Çocuk Diş Hekimliğinde Eksiltmeli Üretim Teknolojisi
Özet
Bu bölüm, çocuk diş hekimliğinde eksiltmeli üretim teknolojilerinin kullanımını ele almaktadır. Eksiltmeli üretim, frezeleme teknolojisi olarak bilinen, daha büyük bir bloktan malzemenin çıkarılması yoluyla restorasyonların üretildiği bilgisayar kontrollü bir üretim sürecidir. Bu yöntem, başta seramik, kompozit, metal veya hibrit bloklar kullanılarak hassas, verimli ve kişiye özel dental restorasyonlar üretebilme yeteneğiyle öne çıkmaktadır. Eksiltmeli üretimin klinikte üç ana uygulama alanı tanımlanmaktadır: hasta başı üretim, laboratuvar temelli üretim ve dış kaynaklı merkezi üretim. Bu teknolojinin avantajları arasında tedavi süresinin kısalması, çoklu ziyaretlerin ortadan kalkması ve materyal ile tasarım üzerinde yüksek düzeyde kontrol sağlanması yer alır. Bu da estetik ve fonksiyonel açıdan optimum sonuçlar elde edilmesini sağlar. Ancak, ekipmanların yüksek maliyeti, uzmanlık gerektirmesi ve atık oluşumu gibi dezavantajları da bulunmaktadır. Çocuk diş hekimliğinde, eksiltmeli üretim teknolojisi prefabrike kronların sınırlamalarının üstesinden gelmek için yaygın olarak kullanılmakta, kişiye özel estetik ve fonksiyonel restorasyonlar sunmaktadır. Bölümde ayrıca, bu sistemlerde yaygın olarak kullanılan seramikler, polimerler ve kompozit reçineler gibi malzemeler ve bunların mekanik özellikleri ile klinik performanslarını karşılaştıran güncel çalışmalar vurgulanmaktadır.
This chapter discusses the application of subtractive manufacturing technologies in pediatric dentistry. Subtractive manufacturing, known as milling technology, is a computer-controlled production process where material is removed from a larger block to produce restorations. This method, primarily used with ceramic, composite, metal, or hybrid blocks, has proven to be highly accurate, efficient, and capable of producing custom dental restorations. Three main clinical applications of subtractive manufacturing are identified: chairside production, laboratory-based production, and outsourced centralized manufacturing. The advantages of this technology include reduced treatment time, elimination of multiple visits, and a high level of control over the material and design, allowing for optimal esthetics and functionality. However, disadvantages include the high cost of equipment, the need for specialized skills, and waste generation. In pediatric dentistry, subtractive manufacturing is increasingly used to overcome the limitations of prefabricated crowns, allowing for custom, esthetic, and functional restorations. The chapter highlights various materials, including ceramics, polymers, and composite resins, commonly used in these systems, along with recent studies comparing their mechanical properties and clinical performance in pediatric dental applications.
Referanslar
Başpınar Alper S. Resin matrix CAD/CAM materials. Journal of International Dental Sciences, 2023;9(1): 1-10. doi: 10.21306/dishekimligi.1171938
Heffernan M J, Aquilino SA, Diaz-Arnold AM, Haselton DR, et al. Relative translucency of six all-ceramic systems. Part II: Core and veneer materials. The Journal of Prosthetic Dentistry, 2002;88(1): 10-15. doi: 10.1067/mpr.2002.126795
Kessler A, Reymus M, Hickel R, et al. Three-body wear of 3D printed temporary materials. Dental Materials, 2019;35(12): 1805–1812. doi: 10.1016/j.dental.2019.10.005
Balhaddad A A, Garcia I M, Mokeem L, et al. Three-dimensional (3D) printing in dental practice: Applications, areas of interest, and level of evidence. Clinical Oral Investigations, 2023;27(6): 2465-2481. doi: 10.1007/s00784-023-04983-7
Miyazaki T, Hotta Y, Kunii J, et al. A review of dental CAD/CAM: Current status and future perspectives from 20 years of experience. Dental Materials Journal, 2009;28(1): 44-56. doi: 10.4012/dmj.28.44
