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CAD/CAM: Ceramics for Every Situation

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CAD/CAM technology enables dentists to fabricate an esthetic crown in one or two visits. So 

long to the days of standard impressions and conventional model making! With CAD/CAM, a

digital impression is scanned with a camera or video, and its software designs a crown that can be modified by the technician. The crown is then milled out in the ceramic of your choice. Now that CAD/CAM has become so popular due to its convenience and efficiency, there are several new ceramics on the market and we must be knowledgeable of all the choices. The leading ceramics on the market today are leucite, alumina, zirconia, and lithium disilicate. Each material has its advantages and disadvantages. Knowing which ceramic to use in different clinical situations is vital to the success of the restoration. In this blog, I will be explaining their advantages and disadvantages and when to use each ceramic.

 

Leucite ceramics have high translucency and are very esthetic, permitting use in the anterior region. However, due to their high glass content, these ceramics have very low strength and should not be used in posterior regions or areas with greater occlusal loads. Alumina ceramics are extremely translucent, in fact, build-ups/core materials may be seen through an alumina restoration. They also have low flexural strength, and with the invention of other ceramics that more effectively combine strength and esthetics, alumina is slowly dying out as a restorative material.

 

Zirconia is one of the newest ceramics on the market and has been a very popular choice for dentists. Zirconia has impressive strength and therefore can be used in posterior regions with heavy occlusal loads. Zirconia can also be used as a bridge framework due to its increased strength--this has better esthetics than a metal framework. Zirconia can either be veneered or monolithic. Monolithic is the strongest and because of these physical properties, it often permits a dentist to use a conservative prep design, similar to a full-gold crown. Veneered zirconia is more esthetic and can be used in the anterior region. Veneered zirconia has decreased strength compared to monolithic zirconia and should be used with caution in posterior areas.

 

Finally, there is lithium disilicate. This ceramic combines many of the attributes of leucite and zirconia materials. Lithium disilicate has the translucency and esthetics of a leucite ceramic, yet a strength similar to zirconia. Lithium disilicate, like zirconia, can either be monolithic or veneered. Monolithic lithium disilicate is the strongest version, but not as strong as monolithic zirconia. However, it is more esthetic than the monolithic zirconia and can be used in the anterior region up to the first molars. Veneered lithium disilicate is more esthetic, yet weaker, and should be used in anterior areas only.

 

CAD/CAM is a growing technology that will only increase in success and popularity. Being informed about the different ceramics and their clinical indications is crucial to the success of the restoration and the success of your business. I hope this information was helpful and I would appreciate anyone’s input regarding the topic!