Digital CAD/CAM Prosthetics: The Future of Prosthetic Dentistry

How a complete CAD/CAM workflow works, the difference between subtractive (milling) and additive (3D printing) fabrication, and why chairside and lab workflows remain two distinct models with different advantages.

CAD/CAM (Computer-Aided Design / Computer-Aided Manufacturing) technology entered manufacturing industry use as early as 1957, but reached dentistry only starting in 1980, with the first commercial systems like Cerec and Procera. The workflow today is organized into three main elements: a digitization tool (intraoral or lab scanner) that captures the three-dimensional model of the mouth or plaster model; design software (CAD) in which the restoration is virtually drawn, defining shape, thicknesses and fit; and a production system (CAM) that turns the digital design into a physical object.

On the production side, two radically different approaches exist. Subtractive fabrication, or milling, starts from a solid block of material — ceramic, zirconia, composite resin, metal — and progressively works it, removing material until the designed shape is achieved: it's the most widely used method for crowns, bridges and veneers in high-strength ceramic materials. Additive fabrication, or 3D printing, builds the object by progressively adding material, layer by layer, through techniques such as stereolithography (SLA), fused deposition modeling (FDM), selective laser melting (SLM) or selective laser sintering (SLS) — an increasingly widespread approach for diagnostic models, surgical guides, positioning jigs and provisionals.

A clinically relevant distinction concerns when and where production takes place. The chairside workflow allows making the entire restoration — from optical scan to final milling — in a single visit, entirely within the dental practice, with no intermediate steps through an outside lab: a significant time advantage for the patient, typically reserved for single restorations such as inlays, onlays, veneers or single crowns. The lab workflow, more traditional, requires at least one additional step — the digital scan is sent to an outside lab or milling center — but remains the preferred choice for more complex, extensive rehabilitations, where the supervision and finishing of a specialized dental technician remain hard to replace.

The scope of CAD/CAM application has progressively expanded well beyond single crowns: today it includes multiple fixed bridges, inlays and onlays, aesthetic veneers, custom abutments and structures for implant prosthetics like All-on-4 rehabilitations, as well as orthodontic devices and surgical guides for computer-guided implant surgery. Digital precision, in particular, has made it possible to minimize tooth preparation in many of these indications, a direct benefit for preserving natural tooth structure that aligns with the principle of minimal invasiveness now central to contemporary prosthetic dentistry.

On Oralzon you'll find blocks and discs for CAD/CAM milling in all the main prosthetic materials, as well as 3D printing resins dedicated to models, surgical guides and provisionals in fully digital workflows.