Health Technology Assessment of CAD/CAM in Dentistry

Authors

1 Young Researchers and Elites club, Science and Research Branch, Islamic Azad University, Tehran, Iran

2 Head of Health Technology Assessment (HTA) Department, Deputy of Curative Affairs, Ministry of Health and Medical Education, Tehran, Iran

3 National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran

4 School of Health Management and Information Sciences, Tehran University of Medical Sciences, Tehran, Iran

5 Standardization and Tariff Office, Deputy of Curative Affairs, Ministry of Health and Medical Education. Tehran, Iran

Abstract

Introduction: Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) are the latest achievements of Prosthodontics and Restorative Dentistry. The aim of this research is to help make appropriate decision whether to use this technology in Iran.

Methods: Studies were included in this review that compared Dental CAD/CAM with conventional restorative methods in terms of safety, efficacy and cost-effectiveness using Cochrane Library, CRD and Pub med. Results were analyzed using qualitative methods.

Results: Six articles were used. Different indices of effectiveness in two types of application were found through the studies. Total failure rate for dental inlays was obtained as 0, 2.6% in 3 studies during a 4-year period and 1.75% in a 7-year period. It was 0.53% and 3.61% in two studies for prosthesis. Five-year survival rate for dental inlays was obtained from 91.6% to 100% and for prosthesis 72.2% to 100% in two studies. In terms of cost-effectiveness ratio of this technique compared to traditional methods, using ceramics fabricated along with chair side CAD/CAM is higher than traditional method; thus using it provides higher cost-effectiveness ratio than restoration by gold.

Conclusion: This technology seems to be safe and effective and if this application is performed by specialists in the field of prosthetics, it will have favorable results. Although this HTA study confirmed the cost effectiveness of the dental CAD/CAM, economic evaluation of the technology in Iran is recommended for the future.

Keywords


Gandjour A, Kerschbaum T. Technology assessment in dentistry: A comparison of the longevity and cost-effectiveness of inlays.International Journal of Technology Assessment in Health Care. 2005; 21(3):319-25. PMID: 16110711
Wuttke A. CAD/CAM Technology in oralImplantology. European Journal for Dental Implantologist. 2009; 5.
Martin N, Jedynakiewicz NM. Clinical performance of CEREC ceramic inlays: a systematic review. Dent Mater. 1999 Jan; 15(1):54-61. PMID: 10483396
Kapos T, Ashy LM, Gallucci GO, Weber HP, Wismeijer D. Computer-Aided Design and Computer-Assisted  Manufacturing in Prosthetic Implant Dentistry. International Journal of Oral & Maxillofacial Implants. 2009; 24 Suppl: 110-7. PMID: 19885438
Hayashi M, Wilson N H, Yeung CA. Systematic review of ceramic inlays. Clinical Oral Investigations. 2003; 7(1): 8-19. PMID: 12673432
Harder S, Kern M. Survival and complications of computer aided-designing and computer-aided manufacturing vs. conventionally fabricated implant-supported reconstructions. Clinical Oral Implants Research. 2009; 20:48-54. PMID: 19663948
Wittneben JG, Wright RF, Weber HP, Gallucci GO. A systematic review of the clinical performance of CAD/CAM single-tooth restorations. Journal of Prosthodontics. 2009; 22(5): 466-471. PMID: 20095195
Otto T, De Nisco S. Computer-aided direct ceramic restorations: a10-year prospective clinical study of CEREC CAD/CAM inlays andonlays. Int J Prosthodont. 2002;15(2):122-8. PMID: 11951800
Posselt A, Kerschbaum T. Longevity of 2328 chairside CERECinlays and onlays. Int J Comput Dent. 2003;6:231-48. PMID: 14601187
Berg NG, Derand T. A 5-year evaluation of ceramic inlays (CEREC). Swed Dent J. 1997;21:121-7. PMID: 9413909
Fasbinder, Dennis J. Clinical performance of chairside CAD/CAM restorations. Journal of the American Dental Association. 2006; Suppl 1: 22S-31S. PMID: 16950934
Reiss B, Walther W. Clinical long-term results and 10-year Kaplan-Meier analysis of Cerec restorations. Int J Comput Dent. 2000;3:9-23. PMID: 11351392
Sjögren G, Bergman M, Molin M, Bessing C. A clinical examinationof ceramic (CEREC) inlays. Acta Odontol Scand 1992;50(3):171-8. PMID: 1632208