Albert Einstein was a smart person. So were Francois Duret, E. Dianne Rekow, Werner Mormann and others who first dared to dream of Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) in dentistry. The naysayers of our profession, rather than pondering the changing face of dentistry, chose to label the concept of CAD/ CAM fabricated restorations as absurd. And the painfully long journey from embryonic idea to “operatory-ready” technologically only fuelled the fire of the naysayers. Undaunted the creative minds, toiling with archaic computers and “garage-built” visualization devices forged ahead.
It was restorative dentist Prof. Werner Mormann and electrical engineer Marco Brandestini, with a machine they painted yellow and affectionately nicknamed “The Lemon”, who first treated a patient at the University of Zurich Dental School. The date was September 19, 1985. The first-ever ceramic inlay directly fabricated via a CAD/ CAM system was bonded into a patient’s tooth. This first step took the once absurd concept of CAD/CAM in dentistry off the lab research bench and parked it front and centre in the dental operatory.
Fast forward to the year 2009. Computers play a significant and indeed irreplaceable role in every industry. Networked computers in dental operatories along with digital radiography are commonplace. Computerized tomography tells us where implants fit. Grid-based sensor technology identifies occlusal interferences. Ultrasonic systems connected to computers identify condylar determinants to aid in the programming of fully adjustable articulators. And CAD/CAM, now a 20+ year reality in dentistry, has flourished.
A very popular orthodontic treatment modality that uses multiple clear, removable appliances is manufactured via CAD/ CAM. Incredibly precise surgical stents that are the heartbeat of computer-guided implant treatment are manufactured via CAD/ CAM. Millions of CAD/CAM ceramic and resin inlays, onlays, veneers and crowns have been placed worldwide. Competitors scurry to gain a foothold in the marketplace. Commercial dental laboratories, never ones to shy away from a good idea, offer CAD/CAM Spinell, Alumina, Zirconia and yttrium-stabilized Zirconium as copings for crowns and bridges and implant-retained prostheses. Tens of millions of research dollars have been invested by the big companies in dental industry because they know that CAD/CAM is on the threshold of mainstream restorative dentistry.
It goes without saying that the journey from absurd concept to mainstream dentistry has been an arduous one fraught with technical challenges, missteps and misinformation. The purpose of this issue of Oral Health is to inform, motivate and hopefully inspire the CAD/ CAM curious as well as the CAD/CAM savvy.
One thing is certain though; dentistry is not static. Change is to be embraced but only after carefully, methodically and systematically measuring and weighing all that change entails.
W. Edwards Deming, a U. S. statistician and professor who made a significant contribution to Japan’s reputation for innovative high-quality products and its economic power said it best:
“It is not necessary to change. Survival is not mandatory.” oh
stsotsos@drtsotsos.com and www.drtsotsos.com
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The naysayers of our profession chose to label the concept of CAD/CAM fabricated restorations as absurd
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A very popular orthodontic treatment modality that uses multiple clear, removable appliances is manufactured via CAD/CAM
