Dental Treatment Evolving with Digital Technology (Part 9)
The Scene around CAD / CAM for Digital Dentistry
Technology does not Happen in a Day, New Technologies Lead to a History of Product Development
When you visit a dentist, you might be likely to see tools and materials that are unfamiliar to you. For dental treatment, Dentists do not administer so many types of medicines as a physician, but they use a variety of special instruments and materials such as cements to attach fillings and coverings. The equipment and materials are provided by manufacturers specialising in dentistry, small companies such as town factories, as well as imports from overseas and companies that might seem unexpected and support dental treatment.
One such company is Kuraray, which was founded on the successful industrialisation of rayon, known as artificial silk. The company began marketing dental adhesives and fillers such as resin using an adhesive system (adhesive monomer) discovered in the course of research into pain-free treatment, which began in 1973.
The knowledge of polymers that Kuraray gained from the development of fibres was applied to composite resins (filling materials made of plastic), in which fine glass components called fillers are kneaded into the resin. You might have used resins to treat grooves in molars or small cavities in front teeth.
The cost of dental treatment in Japan is said to be much lower than in other countries such as the USA, and it might owe to the efforts of these companies, as well as the dedication of dental professionals, that have supported the Japanese insurance system over the years. The insurance points that are converted into treatment fees are ultimately determined by the government, so the cost of materials must also be within a certain range of amounts.
The requirements for dental materials are various properties. Palladium alloys used for insurance treatment and precious metals used for uninsured treatment have long been used because of their strength and the advantages of ease of precision machining. However, concerns have been raised about the appearance of tooth colour, and allergic reactions though it is not so often. In addition, in recent years, the rising cost of metal materials for dentistry has become an issue in terms of the medical economy.
CAD/CAM (Computer Aided Design / Computer Aided Manufacturing) composite resin prosthetics (tooth fillings and crowns) have recently replaced metal in dental treatment. Their use is increasing due to the rising cost of metals and the widening range of insurance treatment coverage.
CAD/CAM composite resins are esthetically similar to the colour of teeth, even if they do not reach the same level of transparency and realism as ceramics. They are also regarded as stronger (high resistance to bending and compression) and more durable than conventional resins, more biocompatible, and do not fluctuate in price as much as metal 1).
CAD/CAM prosthetics also use digital optical impressions made with intraoral scanners, instead of the clay-like moulds that harden in the mouth called impression materials, as has often been done in dentistry. The data is sent to a dental laboratory with CAD/CAM technology, without directly sending models. This series of systems is considered to have the potential to change the process of dental laboratory work, which until now has been largely dependent on manpower, in an age of declining birthrates and ageing populations.
CAD/CAM resin block prosthetics are certainly more susceptible to fracture than metal, but the most common problem is dislodgement, which occurs after installation because it is more difficult to achieve a good fit (precision fit to the tooth) than with metal 2)3). In addition to the properties of the resin block, there are other factors necessary for treatment, such as the performance of the milling machine, the cementation on the tooth and the bonding method.
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