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CHAPTER 3

       Technical factors

1.3.1 Introduction

      In this chapter:

      ■ Conventional vs computer-aided manufacturing techniques

      ■ Optical factors influencing the material selection

      ■ Monolithic and veneered restorations

Digital technologies offer significant new opportunities in many dental and medical fields. Restorative dentistry has been one of the disciplines that has profited the most from these technological advancements in the last decade1. Among these innovations, computer-assisted design and computer-assisted manufacturing (CAD/CAM) technologies have greatly influenced the production of provisional and definitive restorative components1^–3. As the technology establishes and further develops (intraoral optical scanners, cast optical scanners, virtual design software, 3D printers), new indications arise in other treatment phases of the restorative workflow. APart from the previously discussed clinical decision-making criteria, the following technical considerations play an important role for the material selection: the fabrication technology; the optical properties of the tooth/implant substrate; and the selection between purely monolithic or veneered types of restorations.

1.3.2 Conventional vs computer-aided manufacturing techniques

Computer technology is increasingly changing the way dentistry is being performed. CAD/CAM processes are transforming what were previously manual tasks into easier, faster, cheaper, and more predictable mechanized methods3. Current industrial product development would be impossible without CAD technologies. No engineer would consider designing a prototype layering or carving a structure manually; instead a virtual environment is used, where different versions can be tried-in without increasing significantly the time invested and with no impact in the costs. Carving shapes manually has evolved into designing volumes virtually by means of dedicated software. In restorative dentistry, the wax and modeling are evolving into software and mouse-clicks. The restorative team can profit from virtual libraries from where different tooth morphologies can be selected (Exocad, Darmstadt, Germany; 3Shape; Copenhagen, Denmark; Dental Wings, Montreal, Canada; Sirona Dental, Wals, Austria). These software tools offer numerous different tooth shapes categorized according to parameters such as size, age, or patient’s phenotype. Moreover, real teeth can be used as a reference to generate tooth morphology proposals4. These standard shapes can later be modified and adapted to individual patient situations. Working time is substantially reduced by eliminating the mechanical handwork needed for conventional waxing techniques. This allows the technician to focus solely on shapes and tooth arrangements.

To date, subtractive CAM processes dominate the dental manufacturing routines. Restorations