Header

UZH-Logo

Maintenance Infos

CAD-CAM milled dentures: The Geneva protocols for digital dentures


Srinivasan, Murali; Kalberer, Nicole; Naharro, Manuel; Marchand, Laurent; Lee, Hyeonjong; Müller, Frauke (2020). CAD-CAM milled dentures: The Geneva protocols for digital dentures. Journal of Prosthetic Dentistry, 123(1):27-37.

Abstract

This technical report describes 2 workflows for fabricating computer-aided design and computer-aided manufacturing (CAD-CAM) milled complete dentures (CDs). The first technique illustrates a manufacturer-independent workflow using conventional clinical steps and a novel, custom modified tray to successfully fabricate CAD-CAM milled CDs. The second technique highlights a nearly digital workflow for manufacturing a CAD-CAM milled CD and a milled resin interim removable partial denture. Initial attempts to fabricate complete dentures (CDs) with computer-aided design and computer-aided manufacturing (CAD-CAM) technology began in the 1990s 1 , 2 , 3 ; since then, there has been an evolution of the techniques and the associated technologies. 4 , 5 , 6 , 7 , 8 , 9 , 10 The infusion of CAD-CAM techniques into CD fabrication methods has led to the evolution of modified and easier clinical protocols, 11 , 12 the use of materials with improved properties, 13 , 14 , 15 , 16 , 17 , 18 better fit and retention of the CDs, 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 reduction in the chairside and laboratory times, 12 , 30 , 31 , 32 and overall reduction in clinical and laboratory costs. 30 High patient and clinician satisfaction with CAD-CAM CDs has been reported. 33 , 34 , 35 The CAD-CAM clinical protocols used are modified versions of the conventional clinical steps followed during the fabrication of CDs. Although promoted by various manufacturers as being more straightforward and easier, the CAD-CAM protocols require extended time to learn the procedure and to digitize the analog clinical procedures. 34 , 36 Elaborate instruments, depending on the manufacturing system, are often required to carry out these novel clinical protocols. Despite the numerous advantages, the currently practiced CAD-CAM methods for CDs still have limitations. 31 , 37 , 38 , 39 Nevertheless, these protocols are rapidly evolving, and newer alternative protocols incorporating the conventional clinical steps in a manner best suited to satisfying all the required criteria for the successful fabrication of CAD-CAM CDs have been developed. 11 , 40 The newer protocols continue to use analog clinical steps that are then digitized to accomplish the prosthesis. Attempts to use optical scans combined with conventional clinical procedures have demonstrated some success 41 , 42 , 43 ; however, a completely digital clinical workflow for the fabrication of CDs has yet to be demonstrated. The purpose of this technical report was to demonstrate an alternative, manufacturer-independent, clinical workflow that has been routinely used by the Clinic for Gerodontology and Removable Prosthodontics at the University of Geneva for manufacturing CAD-CAM milled CDs. This report further aimed to showcase a nearly digital workflow for fabricating a clinically acceptable CAD-CAM fully milled maxillary CD and a fully milled mandibular resin removable partial denture (RPD), without the use of any analog clinical procedures.

Abstract

This technical report describes 2 workflows for fabricating computer-aided design and computer-aided manufacturing (CAD-CAM) milled complete dentures (CDs). The first technique illustrates a manufacturer-independent workflow using conventional clinical steps and a novel, custom modified tray to successfully fabricate CAD-CAM milled CDs. The second technique highlights a nearly digital workflow for manufacturing a CAD-CAM milled CD and a milled resin interim removable partial denture. Initial attempts to fabricate complete dentures (CDs) with computer-aided design and computer-aided manufacturing (CAD-CAM) technology began in the 1990s 1 , 2 , 3 ; since then, there has been an evolution of the techniques and the associated technologies. 4 , 5 , 6 , 7 , 8 , 9 , 10 The infusion of CAD-CAM techniques into CD fabrication methods has led to the evolution of modified and easier clinical protocols, 11 , 12 the use of materials with improved properties, 13 , 14 , 15 , 16 , 17 , 18 better fit and retention of the CDs, 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 reduction in the chairside and laboratory times, 12 , 30 , 31 , 32 and overall reduction in clinical and laboratory costs. 30 High patient and clinician satisfaction with CAD-CAM CDs has been reported. 33 , 34 , 35 The CAD-CAM clinical protocols used are modified versions of the conventional clinical steps followed during the fabrication of CDs. Although promoted by various manufacturers as being more straightforward and easier, the CAD-CAM protocols require extended time to learn the procedure and to digitize the analog clinical procedures. 34 , 36 Elaborate instruments, depending on the manufacturing system, are often required to carry out these novel clinical protocols. Despite the numerous advantages, the currently practiced CAD-CAM methods for CDs still have limitations. 31 , 37 , 38 , 39 Nevertheless, these protocols are rapidly evolving, and newer alternative protocols incorporating the conventional clinical steps in a manner best suited to satisfying all the required criteria for the successful fabrication of CAD-CAM CDs have been developed. 11 , 40 The newer protocols continue to use analog clinical steps that are then digitized to accomplish the prosthesis. Attempts to use optical scans combined with conventional clinical procedures have demonstrated some success 41 , 42 , 43 ; however, a completely digital clinical workflow for the fabrication of CDs has yet to be demonstrated. The purpose of this technical report was to demonstrate an alternative, manufacturer-independent, clinical workflow that has been routinely used by the Clinic for Gerodontology and Removable Prosthodontics at the University of Geneva for manufacturing CAD-CAM milled CDs. This report further aimed to showcase a nearly digital workflow for fabricating a clinically acceptable CAD-CAM fully milled maxillary CD and a fully milled mandibular resin removable partial denture (RPD), without the use of any analog clinical procedures.

Statistics

Citations

Dimensions.ai Metrics
3 citations in Web of Science®
4 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

2 downloads since deposited on 15 Jan 2021
2 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Klinik für Allgemein-, Behinderten- und Seniorenzahnmedizin
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Oral Surgery
Language:English
Date:1 January 2020
Deposited On:15 Jan 2021 09:25
Last Modified:16 Jan 2021 21:00
Publisher:Elsevier
ISSN:0022-3913
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.prosdent.2018.12.008
PubMed ID:31079883

Download

Closed Access: Download allowed only for UZH members

Content: Published Version
Language: English
Filetype: PDF - Registered users only
Size: 5MB
View at publisher