CAD/CAM in biomedical engineering - Digital prosthetic dentistry

Since the 1970s, the deployment of digital and Computer Aided Design and Manufacturing (CAD/CAM) technologies has played a major role in the design and manufacture of industrial products. The transposition of these technologies to the biomedical field then gave rise to the development of digital CAD/CAM chains dedicated to various healthcare sectors. CAD/CAM in biomedical engineering is now a methodological approach based on the use and development of tools, IT resources and equipment forming "links" integrated into a "digital chain" enabling medical diagnosis, the planning of medical or surgical care, or the production of individualized medical devices.

As early as 1973, Dr. François Duret, in his thesis for the state diploma of Doctor of Dental Surgery, proposed the use of "digital impressions" and computer technology to design and produce single-unit dental prostheses, thus laying the foundations for digital prosthetic dentistry. After a development phase in the 1980s, the first dental CAD/CAM systems were marketed in the 1990s, before enjoying strong commercial growth in the 2000s and 2010s.

There are three types of CAD/CAM methodology on the market for dental prostheses. The direct methodology enables the dental surgeon to design and produce a prosthetic restoration in a single session, based on the digitization of the patient's dentition. Indirect methodology enables the dental technician to design and produce a prosthetic restoration based on the scan of the dental impression or plaster model from the practice. Semi-direct methodology enables the dental technician to design and fabricate a prosthetic restoration in the laboratory, based on an in-office scan of the patient's teeth.

Despite current and future growth in the dental CAD/CAM market in Europe and North America, only 3-5% of dental practices are equipped with direct CAD/CAM, compared with 45-50% of prosthetic laboratories equipped with indirect or semi-direct CAD/CAM. This low level of equipment can be explained by the cost of direct CAD/CAM chains, the lack of training for dentists, new practice organization and new working methods brought about by these technologies. Semi-direct CAD/CAM thus seems the most promising alternative, leaving the practitioner to concentrate on his clinical skills and the prosthodontist on his skills as a prosthesis designer and fabricator. This trend towards semi-direct CAD/CAM will surely be the one that best meets the new European regulations on individualized medical devices.

With the introduction of these new technologies, digital prosthetic dentistry is positioned as a growth sector. New players on the market, manufacturing interoperable and customizable equipment and software, are targeting emerging companies integrating...