CAD-CAM TECHNOLOGY

• CAD/CAM technology refers to digital

design and manufacture.
• CAD software recognizes the geometry of an
object while CAM software is used for the
manufacture
Digital acquisition units

Sole impression system. CAD/CAM impression systems

 Sole impression system.
These systems do not have the ability to design or mill the
restorations chairside. The acquired digital information must
be sent to a qualified dental laboratory via the Internet for
processing and fabrication of the restoration.

TRIOS scanner
the True Definition
Scanner
iTero system
CAD/CAM impression systems
These systems allow for “one day or one appointment” dentistry.
The patient receives the final restoration in one appointment. This
category currently consists of the PlanScan, the
CEREC 3D BlueCam and OmniCam as well as the Carestream CS
3500
Scanning devices
DICOM files Refers to : Digital imaging and
communications in medicine

Although these images generally lack the details necessary for

direct restoration planning, they do offer a picture of the
internal anatomy at sufficient resolution for treatment
planning and development of treatment aids, such as oral
surgery guides.
Conventional Impression
Versus
Digital Impression Making
Real Time Feedback
When looking into a conventional impression,
one sees a negative image of the tooth
preparations. It is difficult, if not sometimes
impossible, to critically evaluate the quality of
a preparation simply by looking at the
negative of the preparation. When using
conventional impression materials, one can
only accurately evaluate the quality of the
impression itself.
Real Time Feedback

Digital impression making has improved

this process and the ability to evaluate the
preparation in real-rime. Having the
capability of acquiring a scan of a
prepared tooth and visualizing it on a
computer monitor eliminates the issues
associated with conventional impressions.
Dimensional Accuracy
All of the currently available conventional
impression materials exhibit some degree of
dimensional change that builds distortion
and inaccuracy into the final restoration.
Digital impressions can reduce the possibility
of dimensional change (shrinkage) that is
evident with all conventional impression
materials. Voids, tears, and pulls that are
routinely experienced with conventional
materials are no longer an issue with digital
scans.
Economics Of Computer-aided Impression Making

Digital impressions also improve the efficiency and profitability

of the dental practice and may be up to 20 minutes faster than
conventional impression making. Remakes of digital
impressions take only seconds, and they are inexpensive
compared to the time needed and the cost of materials required
in remaking a conventional impression.
Contraindications To Digital Impressions
The major contraindication is the inability to access the area with
the digital camera. Either the camera head is too large, or the
patient does not have the ability to open wide enough to
accommodate the camera head. Sizes and weight of camera heads
vary with different systems, but the trend in development is
toward a smaller camera size. Another contraindication for
digital impressions is lack of patient cooperation. Stillness on the
part of the patient is needed to capture adequate images.

Inability to access the area Lack of patient cooperation

Digital Manufacturing
Technology
Direct Digital Manufacturing
DDM technologies can manufacture parts
by two basic approaches:
(i) SMT in which material is selectively
removed from a bulk billet by mechanical
cutting, chemical processes, electrical
discharge, or directed energy and
(ii) AMT in which materials are selectively
fused or deposited, typically in layers.
AMT is more sensitive to the integrity of
these 3D model files as opposed
to the SMT process.
The Subtractive Manufacturing
Technology methods include
SPARK EROSION and MILLING
1. Spark Erosion
The spark erosion can be defined as a metal subtractive process
using continuing sparks to erode material from a metal block
according to the CAD under required conditions.
 2. Milling
Milling techniques are diamond grinding and carbide milling which
are now found together in chairside and in Lab CAD/CAM devices
together.
The materials processed by subtractive milling are metals,
ceramics, resins and waxes.
A key advantage of milling is ensuring the durability of the workpiece
since it is milled from an industrial grade blank. Milling can reduce
fabrication flaws in dental prostheses, by relying more on the tighter
quality control processing of the material manufacturer rather than
commercial laboratory, so that manufacturing deficiencies, such as
porosities and inhomogeneous consistency, are reduced.
Applied mainly with respect to zirconium oxide
blanks with a low degree of pre-sintering.
Advantages:
• Minimal investment costs for the millin
• No moisture absorption by the die Zro
Disadvantages:
• Higher shrinkage values for the framewc. A u.
EXAMPLES : [Zeno 4030 (Wieland- Imes), Lava
Form and Cercon
brain).
 In this process the milling diamond or carbide cutter is
protected by a spray of cool liquid against overheating of the
milled material.
• Useful for all metals and glass ceramic material in order to
avoid damage through heat development.
• 'Wet'processing is recommended, if zirconium oxide ceramic
with a higher degree of pre-sintering
milling process.
Examples:
• Everest (KaVo), Zeno 8060
• inLab (Sirona).
Milling axes
The construction data produced with the CAD software
are converted into milling strips for the CAM
processing and finally loaded into the milling device.
Processing devices are distinguished by means of the
number of milling axes:
3axis devices
4axis devices
5axis devices.
1. (3-axis) milling devices
This type of milling device has degrees of movement in the three
spatial directions, and so the mill path points are uniquely
defined by the X Y and Z values. A milling of subsections, axis
divergences and convergences, however, is not possible.This
demands a virtual blocking in such areas
The advantages of these milling devices are short
milling times and simplified control by means of the
three axis. Also these devices are less costly than those with
ahigher number of axes.
Examples of 3-axis devices:
• inLab (Sirona),
• Lava (3M ESPE),
• Cercon brain (DeguDent).
2. (4-axis) milling devices
In addition to the three spatial axes, the tension bridge for the
component can also be turned infinitely variably .As a result it is
possible to adjust bridge constructions with a large vertical height
displacement into the usual mould dimensions and thus save
material and milling time.
Example: Zeno (Wieland-Imes).
3. (5-axis) milling devices
In addition to the three spatial dimensions and the rotatable tension
bridge (4th axis), the 5-axis milling device has the possibility of rotating
the milling spindle (5th axis). This enables the milling of complex
geometries with complex shapes such as denture base resins.

