Growing up with CAD CAM - David Claridge

People are living longer. The Office for National Statistics[1] recorded that the most common age at death in England and Wales in 2010, was 85 for men and 89 for women. Between 1960 and 2010 lifespan increased by an average of eight years (female) and 10 years (male) and the number of those reaching 100+ years is increasing too. While the population has been slowly living longer, technology has been simultaneously developing quickly.

The use of CAD/CAM technology for dentistry began in the 1970s with Dr. Francois Duret who considered how technology from other industries could be adapted for use in dentistry. From there it has progressed to the integrated systems on offer today, allowing scanning, design and milling chairside, with restoration work all being performed in practice if desired. But what is the connection between dental CAD/CAM and the increase in national longevity?

Increased longevity means an ageing population. There were ten million people over the age of 65 in 2010, with a projected 19 million by 2050[2]. NHS spending on health provision for the retired is nearly double that for non-retired[3] and the dental needs of older people will continue to rise. The older generation – sometimes referred to as the ‘heavy metal generation’ - now retain more teeth and wish to keep them[4]. McHarg J. and  Kay, E.J[5]. point out that :

“Those who were middle aged in 1978, with heavily restored mouths, will have become elderly. Unlike in previous generations, the teeth are likely to be retained, albeit in a compromised state of advanced restoration, due to the restorative cycle the teeth have been involved in for the previous 40 years”.

They go on to highlight that we “face an ever growing number of very elderly people with complex oral health needs”.

In a review of dental CAD/CAM, Miyazaki, T. et al[6] of the Showa University School of Dentistry in Japan note that, with an increasingly ageing society, the continued development of technology will impact on dental services. This is in terms of the quality of life, maintenance of oral function and good quality dental treatment of older people, which CAD/CAM technology can contribute to.

The contribution that CAD/CAM currently makes to workflow and treatment times and methods is already considerable, with some restorations being completed in a single appointment. A scan is first carried out to provide digital images for the design process. This can be either via a scan of the analogue impression or alternatively, an intraoral scanner. The latter can be used to send images direct from the patient’s mouth avoiding the need for analogue impressions (much to the relief of some patients!). Once scans are sent to the imaging system the information is converted into a digital three-dimensional model from which the design process can then take place.

This digital workflow from scan to three-dimensional design removes the need for temporary prosthesis and can enable all the work to be completed rapidly. Using the dedicated software to undertake the process, a precision design can be worked out and implemented, often with the option to customize where needed.

CAD/CAM systems can also offer an integrated connectivity between all components. Once the process is complete, the files are sent to either the integrated milling machine where a crown can be produced, or to a laboratory of choice. Choosing to mill in-house provides the option to complete the restoration process in one appointment, offering both patient and dentist valuable time-saving benefits and an enhanced and technologically-driven service for the patient.

Miyazaki, et al[7] also looked at the advantages of using CAD/CAM technology. They number amongst these the reduction of labour involved in contrast to conventional laboratory production, the reduction in cost when milling from a pre-fabricated porcelain block as opposed to the laboratory process, quality control benefits, and  being able to follow up saved data which can assist with the restoration prognosis.

The potential benefits offered to a practice by a fully-integrated CAD/CAM system are considerable, but making changes can sometimes be daunting. Being informed and supported can make a difference and one such company who offers CAD/CAM systems together with accessible training and support, is Carestream Dental.  Its range of solutions can be bought separately or as a package in CS Solutions and include the CS 3500 intraoral scanner, CS 9300 and CS 9000 3D CBCT systems, CS Restore software and the CS 3000 milling machine, enabling single tooth restoration in as little as an hour. Carestream Dental also supplies CS R4 practice management software which combines the management of clinical notes, care pathways, baseline charts and more, for enhanced service, functionality and productivity of your practice.

A popular quote points out that “Growing old is inevitable, growing up is optional”[8]. Dental practices face the challenge of growing up and moving on in today’s fast moving technological environment. The fact that patients may be growing older simultaneously should not be a barrier but a motivation, to ensure that the dental services on offer grow with them efficiently.

For more information on CS Solutions or bespoke advice on CAD/CAM technologies, please call the experts at Carestream Dental

on 0800 169 9692 or visit www.carestreamdental.com