CAD/CAM Technology for Implant Abutments, Crowns, and Superstructures

Purpose: The aim of this systematic review was to compare implant prostheses fabricated by computer-assisted design and computer-assisted manufacturing (CAD/CAM) with conventionally fabricated implant prostheses when assessing esthetics, complications (biologic and mechanical), patient satisfaction, and economic factors. Materials and Methods: Electronic searches for clinical studies focusing on long-term follow-up were performed using the PubMed and Ovid search engines. Concentrating on the restorative aspect of the CAD/CAM technology applicable to implant dentistry, pertinent literature was divided into articles related to implant abutments, crowns, and frameworks. Results: A total of 18 articles satisfied the inclusion criteria. Two articles reported on CAD/CAM crowns, six on abutments, and 10 on implant-supported CAD/CAM frameworks. The mean survival rate for CAD/CAM crowns was 98.85% and for CAD/CAM abutments 100%. The mean survival rate for CAD/CAM frameworks was 95.98%. Conclusion: Based on the current literature, CAD/CAM fabricated crowns, abutments, and frameworks demonstrate survival rates comparable to conventionally fabricated prostheses. Implant survival appears unaffected by fabrication technique. Since this technology encompasses several manufacturing variations, a new definition might be necessary to accurately define the processes under which the CAD/CAM restorations are fabricated. "Complete CAD/CAM product" where no or minimal manual intervention is employed could be a possible term.