Example in the Laboratory Area: Everest

Engine (KaVo).
Example in the Production Centre: HSC
Milling Device (etkon).
THE ADVANTAGES OF SMT INCLUDE:
1. High surface finish
2. Ease of use
3. Capable of handling incorrect STL files
4. Wide choice of materials
5. Cost: light CNC milling machines can be less than one
thousand US
dollars
6. Definable accuracy: the distance between the tool paths can
be chosen, generallyfrom 0.01 mm to 10 mm or larger.
However, building speed is slower the greater the
resolution.
 THE DISADVANTAGES OF SMT INCLUDE:

• Not suited for cross-sectional fabrication: cannot produce

structures within structures or enclosed hollow structures;
• Limited Axis of rotation: there is some limitation of the accuracy
and achievability of an organic shape due to the number of axis the mill
allows. The basic CNC machine uses 3 controlled axes: x, y, and z.
Advanced machines may be equipped with a fourth axis (rotation
table), or with 5 axes where the tool can be rotated to approach the
geometry from different directions.
• Cutter Wear: due to the nature of the technology, cutters can become
dull and inefficient if hard materials are desired. In dental fabrication,
non-sintered materials are often used to increase cutter life.
Addedtive Manufacturing Technology
AMT has had many different names: Rapid
Prototyping, Layered Manufacturing Technology
(LMT), eManufacturing, freeform fabrication, and
generally as 3D Printing.

The majority of commercially available AM

processes build a part in sequential layers, stacked
vertically (z axis). Material is deposited in a plane
transverse to the vertical (x – y plane) and layers
are sequentially deposited. Depending on the
process, additional support structures are often
necessary to fix the part during the layering process
and support overhangs against the force
of gravity.
The advantages of AMT devices include:

• Design Freedom: it is virtually unlimited as to what

can be designed for AMT to include hollow and
functioning devices/rapid proto- types.
• Produce complex geometry: a complex design can
be produced in one fabrication cycle, unlike in SMT
where different parts would need to be fabricated and
assembled.
• Ease of use:the complexity of the system is in the
design of the .stl file for fabrication. Items can be scaled
and easily oriented on fabrication platforms, once the
platform is virtually “loaded,” it is pretty much a “click
OK” and fabrication commences.
• More material saving.
The disadvantages of AMT include:

• Cost: the initial cost of most of commercially available AMT devices can
be well over $100,000 US. However, some of the smaller producing
machines can fall in the range of 15,000–60,000 US dollars.

• Finishing: Generally the products produced need some post-

processing and polishing, especially with the metal AMT. There is a need
to provide some post-polishing by either CNC or manual methods,
although the resolution of the machines and the powder sizes continue to
be improved and will eventually rival the surfaces seen from milling.
• Materials: the range of materials is specific to the AMT being used.
Unlike CNC that can generally be used on any material that can
withstand the milling forces, the method of production has limitations
in the materials can use.
• Product design: although there is a lot of design freedom, AMT is
very sensitive to inconsistency in the STL file to include open triangles
and a need for “watertight” designs. In addition, the software to
manipulate the files can be expensive.
Additive Manufacturing Technology
 1- Vat Polymerization
Vat polymerisation uses a vat
of liquid photopolymer resin,
out of which the model is
constructed layer by layer. An
ultraviolet (UV) light is used to
cure or harden the resin where
required, whilst a platform
moves the object being made
downwards after each new
A. The Stereolithography Apparatus (SLA)
layer is cured.
B. Digital Light Processing (DLP)
The Stereolithography Apparatus (SLA)
technique
This technique uses ultraviolet (UV)
laser for layer-by-layer polymerization of
materials. The technique is used for the
manufacture of dental models from UV-
sensitive liquid resins. As the first
layer is polymerized, a platform is lowered a
few microns and the next layer is cured. This
process is repeated until the whole solid object
is completed. The object is then rinsed with a
solvent and placed in an ultraviolet oven to
thoroughly cure the resin.
Digital Light Processing (DLP)

It uses UV laser and visible light for

polymerization and is used for the manufacture
of dental models, wax patterns, removable
partial frameworks, and provisional restorations
from visible light sensitive resins, wax, and
composite materials. After the material is
printed, it is cured using a light-emitting diode
light source or lamp. Also, polymethyl
methacrylate (PMMA) is used in the DLP
technique.
2- Material Jetting
This technique uses a series of inkjet
print heads and tiny pieces of
material jetted onto support
material and create each layer of the
part. Then, each jetted layer is
hardened using a UV lamp, light
source, or heating. This technique is
used for the manufacture of dental
models, surgical drill guides,
aligners, wax patterns, and
removable frameworks from dental
resin and waxes.
3- POWDER BED FUSION
Powder bed fusion (PBF) methods use either a laser or electron beam to melt
and fuse material powder together.
The Powder Bed Fusion process includes the following commonly used printing
techniques: Direct metal laser sintering (DMLS), Electron beam melting (EBM),
Selective heat sintering (SHS), Selective laser melting (SLM) and Selective laser
sintering (SLS).
SLS is a powder-based technique wherein high-power laser beam hits the
powder, resulting in melt and fusion of the powder particles. This
technique is used for the manufacture of dental models, copings, and
surgical guides from cobalt-chrome, palladium chrome, and nylon.
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