dentistry show 2011 why move to cad/cam?

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Why move to CAD/CAM solutions?

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Where we come from

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Ripon, Digital Dentistry Hub?

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What is CAD/CAM? C.A.D. = Computer Aided Design C.A.M. = Computer Aided Manufacture Over 180 CAD/CAM related companies at the last IDS in Koln

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A very brief history of CAD/CAM The groundwork for this quantum leap in dental technology was laid in 1985. Using a Fairchild video sensor (At the time this tech was only used for military purposes, so special permission was required for the CCD video chips to be used in dentistry) For the first time it was possible for a preparation made visible intra-orally with a triangulation camera to be measured multi-dimensionally and transferred onto a screen. Then, with the help of a PC, imaging software, and a connected CNC grinding unit, the first inlay of silicate ceramic was produced at the University of Zurich. since then, more than 21 million all-ceramic restorations have been produced using intraoral cameras, design software and milling units

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Now CAD/CAM can do much more

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Let’s start with custom milled abutments Patient-specific abutments unique to each case Often designed from final tooth shape using either software or pre-op scans Consistent, monitored precision and quality Guaranteed !

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Analyse, test, analyse, test…….. Some CAD/CAM abutments do not copy original designs but optimizes fit in key areas , based on research and mechanical testing. Finite Element Analysis (FEA) performed on every component to optimize strength of critical regions Key Areas: Seating surface necessary to maintain tight seal and stability Anti-rotation features to index the abutment to the implant Detailed engineering requirements for each specific retentive screw Tested to meet or exceed all regulatory, FDA and ISO requirements

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Offer more restorative options gold shaded abutment zirconia abutment shade 00 zirconia abutment shade 10 abutment in titanium

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Cover all the major implant systems Nobel Biocare Straumann Astra Tech Dentsply Biomet 3i BioHorizons Zimmer Dental

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Why switch to CAD/CAM? Laboratory Benefits

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Switching to CAD/CAM has great lab benefits Increases Lab Productivity Frees Skilled Technicians

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Start using CAD/CAM tomorrow

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3 reasons to use CAD/CAM instead of stock abutments Better for you surgeons!

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modified stock 1. Less alloy needed for restoration 3 reasons to use CAD/CAM CAD/CAM

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modified stock 2. Cement junction easier to access 3 reasons to use CAD/CAM CAD/CAM

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3 reasons to use CAD/CAM modified stock CAD/CAM 3. More surface area to retain restorations

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So, what’s wrong with cast gold abutments? The traditional laboratory methods

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Consistency and cost In total these cost the surgeon £436.61 each

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CAD/CAM offers flexibility CAD/CAM

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CAD/CAM offers flexibility Smart Sourced Partners In House

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There’s a world of CAD/CAM partners out there!

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Atlantis ™ Web Order

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Web order

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emergence width options Improved Communication with CAD/CAM Surgeons have extra information tools to relay to the laboratory the way in which you wish to develop the soft tissue site.

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Full 3D imaging Improved Communication with CAD/CAM 3D images to inspect, measure and modify Share and discuss case before it’s milled Improves communication leading to better results

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CAD/CAM cases from the lab

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Model after cast and soft tissue CAD/CAM for real, everyday cases in the lab

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Diagnostic wax-up CAD/CAM for real, everyday cases in the lab

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Abutments milled and ready for metalwork CAD/CAM for real, everyday cases in the lab

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Profile view of abutments CAD/CAM for real, everyday cases in the lab

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Abutments within matrix of diagnostic wax-up CAD/CAM for real, everyday cases in the lab

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Framework ready for ceramic CAD/CAM for real, everyday cases in the lab

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Finished ceramic bridge CAD/CAM for real, everyday cases in the lab

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Case on 8x 3i certain implants CAD/CAM Larger case, greater lab benefits

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CAD/CAM Larger case, greater lab benefits

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CAD/CAM Larger case, greater lab benefits

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CAD/CAM Larger case, greater lab benefits

An inventive use of the system:

An inventive use of the system CAD/CAM creative solutions

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2x 3i Certain MicroMiniplants 3.25mm in Zirconia with direct build-up Images courtesy of Dr. Kevin Lochhead Edinburgh Dental Specialists CAD/CAM creative solutions

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2x 3i Certain MicroMiniplants 3.25mm in Zirconia with direct build-up Images courtesy of Dr. Kevin Lochhead Edinburgh Dental Specialists CAD/CAM creative solutions

