CAD/CAM techniques for the conservative and efficient management of tooth wear

Combining Orthodontic and Restorative Care with Novel Workflows

This report describes multidisciplinary care combining orthodontics and restorative dentistry for a patient with Class II occlusion and stained mandibular and maxillary resin composite veneers. The orthodontic treatment improved severe overjet and malocclusion prior to restorative care. Occlusal assessment was provided with a novel digital device (PlaneSystem, Zirkonzahn) that is integrated with digital workflows for the evaluation of the occlusal plane and condylar path inclination. Diagnostic digital impressions and digital wax-up for intraoral mock-ups led to the patient's treatment acceptance. Minimally invasive tooth preparation, final digital impressions, and bonding under dental dam isolation fulfilled the patient's esthetic and functional demands with all-ceramic restorations.

CAD/CAM-Workflow bei der Herstellung metallischer kieferorthopädischer Apparaturen

Die CAD/CAM-Technologie wurde in den letzten Jahren enorm weiterentwickelt und ermöglicht, metallische kieferorthopädische Apparaturen wie Hyrax-Gaumennahterweiterungsapparaturen, Herbst-Scharniere, Zungengitter, Transpalatinal- und Lingualbögen mit hoher Präzision und hohem Patientenkomfort herzustellen. Hierbei können sowohl additive Verfahren wie der Metallguss (im Anschluss an den 3-D-Druck der Apparatur aus Acrylat-Photopolymer mit Wachsanteil), der Metalldruck (Laser Sintering/Laser Melting) als auch subtraktive Verfahren wie die CNC-Frästechnik zur Anwendung kommen. (CAD: Computer-Aided Design, computerunterstütztes Design, CAM: Computer-Aided Manufacturing, computerunterstützte Fertigung)

Mechanical, Chemical, and Biological Properties of 3D-Printed Abutments: A Systematic Review

Aim:

A systematic review of the methods of 3D printing and the materials used so far for the manufacture of abutments was performed to evaluate whether their clinical use is indicated through the mechanical, chemical, and biological analyses carried out.

Materials and Methods:

An electronic search conducted by three independent reviewers was carried out in the PubMed, Web of Science, Cochrane Library, Science Direct, and Lilac databases. The inclusion criterion was researching articles in English that contained as subject the manufacturing of abutments through 3D printing/additive manufacturing. Any meta-analyses, reviews, book chapters, abstracts, letters, conferences papers, and studies without abutments printed were excluded.

Results:

We found 780 references, which after applying the exclusion criteria resulted in the final inclusion of seven articles for review. The studies had a high heterogeneity, showing different materials and methodologies to manufacture abutments, which makes a comparison between them difficult, and for this reason it was not possible to carry out a meta-analysis with the data found.

Conclusions:

Even with the limitations found in the present research, it is possible to conclude that printed abutments have adequate mechanical, chemical, and biological properties that can indicate their clinical use. 3D printing presents high accuracy and speed and can produce customized abutments according to each case.

Esthetic and functional rehabilitation of peg‐shaped maxillary lateral incisors: Practical recommendations

Peg‐shaped maxillary lateral incisors cause many functional and esthetic major consequences in affected patients. Their esthetic and functional rehabilitations are often multidisciplinary, involving different clinical procedures like periodontal, orthodontic, or prosthodontic procedures. No exhaustive protocol has been established to improve their comprehensive management by general dentists or specialists. The aim of this article is to elaborate a simplified clinical protocol of complete management of peg‐shaped maxillary lateral incisors by a multidisciplinary team (general practitioners, orthodontists, and prosthodontists). A clinical case of two peg‐shaped maxillary lateral incisors completely rehabilitated with multidisciplinary approaches including orthodontic treatment and restoration by veneers and direct composite resin, according to the established protocol. Extraoral, intraoral, and smile clinical analysis are crucial to ensure optimal rehabilitation. Treatment results previsualization via wax‐up and/or mock‐up play a key role in the communication between practitioner and patient to help the latter make decision. These options also facilitate the achievement of a multidisciplinary approach by accurately estimating the number of dental movements and the type of restorations that are most suitable to the presenting clinical situation.