Almeida e Silva JS, Erdelt K, Edelhoff D, et al. Marginal and internal fit of four-unit zirconia fixed dental prostheses based on digital and conventional impression techniques. Clinical Oral Investigations, 2014;18(2): 515-523. doi: 10.1007/s00784-013-0987-2
İnal CB, Bankoğlu Güngör M, Karakoca Nemli S. Hasta başı CAD-CAM uygulamaları. Ankara Diş Hekimleri Odası Klinik Bilimler Dergisi. 2023;12(3): 458-466.doi: 10.54617/adoklinikbilimler.1174085
Abduo J, Lyons K, Bennamoun M. Trends in computer-aided manufacturing in prosthodontics: A review of the available streams. International Journal of Dentistry, 2014;14(1): 1-15. doi: 10.1155/2014/783948
Skorulska A, Piszko P, Rybak Z, el al. Review on polymer, ceramic and composite materials for CAD/CAM indirect restorations in dentistry: Application, mechanical characteristics and comparison. Materials, 2021;14(7): 1592-1606. doi: 10.3390/ma14071592
Davidowitz G, Kotick PG. The use of CAD/CAM in dentistry. Dental Clinics of North America, 2011;55(3): 559-570. doi: 10.1016/j.cden.2011.02.011
Strub JR, Rekow ED, Witkowski S Computer-aided design and fabrication of dental restorations: Current systems and future possibilities. Journal of the American Dental Association, 2006;137(9): 1289-1296. doi: 10.14219/jada.archive.2006.0389
Oğuz EI, Bezgin T, Orhan AI, Orhan K. Comparative evaluation of adaptation of esthetic prefabricated fiberglass and CAD/CAM crowns for primary teeth: Microcomputed tomography analysis. BioMed Research International, 2021;21(1): 1-9. doi: 10.1155/2021/1011661
Blatz MB, Conejo J. The current state of chairside digital dentistry and materials. Dental Clinics of North America, 2019;63(2): 175–197. doi: 10.1016/j.cden.2018.11.002
Davidovich E, Shay B, Nuni E, et al. An innovative treatment approach using digital workflow and CAD-CAM Part I: The restoration of endodontically treated molars in children. International Journal of Environmental Research and Public Health, 2020;17(4): 1364-1374. doi: 10.3390/ijerph17041364
Mete A, Yılmaz Y, Derelioğlu SS. Fracture resistance force of primary molar crowns milled from polymeric computer-aided design/computer-assisted manufactured resin blocks. Nigerian Journal of Clinical Practice, 2018;21(4): 525-530. doi: 10.4103/njcp.njcp_169_17
Kist S, Stawarczyk B, Kollmuss M, et al. Fracture load and chewing simulation of zirconia and stainless-steel crowns for primary molars. European Journal of Oral Science, 2019;19(127): 369-375. doi: 10.1111/eos.12645
El Shahawy OI, Azab MM. Fracture resistance of prefabricated versus custom-made zirconia crowns after thermo-mechanical aging: An in-vitro study. BioMed Central Oral Health, 2022;22(1): 587-593. doi: 10.1186/s12903-022-02628-x
Oğuz EI, Bezgin T, Işıl Orhan A, et al. Fracture resistance of esthetic prefabricated and custom-made crowns for primary molars after artificial aging. Pediatric Dentistry, 2022;44(5): 368-374.
Bolaca A, and Erdoğan Y. Fracture resistance evaluation of CAD/CAM zirconia and composite primary molar crowns with different occlusal thicknesses. Journal of Applied Biomaterials and Functional Materials, 2024;24(22): 14-16. doi: 10.1177/22808000241235994
Demirel A, Bezgin T, Akaltan F, et al. Resin nanoceramic CAD/CAM restoration of the primary molar: 3-Year follow-up study. Case Reports in Dentistry, 2017;17(1): 1-5. doi: 10.1155/2017/3517187
Gupta G, Gupta DK, Bhat M, et al. Digitally customized esthetic restoration for restoring young permanent molars: A novel approach. International Journal of Clinical Pediatric Dentistry, 2023;16(4): 656-658. doi: 10.5005/jp-journals-10005-2647
Hijaz A, Altinawi MK, Alzoubi H. Comparing the fracture resistance of dentine posts and glass fiber posts in primary maxillary incisors: An in vitro study. Cureus, 2023;15(2): 1-8. doi: 10.7759/cureus.34591