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Case on 2x 3i Certain MicroMiniplants 3.25mm in Zirconia with direct build-up Images courtesy of Dr. Kevin Lochhead Edinburgh Dental Specialists CAD/CAM creative solutions

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Unique to some new CAD/CAM systems Unique options using CAD/CAM

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CAD/CAM Duplicate abutments

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CAD/CAM Duplicate abutments

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CAD/CAM Duplicate abutments

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CAD/CAM Duplicate abutments

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CAD/CAM Duplicate abutments

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Average abutment costs Titanium Stock Cast Gold All above are the basic components without laboratory charges Atlantis Titanium £172.73 £ 225.60 + Gold £ 147.90 £166.85 £ 176.25 + Gold £ 147.90 £141.00 £ 164.50 + Gold £ 147.90 £151.57 £ 147.65 + Gold £ 147.90 Including fitting screws Prices correct on 16/09/2010

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The true total cost of abutments Modified stock abutment *Stock abutment £172.73 Laboratory charge £ 84.95 *Lab analogue £27.60 Soft tissue model £ 15 Verification jig £ 17 Total cost £317.28 CAD/CAM titanium abutment CAD/CAM abutment £ 147.90 Laboratory charge £84.95 Lab analogue £ 27.60 Soft tissue model £ 15 Verification jig £ 17 One way Shipping £13.50 Total cost £305.95 You could actually save your surgeon £11.33 per fixture restored *usually billed to surgeons account separately by the implant manufacturer.

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CAD/CAM Benefits Better for the Lab, Surgeon & Patient Most CAD/CAM partners offer a full warranty for complete peace of mind Easily integrated into your current lab routine Better retention & saves money on alloy Saves time, increasing productivity & profitability VAD ™ provides excellent fit, esthetics and reliability

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Share, discuss & develop www.dentinaltubules.com

What about multiple units & implant bars/beams?:

What about multiple units & implant bars/beams? Let’s start with the clinical benefits

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Milling vs. Casting Cast Gold Alloy bar No casting stresses CAD/CAM bar Images courtesy of Lance Mayer & Manuel Ureña

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Milling vs. Casting Casting/Investing problems Welding problems Images courtesy of Lance Mayer & Manuel Ureña

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Milling vs. Casting Cost and casting problems http://timetowaxup.wordpress.com

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You stay in control of your design

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A wide range of restorative options http://www.hughesdentallaboratory.com

Overview of a CAD/CAM U/L titanium beam case:

Overview of a CAD/CAM U/L titanium beam case

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Surgeon takes traditional pickup impression

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Lab casts soft tissue model

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Models are verified

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Wax setup (should be verified in mouth)

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Bar/beam is designed to fit within setup

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Bar/beam is designed to fit within setup

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Arrive polished and ready to go!

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Acrylic is processed onto beams

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Patient happy with final restorations

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Financial benefits

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It’s a premium product, it’ll cost more!? Traditional cast gold beam on 4 fixtures CAD/CAM milled beam on 4 fixtures Gold cast to cylinders per fixture 4 £75.90 £303.60 *Soft tissue model 1 £17.00 £17.00 *Verification jig per fixture 4 £15.00 £60.00 *Beam/Bar wax and finish charge 1 £800.00 £800.00 *Prosthetic charge (all stages inc.) 1 £750.00 £650.00 Complete cost cast gold beam with acrylic work £ 1,930.60 + Alloy (£350+?) As you can see when you compare costs of the final restorations the CAD/CAM is more cost effective Quantity Price Subtotal CAD/CAM milling charge 1 £570.00 £570.00 *Soft tissue model 1 £17.00 £17.00 *Verification jig per fixture 4 £15.00 £60.00 *Beam/Bar charge 1 £500.00 £500.00 *Prosthetic charge (all stages inc.) 1 £750.00 £650.00 Complete price for CAD/CAM beam with acrylic work £ 1,897.00 Quantity Price Subtotal

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CAD/CAM Why Switch? Consistent accuracy and passivity Enhanced design sharing possibilities Easy and cost effective to start using CAD/CAM Get started straight away!

So, why wouldn’t you move to CAD/CAM? :

S o, why wouldn’t you move to CAD/CAM? By Mark Ambridge & Steve Campbell With thanks to our surgical partners and all the team at the lab for their exceptional work and support Email: mark@ambridgeceramics.com steve@ambridgeceramics.com Web: www.ambridgeceramics.com Find us on