HOME - Clinical cases - Prosthodontics
29 January 2020

CAD/CAM or conventional ceramic materials: which last longer?

Co-author: Allegra Comba

Lorenzo Breschi

When discussing about restorative dentistry and prosthodontics, rehabilitations with CAD/CAM high performance materials are an alternative to traditional techniques because of the easy accessibility of chairside fabrication of the final restoration.
Use of CAD/CAM technology has become more and more common in recent years, with an increased number of bridges, crowns, onlays, and inlays placed every year. Furthermore, there has been a considerable increment in the number of available chairside systems and one of the main reasons for this is that intraoral scanners have become increasingly better, smaller, and faster, while the design software has become more and more user-friendly. Many work steps are now automated, and a very large range of materials is now available for dental chairside applications. However, even if CAD/CAM technology has significantly improved over time and has been shown to be more time efficient in ceramic prosthesis fabrication than the conventional method, other factors like adaptation and quality of the manufactured should be taken into consideration.

A recent review by Becker Rodrigues et al, from Brazil, reported that the estimated five-year survival of all-ceramic crowns ranges between 90.7% and 96.6% (feldspathic/silica based ceramics and leucite or lithium-disilicate reinforced glass ceramics), whereas the clinical performance of CAD/CAM single tooth restorations is attested around 91.6% after five years. In that context, the purpose of the research conducted by the group of the Federal University of Rio Grande do Sul was to evaluate the longevity of conventional and CAD/CAM techniques for tooth-supported ceramic prosthesis (single crown, multipleunit or partial ceramic crown) and to identify the complication types associated with the main clinical outcomes.

The authors included in the review and meta-analysis only studies evaluating the survival of milling or CAD/ CAM prostheses after a minimum of two years of follow-up time. Two reviewers independently assessed the titles and abstracts of all of the selected articles. The articles were first reviewed by title and abstract and subsequently by a full text reading. Electronic database searches from all sources (PubMed, SCOPUS, LILACS and Web of Science) identified 1897 publications. After evaluating the titles and abstracts, 159 publications were selected for full text reading. In the end, fourteen studies (published between 1966 to October 10th, 2017) were included in the systematic review and seventeen comparisons groups were included in the meta-analysis (one publication presented one test and three control groups). This interesting paper provided an overview on the longevity of ceramic restorations according to techniques (conventional or CAD/CAM) using a tooth-supported single crown, multiple-unit and partial single crown.

The result obtained suggested that CAD/CAM system resulted in more chances to fail compared to conventional manufacturing of a ceramic restoration, considering losses of follow-up as failures or as successes. Furthermore, the results of the meta-analysis suggested that the longevity of tooth-supported single crown, multiple unit or partial ceramic crowns made by CAD/CAM is lower than that of crowns made by conventional techniques.

The authors concluded that the material type and process were the most frequent reasons for CAD/CAM failures and suggest a more in-depth analysis to evaluate the difference between CAD/CAM generations and software limitations to elucidate the reasons that CAD/CAM results in a higher risk of failure.  

(Photocredit: Dr Edoardo Mancuso, Dr Emanuele Bergantin)

For more information: CAD/CAM or conventional ceramic materials restorations longevity: a systematic review and meta-analysis. 

Related articles

The restoration of endodontically treated teeth with post and core restorations has been extensively studied in the last 20 years. Yet, the association between tooth type, location in the dental arch...

Several prosthodontics rehabilitation processes are needed to recreate a correct masticatory function. The provisional stage is quite important and materials employed in this phase are not completely...

The use of restorative materials to adhere to the dental surfaces and to preserve as much dental tissue as possible, has determined and conditioned the choice...

The restoration of endodontically treated teeth is always a topic of crucial attention for dentists. If until a few years ago, the therapeutic choice of...

Co-authors: Storelli S, Del Fabbro M, Scanferla M, Romeo E

Implant placement can be limited by anatomical conditions that may be overcome with different solutions: reduced dimension implants, bone regeneration procedures or...

Read more

Bisphosphonates are widely used for the treatment of abnormal bone metabolism for example in osteoporosis. Their continuative use leads to a strong inhibition...

Author: Luigi Campopiano

1. In the light of the fact that the 9 trillion euro of Italian savings are more than 90 % invested in Italy in euros, it is a good idea to expand the scope of investments to other markets that...

Demand of esthetic outcomes is becoming more and more frequent in dentistry and ceramic laminate veneers represent one of the main choices to functionally and...

There is still no accordance on the antibiotic prophylaxis regimen to prevent failures or postoperative infections in healthy patients undergoing standard implant surgery.Some authors proposed...

Editorials     28 July 2020

Welcome Summer 2020

Dear readers, Summer 2020 is definitely a strange and, under certain aspects, never existing season for our planet. The recent notorious burst of...




Most popular