Khattab NMA, Makawi YMFE, Elheeny AH. Clinical evaluation of CAD/CAM ceramic endocrown versus prefabricated zirconia crown in the restoration of pulpotomized primary molars: A two-year split-mouth randomized controlled trial. European Journal of Dentistry, 2022;16(3): 627-636. doi: 10.1055/s-0041-1736417
Mourouzis P, Arhakis A, Tolidis K. Computer-aided design and manufacturing crown on primary molars: An innovative case report. International Journal of Clinical Pediatric Dentistry, 2019;12(1): 76-79. doi: 10.5005/jp-journals-10005-1591
Möhn M, Frankenberger R, Krämer N. Wear and marginal quality of aesthetic crowns for primary molars. International Journal of Pediatric Dentistry, 2022;32(2): 273-283. doi: 10.1111/ipd.12852
Dursun E, Monnier-Da Costa A, Moussally C. Chairside CAD/CAM composite onlays for the restoration of primary molars. The Journal of Clinical Pediatric Dentistry, 2018;42(5): 349-354. doi: 10.17796/1053-4625-42.5.5
Prabhu D, Anantharaj A, Praveen P, et al. A clinical and radiographic comparative evaluation of custom-made zirconia crowns using CAD-CAM and stainless steel crowns in primary molars. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 2022;40(1): 34-42. doi: 10.4103/jisppd.jisppd_269_21
Kamanski D, Tavares JG, Weber JB, et al. Crown fracture of an unerupted incisor in a young child: Case report and restorative protocol. International Journal of Clinical Pediatric Dentistry, 2022;15(5): 636-641. doi: 10.5005/jp-journals-10005-2437
Dolev E, Doitch O, Aderet N, et al. Digital restoration of maxillary central incisors after trauma using an intraoral scanner and a CAD/CAM system in an 11-year-old., Journal of Clinical Review and Case Reports, 2021;6(11): 770-771. doi: 10.33140/JCRC
Noirrit E, Chabreron O, Nasr K, et al. A contribution of CAD/CAM treatment of a dental trauma in a special care patient. Special Care in Dentistry, 2018;38(1): 55-57. doi: 10.1111/scd.12261
Akkuş G, Özdaş Öner D, Küçükkılıç S, et al. Who says that CAD/CAM cannot be done for children?. International Dental Journal, 2023;73(1): 34-57. doi: 10.1016/j.identj.2023.07.621
Foucher F, Mainjot AK. Polymer infiltrated ceramic network, CAD/CAM restorations for oral rehabilitation of pediatric patients with X-linked ectodermal dysplasia. The International Journal of Prosthodontics, 2018;31(6): 610-612. doi: 10.11607/ijp.5904
Sarapultseva M, Leleko A, Sarapultsev A. Case report: Rehabilitation of a child with dentinogenesis imperfecta with CAD/CAM approach: Three-year follow-up. Special Care in Dentistry, 2020;40(5): 511-518. doi: 10.1111/scd.12500
Davidovich E, Dagon S, Tamari I, et al. An innovative treatment approach using digital workflow and CAD-CAM Part II: The restoration of molar incisor hypomineralization in children. International Journal of Environmental Research and Public Health, 2020;17(5): 1499-1510. doi: 10.3390/ijerph17051499
Rodrigues LP, Dourado PHN, de Araújo CAR, et al. Digital workflow to produce esthetic space maintainers for growing patients. The Journal of Prosthetic Dentistry, 2024;131(5): 800-803. doi: 10.1016/j.prosdent.2022.02.026
Lee J. H. Fully digital workflow for the fabrication of a tooth-colored space maintainer for a young patient. Journal of Esthetic and Restorative Dentistry, 2023;35(4): 561–566. doi: 10.1111/jerd.12939
Wang Q, Zhang Z, Zhong S, et al. Clinical application of a digital semi-rigid bridge space maintainer fabricated from polyetheretherketone for premature loss of primary molars. BioMed Central Oral Health, 2023;23(1): 944-951. doi: 10.1186/s12903-023-03570-2
Soni HK. Application of CAD-CAM for fabrication of metal-free band and loop space maintainer. Journal of Clinical and Diagnostic Research, 2017;11(2): 14-16. doi: 10.7860/JCDR/2017/23459.9246
Referanslar
