CAD/CAM All Ceramic Dental Restorations on Implants: A Panacea or a Challenge?

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  • TAMAKI Yukimichi
    Department of Oral Biomaterials and Technology, Showa University School of Dentistry
  • HOTTA Yasuhiro
    Department of Oral Biomaterials and Technology, Showa University School of Dentistry
  • KUNII Jun
    Department of Oral Biomaterials and Technology, Showa University School of Dentistry
  • KURIYAMA Soichi
    Department of Oral Biomaterials and Technology, Showa University School of Dentistry
  • HIGUCHI Daisuke
    Department of Prosthodontics, Showa University School of Dentistry
  • MIYAZAKI Takashi
    Department of Oral Biomaterials and Technology, Showa University School of Dentistry

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Abstract

The aim of the present study was to evaluate whether all-ceramic restorations fabricated by computer-aided design and manufacturing (CAD/CAM) are a panacea for the application to conventional prostheses and implant prostheses or if there exist challenges that must be overcome first. Fracture tests of CAD/CAM milled porcelain single crowns adhered to a master abutment model were performed to evaluate mechanical durability. The fits of CAD/CAM-milled and post-sintered zirconia angled frameworks for bridge restorations (APAPA, A: abutment, P: pontic) were evaluated by measuring the cement space at the margin of the sectioned surface of the framework and abutment. The bonding strengths of porcelain (a machinable glassy ceramic) and zirconia were evaluated by measuring the bending strength of porcelain adhering to zirconia specimens and porcelain fused to zirconia specimens. A CAD/CAM-fabricated porcelain single crown seemed promising, but adhering treatment was mandatory to guarantee its durability. The fits of CAD/CAM-fabricated and post-sintered zirconia frameworks were excellent and satisfied criteria for clinical acceptance of cement-retained superstructures of implants. However, fusing porcelain to a zirconia framework in the conventional manner has several disadvantages. Therefore, we propose a new hybrid all-ceramic restoration system of CAD/CAM porcelain veneering adhering to CAD/CAM zirconia frameworks. In conclusion, CAD/CAM all-ceramic restoration alone is not yet a panacea but already a very useful tool even for implant prostheses.

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