Computer-aided design and computer-assisted manufacturing in prosthetic implant dentistry.

PURPOSE The aim of this systematic review was to evaluate the existing scientific evidence on human clinical studies describing the application of computer-aided design/computer-assisted manufacturing (CAD/CAM) technology in restorative implant dentistry. MATERIALS AND METHODS Electronic searches for clinical studies from 1966 through May 2008 focusing on long-term follow-up were performed using the PubMed search engine. Concentrating on the restorative aspect of the CAD/CAM technology applicable to implant dentistry, pertinent literature was divided into articles related to implant abutments and implant frameworks. RESULTS Of the 885 articles initially reviewed, 5 articles (3 CAD/CAM framework and 2 CAD/CAM abutment) satisfied the search criteria of the literature search performed. Combining the results from the framework clinical trial studies, there were a total of 189 prostheses supported by 888 implants. The follow-up varied between 12 and 60 months. Four implants were lost prior to the insertion of the prosthesis and 46 after the insertion. One prosthesis failure was reported. Similarly, in the 2 abutment clinical trial studies there were a total of 53 ceramic abutments supported by 53 implants. The patients were followed between 12 and 44 months. No significant failures or complications were reported in association with the implants and their restorations. CONCLUSIONS Based on a systematic review of literature concerning CAD/CAM used for fabrication of frameworks and abutments, preliminary proof of concept was established. Clinical studies on the use of these techniques were too preliminary and underpowered to provide meaningful conclusions regarding the performance of these abutments/frameworks.

[1]  T Jemt,et al.  Precision of CNC-milled titanium frameworks for implant treatment in the edentulous jaw. , 1999, The International journal of prosthodontics.

[2]  M. Wood,et al.  A review of selected dental literature on evidence-based treatment planning for dental implants: report of the Committee on Research in Fixed Prosthodontics of the Academy of Fixed Prosthodontics. , 2004, The Journal of prosthetic dentistry.

[3]  Carl J Drago,et al.  Treatment of an edentulous patient with CAD/CAM technology: a clinical report. , 2007, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[4]  R. Haas,et al.  Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. , 2005, Clinical oral implants research.

[5]  Paolo Vigolo,et al.  An in vitro evaluation of titanium, zirconia, and alumina procera abutments with hexagonal connection. , 2006, The International journal of oral & maxillofacial implants.

[6]  George A Zarb,et al.  A comparison of the accuracy of fit of 2 methods for fabricating implant-prosthodontic frameworks. , 2007, The International journal of prosthodontics.

[7]  Irena Sailer,et al.  A systematic review of the survival and complication rates of all‐ceramic and metal–ceramic reconstructions after an observation period of at least 3 years. Part II: fixed dental prostheses. , 2007 .

[8]  Golec Ts,et al.  CAD-CAM multiplanar diagnostic imaging for subperiosteal implants. , 1986 .

[9]  Torsten Jemt,et al.  Evaluation of custom-made procera ceramic abutments for single-implant tooth replacement: a prospective 1-year follow-up study. , 2003, The International journal of prosthodontics.

[10]  Daniel Edelhoff,et al.  Marginal and internal fits of fixed dental prostheses zirconia retainers. , 2009, Dental materials : official publication of the Academy of Dental Materials.

[11]  H. Ehrenkranz,et al.  Complete-arch maxillary rehabilitation using a custom-designed and manufactured titanium framework: a clinical report. , 2008, The Journal of prosthetic dentistry.

[12]  George Priest,et al.  Virtual-designed and computer-milled implant abutments. , 2005, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  Paolo Vigolo,et al.  Evaluation of gold-machined UCLA-type abutments and CAD/CAM titanium abutments with hexagonal external connection and with internal connection. , 2008, The International journal of oral & maxillofacial implants.

[14]  T. Jemt,et al.  Clinical experiences of computer numeric control-milled titanium frameworks supported by implants in the edentulous jaw: a 5-year prospective study. , 2004, Clinical implant dentistry and related research.

[15]  Yoav Grossmann,et al.  A novel technique using a coded healing abutment for the fabrication of a CAD/CAM titanium abutment for an implant-supported restoration. , 2006, The Journal of prosthetic dentistry.

[16]  I. E. Ruyter,et al.  Implant-fixed, dental bridges from carbon/graphite fibre reinforced poly (methyl methacrylate) , 1986 .

[17]  B. Engquist,et al.  Simplified methods of implant treatment in the edentulous lower jaw. Part II: Early loading. , 2004, Clinical implant dentistry and related research.

[18]  Daniel van Steenberghe,et al.  Immediately loaded CAD-CAM manufactured fixed complete dentures using flapless implant placement procedures: a cohort study of consecutive patients. , 2007, The Journal of prosthetic dentistry.

[19]  Mehmet Avci,et al.  The implant-abutment interface of alumina and zirconia abutments. , 2008, Clinical implant dentistry and related research.

[20]  B. Kucey,et al.  The Procera abutment--the fifth generation abutment for dental implants. , 2000, Journal.

[21]  Torsten Jemt,et al.  Comparisons of precision of fit between cast and CNC-milled titanium implant frameworks for the edentulous mandible. , 2003, The International journal of prosthodontics.

[22]  G. Rasperini,et al.  In vivo early plaque formation on pure titanium and ceramic abutments: a comparative microbiological and SEM analysis. , 1998, Clinical oral implants research.

[23]  Carl J Drago.  Two new clinical/laboratory protocols for CAD/CAM implant restorations. , 2006, Journal of the American Dental Association.

[24]  Bjarni E Pjetursson,et al.  A systematic review of the survival and complication rates of resin-bonded bridges after an observation period of at least 5 years , 2008, BDJ.

[25]  Marianella Sierraalta,et al.  Evolution and use of aluminum oxide single-tooth implant abutments: a short review and presentation of two cases. , 2002, The International journal of prosthodontics.

[26]  Toshiyuki Takahashi,et al.  Fit of implant frameworks: an in vitro comparison between two fabrication techniques. , 2003, The Journal of prosthetic dentistry.

[27]  Irena Sailer,et al.  Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study. , 2004, The International journal of prosthodontics.

[28]  T. Jemt,et al.  Fixed implant-supported prostheses with welded titanium frameworks. , 1992, The International journal of periodontics & restorative dentistry.

[29]  M. Razzoog,et al.  Management of a partially edentulous patient with malpositioned implants, using all-ceramic abutments and all-ceramic restorations: A clinical report. , 2006, The Journal of prosthetic dentistry.

[30]  Luigi Canullo,et al.  Clinical outcome study of customized zirconia abutments for single-implant restorations. , 2007, The International journal of prosthodontics.

[31]  Herman K Kupeyan,et al.  Definitive CAD/CAM-guided prosthesis for immediate loading of bone-grafted maxilla: a case report. , 2006, Clinical implant dentistry and related research.