Başpınar Alper S. Resin matrix CAD/CAM materials. Journal of International Dental Sciences, 2023;9(1): 1-10. doi: 10.21306/dishekimligi.1171938
Heffernan M J, Aquilino SA, Diaz-Arnold AM, Haselton DR, et al. Relative translucency of six all-ceramic systems. Part II: Core and veneer materials. The Journal of Prosthetic Dentistry, 2002;88(1): 10-15. doi: 10.1067/mpr.2002.126795
Kessler A, Reymus M, Hickel R, et al. Three-body wear of 3D printed temporary materials. Dental Materials, 2019;35(12): 1805–1812. doi: 10.1016/j.dental.2019.10.005
Balhaddad A A, Garcia I M, Mokeem L, et al. Three-dimensional (3D) printing in dental practice: Applications, areas of interest, and level of evidence. Clinical Oral Investigations, 2023;27(6): 2465-2481. doi: 10.1007/s00784-023-04983-7
Miyazaki T, Hotta Y, Kunii J, et al. A review of dental CAD/CAM: Current status and future perspectives from 20 years of experience. Dental Materials Journal, 2009;28(1): 44-56. doi: 10.4012/dmj.28.44
Almeida e Silva JS, Erdelt K, Edelhoff D, et al. Marginal and internal fit of four-unit zirconia fixed dental prostheses based on digital and conventional impression techniques. Clinical Oral Investigations, 2014;18(2): 515-523. doi: 10.1007/s00784-013-0987-2
İnal CB, Bankoğlu Güngör M, Karakoca Nemli S. Hasta başı CAD-CAM uygulamaları. Ankara Diş Hekimleri Odası Klinik Bilimler Dergisi. 2023;12(3): 458-466.doi: 10.54617/adoklinikbilimler.1174085
Abduo J, Lyons K, Bennamoun M. Trends in computer-aided manufacturing in prosthodontics: A review of the available streams. International Journal of Dentistry, 2014;14(1): 1-15. doi: 10.1155/2014/783948
Skorulska A, Piszko P, Rybak Z, el al. Review on polymer, ceramic and composite materials for CAD/CAM indirect restorations in dentistry: Application, mechanical characteristics and comparison. Materials, 2021;14(7): 1592-1606. doi: 10.3390/ma14071592
Davidowitz G, Kotick PG. The use of CAD/CAM in dentistry. Dental Clinics of North America, 2011;55(3): 559-570. doi: 10.1016/j.cden.2011.02.011
Strub JR, Rekow ED, Witkowski S Computer-aided design and fabrication of dental restorations: Current systems and future possibilities. Journal of the American Dental Association, 2006;137(9): 1289-1296. doi: 10.14219/jada.archive.2006.0389
Oğuz EI, Bezgin T, Orhan AI, Orhan K. Comparative evaluation of adaptation of esthetic prefabricated fiberglass and CAD/CAM crowns for primary teeth: Microcomputed tomography analysis. BioMed Research International, 2021;21(1): 1-9. doi: 10.1155/2021/1011661
Blatz MB, Conejo J. The current state of chairside digital dentistry and materials. Dental Clinics of North America, 2019;63(2): 175–197. doi: 10.1016/j.cden.2018.11.002
Davidovich E, Shay B, Nuni E, et al. An innovative treatment approach using digital workflow and CAD-CAM Part I: The restoration of endodontically treated molars in children. International Journal of Environmental Research and Public Health, 2020;17(4): 1364-1374. doi: 10.3390/ijerph17041364
Mete A, Yılmaz Y, Derelioğlu SS. Fracture resistance force of primary molar crowns milled from polymeric computer-aided design/computer-assisted manufactured resin blocks. Nigerian Journal of Clinical Practice, 2018;21(4): 525-530. doi: 10.4103/njcp.njcp_169_17
Kist S, Stawarczyk B, Kollmuss M, et al. Fracture load and chewing simulation of zirconia and stainless-steel crowns for primary molars. European Journal of Oral Science, 2019;19(127): 369-375. doi: 10.1111/eos.12645
El Shahawy OI, Azab MM. Fracture resistance of prefabricated versus custom-made zirconia crowns after thermo-mechanical aging: An in-vitro study. BioMed Central Oral Health, 2022;22(1): 587-593. doi: 10.1186/s12903-022-02628-x
Oğuz EI, Bezgin T, Işıl Orhan A, et al. Fracture resistance of esthetic prefabricated and custom-made crowns for primary molars after artificial aging. Pediatric Dentistry, 2022;44(5): 368-374.
