIONADVANTAGESAbility to
customize tooth arrangements and to confirm all preceding steps
before the trial placement stageClinically predictable
outcomesDISADVANTAGESThe need for a minimum of 4 to 5 patient
visits and additional post-insertion visitsHigh treatment costs due
to increased patient visitsVarying laboratory expenses and timeLack
of intimate fit of the denture bases with underlying tissues due to
polymerization shrinkageInability to easily create an optimal
duplicate denture
The desired geometry is obtained by physical removing the extra
materials via machining (ie, cutting/ milling) according to the
digital model. The subtractive manufacturing has been extensively
used to fabricate fixed prosthesis, such as inlays, onlays,
veneers, crowns, and fixed bridges.
Bidra AS, Taylor TD, Agar JR. Computer-aided technology for
fabricating complete dentures: systematic review of historical
background, current status, and future perspectives. J Prosthet
Dentistry2013;109:3616.
THE CAM TECHNOLOGY COULD BE CLASSIFIED INTO 2 TYPESADDITIVE
MANUFACTURING AND SUBTRACTIVE MANUFACTURING
All impressions, jaw relations, occlusal plane orientation,
tooth mold and shade selection, and maxillary anterior tooth
positioning could be finished in 1 patient visit for the
fabrication of complete dentures, saving a lot of time and
materials for both patients and/or dentists.
REVIEW OF LITERATURE
Maeda et al (1994)They developed a computer-aided system
including a work station for determining artificial tooth
arrangements, occlusion, the outline of polished surface, and
denture border location using a knowledge data base.
A complete denture was fabricated from photopolymerized resin
composite material using a 3D laser lithography machine via
printing, but this complete denture had poor mechanical properties
such as the strength, thus being unusable in patients.Maeda Y,
Minoura M, Tsutsumi S, Okada M, Nokubi T. A CAD/CAM system for
removable denture. Part I: Fabrication of complete dentures. Int J
Prosthodont 1994;7:17-21
Kawahata et al (1997)Data acquisition: CCD cameras assisted by
lasers to record digital images of cameo and intaglio surfaces of
set of complete dentures of patient.Denture fabrication:
computerized numerical control (CNC) milling by using block of wax
to create duplicate dentureKawahata N, Ono H, Nishi Y, Hamano T,
Nagaoka E. Trial of duplication procedure for complete dentures by
CAD/CAM. J Oral Rehabil 1997;24:540-8.
Busch and Kordass (2006)Data acquisition: Scanning of edentulous
casts with laser and other types of scanners.Digital tooth
arrangement performed with a specialized computer program using
anatomic measurements and averages.Busch M, Kordass B. Concept and
development of a computerized positioning of prosthetic teeth for
complete dentures. Int J Comput Dent 2006;9:113-20.
Sun et al (2008)Data acquisition: 3D laser scanning of
edentulous casts and occlusal rims, followed by digital tooth
arrangement and creation of virtual flasks for denture
processing.Denture fabrication: Rapid Prototyping technology to
create physical flasks, followed by insertion of teeth and
conventional laboratory procedures to fabricate complete
denturesSun Y, Lu P, Wang Y. Study on CAD&RP for removable
complete denture. Comput MethodsPrograms Biomed 2009;93:266-72.
Zhang et al (2011)Tooth arrangement performed by using prototype
multimanipulator tooth arrangement robot system.Zhang YD, Jiang JG,
Liang T, Hu WP. Kinematics modeling and experimentation of the
multi-manipulator tooth-arrangement robot for full denture
manufacturing. J Med Syst 2011;35:1421-9
Kanazawa et al (2011)Data acquisition: Separate extraoral cone
beam computed tomography (CBCT) scans of patients dentures and
artificial teeth, followed by virtual tooth arrangement.Denture
fabrication: CNC milling of denture base by using a clear block of
acrylic resin, followed by manual bonding of denture teeth into the
recesses of base.Kanazawa M, Inokoshi M, Minakuchi S, Ohbayashi N.
Trial of a CAD/CAM system for fabricating complete dentures. Dent
Mater J 2011;30:93-6
Goodacre et al (2012)Data acquisition: Scan of silicone
impressions made by neutral zone technique and scan of
interocclusal records, followed by virtual tooth
arrangement.Denture fabrication: CNC milling of denture base by
using pink block of acrylic resin, followed by manual bonding of
denture teeth into recesses of base.Goodacre CJ, Garbacea A, Naylor
WP, Daher T, Marchack CB, Lowry J. CAD/CAM fabricated complete
dentures: concepts and clinical methods of obtaining required
morphological data. J Prosthet Dent 2012;107:34-46.
Inokoshi et al (2012)Data acquisition: CBCT scans of wax trial
dentures of 10 patients, followed by various modifications
performed on computer.Denture fabrication: Rapid Prototyping
technology to create 7 prototype dentures for each patient with
various alterations in tooth positions to study feasibility of
using prototype dentures for trial placement purposesInokoshi M,
Kanazawa M, Minakuchi S. Evaluation of a complete denture trial
method applying rapid prototyping. Dent Mater J 2012;31:40-6
FABRICATION PROCESS
CAD/CAM DENTURES: ADVANTAGES
1)educed number of patient visits, which is especially
beneficial to elderly patients 2) superior strength and fit of
dentures due to use of prepolymerized acrylic resin blocks for
milling3) reduced potential for dentures to harbor microorganisms
and minimize resultant infections;4) reduced cost for the
patientand the clinician; 5) easily reproducible(creation of
duplicate dentures)due to stored digital data; 6) improvedpotential
for standardization in clinicalresearch on complete dentures as
wellas implant-retained overdentures; and7) ability for better
quality control.22
CRITIQUE AND CONCLUSIONThe article does not mention the
following key-points:Try-inSpecial occlusal
considerationsCharacterization Post-insertion careComparison to
conventional denture bases
Thank You
