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cappmea
02-15-2010, 07:01 AM
CAE Computer Aided Esthetics
Dr. ******* Kurbad
Speaker at the 4th CAD/CAM & Computerized Dentistry International Conference

An excellent design and, in the second place, the predictability of results are very important success factors when restoring teeth in the esthetic zone. In most esthetic dentistry cases, a re-design of the shape and contour of the respective teeth is required. In conventional treatment procedures, this is accomplished by means of a wax up. Once approved by the patient, the wax-up represents the basis for all the working steps that are carried out in the course of the treatment. Very frequently, the wax-up is used to fabricate splints for so-called mock-ups or provisional restorations. Moreover, silicone matrices are made to ensure control of the amount of tooth structure removed during preparation. These matrices enable the mandatory minimum layer thickness to be observed and the shape and contour of the final restoration previously defined by means of the wax-up to be reproduced. To provide patients with a restoration whose appearance is very close to that originally defined in the treatment plan is crucial to treatment success.
Especially as far as the design is concerned, nearly all the steps involved are performed by means of computers today. There is not a single car in the world that is created without the help of computer-aided design (CAD) programs. Therefore, we should also take esthetic dentistry to the next level by no longer fabricating physical wax-ups but creating them in digital form on computers instead. The first step involves the digitization of the jaws. This can be done by means of the models or directly in the oral cavity. Additionally, a bite registration is made. The result is a three-dimensional digital image, which can be displayed on a computer screen. This offers a lot of advantages: Design databases can be utilized to achieve quick and case-related results. Functional movements can be simulated. Prior to the digital-to-material conversion, ideas can be discussed with the patient by displaying the three-dimensional images on a computer screen. The wishes of the patient can be taken into account immediately. Functional aspects can be included. Once the digital proposal has been accepted by all the relevant partners, the virtual design can be used for various purposes, such as milling a wax-up or an acrylic splint, for example.
Following tooth preparation, the new situation will be scanned again and matched with the data of the case already stored in the computer. The digital wax-up can then be used for the design of the final restoration. The modern, highly esthetic all-ceramic materials available today even allow full-contour restorations to be milled, which only need to be stained and glazed. In challenging cases, a slight cut-back can be performed to optimize the result.
All in all, this is a completely new way of achieving highly esthetic outcomes in the management of restoration cases. It allows the predictability of results to be increased in a very cost-effective way.

13 -14 May, 2010
The Address Dubai Marina
Dubai UAE


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