Technique: Creating monolithic zirconia splinted crowns
How CAD/CAM can improve your results.
Computer-aided design/computer-assisted manufacturing (CAD/CAM) systems and machinable all-ceramic materials (e.g., zirconia, lithium disilicate) represent exciting new ways for dentists to deliver prosthodontic care to patients.
CAD software enables virtual smile design, drives the restorative process and ultimate CAM fabrication, and facilitates engaging patient education about the clinical, functional and esthetic rationale for proposed treatments.1 Cases can be treated in one dental appointment or, when more complex, in a more efficient and accurate manner when CAD/CAM processes (e.g., printed models, milled provisionals) are used.
The cornerstones of a CAD/CAM based workflow are digitally scanned intraoral images that replace analog impressions and form the basis of virtually and digitally designed CAD representations of proposed restorations.2 Digital diagnostic “waxups” can be used to assess the treatment plan, and once patients approve the design, the teeth can be prepared and digital intraoral impression scans can be taken.
Digital diagnostic “waxups” based on CAD designs can also be used to create CAM-fabricated provisionals that demonstrate the anticipated contours, shape, length, function and esthetics of the final restorations. After the patient approves the provisional restorations, those can also be digitally scanned for designing the final restorations, including shade determination, and the CAD software used to finalize the proposed restorations.3
Contributing to increasing applications of dental CAD/CAM has been the introduction of material advances (e.g., lithium disilicate, zirconia) specifically designed to produce esthetic, functional and cost-effective alternatives for prosthodontic cases.4,5 In fact, monolithic zirconia restorations (e.g., Zenostar/Wieland, Ivoclar Vivadent) that can be individually characterized are now possible with CAD/CAM to help dentists realize greater efficiency and patient comfort when treating multiple-unit cases.6-8