Bolaca A, and Erdoğan Y. Fracture resistance evaluation of CAD/CAM zirconia and composite primary molar crowns with different occlusal thicknesses. Journal of Applied Biomaterials and Functional Materials, 2024;24(22): 14-16. doi: 10.1177/22808000241235994
Demirel A, Bezgin T, Akaltan F, et al. Resin nanoceramic CAD/CAM restoration of the primary molar: 3-Year follow-up study. Case Reports in Dentistry, 2017;17(1): 1-5. doi: 10.1155/2017/3517187
Gupta G, Gupta DK, Bhat M, et al. Digitally customized esthetic restoration for restoring young permanent molars: A novel approach. International Journal of Clinical Pediatric Dentistry, 2023;16(4): 656-658. doi: 10.5005/jp-journals-10005-2647
Hijaz A, Altinawi MK, Alzoubi H. Comparing the fracture resistance of dentine posts and glass fiber posts in primary maxillary incisors: An in vitro study. Cureus, 2023;15(2): 1-8. doi: 10.7759/cureus.34591
Khattab NMA, Makawi YMFE, Elheeny AH. Clinical evaluation of CAD/CAM ceramic endocrown versus prefabricated zirconia crown in the restoration of pulpotomized primary molars: A two-year split-mouth randomized controlled trial. European Journal of Dentistry, 2022;16(3): 627-636. doi: 10.1055/s-0041-1736417
Mourouzis P, Arhakis A, Tolidis K. Computer-aided design and manufacturing crown on primary molars: An innovative case report. International Journal of Clinical Pediatric Dentistry, 2019;12(1): 76-79. doi: 10.5005/jp-journals-10005-1591
Möhn M, Frankenberger R, Krämer N. Wear and marginal quality of aesthetic crowns for primary molars. International Journal of Pediatric Dentistry, 2022;32(2): 273-283. doi: 10.1111/ipd.12852
Dursun E, Monnier-Da Costa A, Moussally C. Chairside CAD/CAM composite onlays for the restoration of primary molars. The Journal of Clinical Pediatric Dentistry, 2018;42(5): 349-354. doi: 10.17796/1053-4625-42.5.5
Prabhu D, Anantharaj A, Praveen P, et al. A clinical and radiographic comparative evaluation of custom-made zirconia crowns using CAD-CAM and stainless steel crowns in primary molars. Journal of the Indian Society of Pedodontics and Preventive Dentistry, 2022;40(1): 34-42. doi: 10.4103/jisppd.jisppd_269_21
Kamanski D, Tavares JG, Weber JB, et al. Crown fracture of an unerupted incisor in a young child: Case report and restorative protocol. International Journal of Clinical Pediatric Dentistry, 2022;15(5): 636-641. doi: 10.5005/jp-journals-10005-2437
Dolev E, Doitch O, Aderet N, et al. Digital restoration of maxillary central incisors after trauma using an intraoral scanner and a CAD/CAM system in an 11-year-old., Journal of Clinical Review and Case Reports, 2021;6(11): 770-771. doi: 10.33140/JCRC
Noirrit E, Chabreron O, Nasr K, et al. A contribution of CAD/CAM treatment of a dental trauma in a special care patient. Special Care in Dentistry, 2018;38(1): 55-57. doi: 10.1111/scd.12261
Akkuş G, Özdaş Öner D, Küçükkılıç S, et al. Who says that CAD/CAM cannot be done for children?. International Dental Journal, 2023;73(1): 34-57. doi: 10.1016/j.identj.2023.07.621
Foucher F, Mainjot AK. Polymer infiltrated ceramic network, CAD/CAM restorations for oral rehabilitation of pediatric patients with X-linked ectodermal dysplasia. The International Journal of Prosthodontics, 2018;31(6): 610-612. doi: 10.11607/ijp.5904
Sarapultseva M, Leleko A, Sarapultsev A. Case report: Rehabilitation of a child with dentinogenesis imperfecta with CAD/CAM approach: Three-year follow-up. Special Care in Dentistry, 2020;40(5): 511-518. doi: 10.1111/scd.12500
Davidovich E, Dagon S, Tamari I, et al. An innovative treatment approach using digital workflow and CAD-CAM Part II: The restoration of molar incisor hypomineralization in children. International Journal of Environmental Research and Public Health, 2020;17(5): 1499-1510. doi: 10.3390/ijerph17051499
Rodrigues LP, Dourado PHN, de Araújo CAR, et al. Digital workflow to produce esthetic space maintainers for growing patients. The Journal of Prosthetic Dentistry, 2024;131(5): 800-803. doi: 10.1016/j.prosdent.2022.02.026
Lee J. H. Fully digital workflow for the fabrication of a tooth-colored space maintainer for a young patient. Journal of Esthetic and Restorative Dentistry, 2023;35(4): 561–566. doi: 10.1111/jerd.12939
Wang Q, Zhang Z, Zhong S, et al. Clinical application of a digital semi-rigid bridge space maintainer fabricated from polyetheretherketone for premature loss of primary molars. BioMed Central Oral Health, 2023;23(1): 944-951. doi: 10.1186/s12903-023-03570-2
Soni HK. Application of CAD-CAM for fabrication of metal-free band and loop space maintainer. Journal of Clinical and Diagnostic Research, 2017;11(2): 14-16. doi: 10.7860/JCDR/2017/23459.9246
