Inside Dental Technology
Merging Digital Technologies
A promising future for dental technology that will improve precision, esthetics, and efficiency.
A new breakthrough has occurred in the way that computer-aided design and computer-aided manufacturing (CAD/CAM) technologies are being applied to the field of implant dentistry. Digital intraoral scanning systems for the first time are being used in conjunction with coded implant healing abutments. The merger of these two technologies holds the promise of benefits for laboratory technicians.
CAD/CAM technologies were first introduced to the field of dentistry 40 years ago. Since then, the technologies have transformed many aspects of the way dentistry is practiced. For example, dentists and dental laboratories have employed CAD/CAM technologies to fabricate implant abutments for more than a dozen years. Like cast custom abutments, customized CAD/CAM abutments can improve esthetic results by providing better peri-implant soft-tissue support.
The newest breakthrough marries two well-established technologies.
For several years, commercially available intraoral scanning systems have served as an alternative to conventional elastomeric impressions. Such systems do require an initial capital investment, and it takes time to learn how to use them. However, the use of digital intraoral scanners eliminates the need for restorative dentists to purchase impression material and trays, mix and clean up the mess of conventional impression material, disinfect the impressions, ship the impressions to the laboratory, and store casts long-term.
Coded implant healing abutments (BellaTek™ Encode® Healing Abutments, BIOMET 3i, www.biomet3i.com) are also a well-established technology. First introduced in 2004, such abutments eliminate the need for impression copings. Instead, various arrangements of facets on the occlusal surfaces of the abutments identify the implant-platform diameter, the healing abutment height, the hex position of the implant, and the diameter of the emergence profile, all from a supragingival impression (BellaTek Encode Impression System).
While digital sensor technology up to now has not been used for taking impressions of dental implants, in March 2011, the Food and Drug Administration granted 510(K) Clearance to market the use of the Lava™ Chairside Oral Scanner C.O.S. (3M ESPE, www.3mespe.com) and iTero™ (Cadent, www.cadentinc.com) systems for capturing digital impressions of coded implant healing abutments.
Combining these two technologies offers several benefits. The restorative dental team no longer needs to select a tray, dispense impression material, allow time for material setting, disinfect the impression, package it up, and ship it to the laboratory. The accuracy of intraoral scanning also may eliminate costly remakes and adjustments.
For the dental laboratory, this streamlined process offers an opportunity to play an integral role in delivering esthetic, precise restorations supported by dental implants.
Laboratory technicians do not need to fabricate a master cast. The steps of pouring plaster; fabricating a base; and pinning, cutting, trimming, and articulating the casts are eliminated.
Instead, after the restorative dentist electronically transmits the data from the digital impressions to the laboratory, the laboratory technician works with the scan data using software specific to the intraoral scanner. Soft-tissue margins are marked prior to the fabrication of a rapid-prototype model (Figure 1). The laboratory also may use the CAD data to complete the virtual workflow while working with the data to design and fabricate copings and the definitive restoration.
By sending the abutment design simultaneously to the BellaTek Production Center (BIOMET 3i) for milling of the abutment(s) and to a separate facility for fabrication of a rapid prototype model of the abutment(s) in the arch, even more time can be saved. The rapid prototype model is sent to the laboratory for use in fabricating the definitive restoration at the same time that the definitive abutment or abutments are being milled. Alternatively, CAD/CAM copings and crown fabrication can be done directly from the CAD design of the BellaTek Abutment (Figure 2).
Abutments created with these technologies are patient-specific. All of these factors translate into direct economic benefits, and these technologies offer an exciting future that is evolving at a rapid pace.
The manufacturer provided the preceding material. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dental Technology.
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