COMPUTERIZED DENTAL PROSTHETICS
treatment as well as laboratory work steps were
performed and compared. All digitally generated
crowns required no interproximal or occlusal
adaptations. In addition, the clinical treatment
could be managed during two appointments
for (1) intraoral impression and (2) prosthetic
placement, with a mean total chair time of 20 min
per patient/reconstruction. The mean overall time
analyses for the dental lab revealed differences for
group A (40 min) compared with group B (90 min).
Total laboratory costs were lower for group A (no
cost for traditional delivery and quality control)
compared with group B. The advantages for the
dental lab could be summarized in:
m lower price in terms of quality control costs;
m reduced traditional working time;
m property maintenance of the prosthodontic
project.
At the 12 months follow-up visit, all patients were
evaluated, and no complications or failures were
recorded. The mean White Esthetic Scores (WES) 15
were comparable within the two groups. Patient’s
satisfaction was high in all cases.
Discussion and Conclusions
Among the wishes of dental practitioners there
is the interest to offer the advantages of oral
rehabilitations to more patients. This can be
accomplished by reducing the overall clinical
treatment cost and time used, and the total
amount of technical production process to achieve
a reasonable cost-benefit ratio in combination
with high quality and precision of the prosthetic
reconstructions.16-17 Technical development in the
field of digital dental medicine has opened this
opportunity. But new competences are requested
to dental operators to achieve the entire fabrication
digital dental process, starting clinically, following
digital designing avoiding the risk to delegate the
prosthodontic project to a third part, and last but
not least assuming all the competence the digital
process is requesting. The findings of this clinical
case series revealed that this a feasible treatment
concept in the digital workflow in prosthesis
manufacture. Dental practitioners can offer a
streamlined treatment approach for single-tooth
replacement, at least for posterior sites.
Clinicians, dental technicians and patients
would even benefit more from these procedures
because manufacture only should be delegated to
production centers.
The prosthesis design will remain in the dental
clinic and lab, avoiding the delegation of the
prosthodontic project to third parts. A more
patient-centered outcome will be obtained.
Of course, the current data were limited to
single unit posterior crowns, and the procedure
should be tested for more complex restorative
procedures. Obviously further large-scale studies
with long-term follow-up observations are
necessary to investigate the clinical performance
of the treatment concept.
Bibliography
1. Beuer F, Stimmelmayr M, Gueth JF, Edelhoff D, Naumann
M. In vitro performance of full-contour zirconia single crowns.
Dent Mat. 2012;28(4):449-456.
2. Patel N. Integrating three-dimensional digital technologies
for comprehensive implant dentistry. J Am Dent Assoc.
2010;141(Suppl 2):20S-24S.
3. Johnson GH, Craig RG. Accuracy of four types of rubber
impression materials compared with time of pour and a repeat
pour of models. J Prosthet Dent. 1985;53(4):484-490.
4. Millstein PL. Determining the accuracy of gypsum casts made
from type IV dental stone. J Oral Rehabil. 1992;19(3):239-243.
5. Denry IL, Holloway JA, Rosenstiel SF. Effect of ion exchange
on the microstructure, strength, and thermal expansion
behavior of a leucite reinforced porcelain. J Dent Res. 1998;
77(4):583-588.
6. Walton TR. An up to 15-year longitudinal study of 515
metal-ceramic FPDs: Part 1. Outcome. Int J Prosthodont.
2002;15(5):439-445.
7. Keating AP, Knox J, Bibb R, Zhurov AI. A comparison of
plaster, digital and reconstructed study model accuracy. J
Orthod. 2008;35(3):191-201; discussion 175.
8. Bindl A, Mörmann WH. Marginal and internal fit of allceramic CAD/CAM crown copings on chamfer preparations. J
Oral Rehabil. 2005;32(6):441-447.
9. Christensen GJ. Marginal fit of gold inlay castings. J Prosthet
Dent. 1966;16(2):297-305.
10. Bandlish RB, McDonald AV, Setchell DJ. Assessment of the
amount of remainin