Dental CAD/CAM systems: a 20-year success story.

T he stage was set for exciting advances in dentistry in the 1950s and 1960s when prototypes of computer-aided design (CAD) and computer-aided manufacturing (CAM) were introduced into industrial settings. 1 In those applications , the geometry of the " parts " was simpler than that generally needed for dental restorations , but the same techniques could be applied to creating dental crowns. Early dreamers like Mörmann, 2 Duret and colleagues 3 and me 4 were intrigued by the possibilities. But the road was far less smooth than any of us imagined. Computing power was limited; a gigabyte drive was unheard of, yet design of the complex geometries of crowns was computationally intensive. CAM systems were large, and the thought of having a desktop milling machine was laughable. Equipment companies perceived that dental CAD/CAM systems would be like cameras for which revenue would be driven by selling the materials like film. Simultaneously, the material companies perceived that the systems were equipment and beyond the scope of their product line. Perseverance, however, paid off. The dreamers continued to work, and CAD/CAM systems are now part of everyday dentistry. In this supplement, you will read about the success of one of the systems that emerged as an effective in-office automated system known as the CEREC system though much of what you read will apply to any CAD/CAM system. The CEREC system has been available commercially for 20 years, is used by more than 17,000 dentists and in 28 dental schools in the United States, and has produced approximately 12 million restorations. In the first article of this supplement, Mörmann 5 chronicles the evolution of his idea into a series of increasingly robust systems. At first blush, the thought of machining a brittle material like dental ceramics was ridiculous. But as Giordano 6 describes in the second article of this supplement, innovations in materials created esthetic materials that could withstand potential damage introduced by CAD/CAM operations. When created with an in-office CAD/CAM system, esthetic restorations provided in a single appointment are a reality. But can an automatically produced restoration fabricated in the dental office perform as well and deliver the same esthetics as those created by skilled artist technicians? In the third article of this supplement, Fasbinder 7 reviews the literature pertaining to performance of CEREC-generated restorations. He provides insight into the types of restorations that could be produced over time and the …