Modern dentistry is undergoing a rapid digital transformation, integrating CAD/CAM technologies into clinical and laboratory workflows, increasing efficiency.
CAD/CAM and associated digital workflows — scanning, virtual design, milling and 3D‑printing — are shaping a new paradigm for the fabrication of restorations; the choice between additive and subtractive technologies should be based on evidence-based medicine, biological criteria and clinical indications, and not solely on speed or convenience.
Clinical practice requires restorations with predictable longevity and stable esthetics; long-term clinical validation of ceramic materials provides a high level of confidence among clinicians and serves as a guide when making decisions in favor of definitive restorations.
Long-term studies show survival of restorations made from lithium disilicate and zirconia materials exceeding 90 percent at 10 years; these data are important when assessing risk of fracture, marginal stability and plaque accumulation — parameters that directly affect periodontal and functional outcomes. An expert approach implies considering not only static strength metrics but also results of cyclic loading, wear resistance and clinical adaptation to antagonists.
The optimal choice of material is determined by the combination of mechanical properties, biocompatibility and technological processing requirements; understanding the differences between polycrystalline ceramics and composite/resin systems is critical for indication selection.
Flexural strength — a key parameter: hybrid 3D‑printable resins with ceramic filler (>50% by mass) demonstrate flexural strength on the order of 80–150 МПа, whereas lithium disilicate blocks — about 500 МПа, and high-strength zirconia frameworks — up to 1 200 МПа; these numerical relationships determine indications for use depending on restoration location and occlusal load. Biocompatibility is critical — the presence of reactive monomers and unpolymerized components requires strict control of post-polymerization, validation of elution of substances and documented assessment of cytotoxicity and sensitization.
Additive technologies significantly accelerate the production of diagnostic models, surgical guides and provisional restorations, which improves clinic and laboratory logistics; however, for definitive restorations it is necessary to compare productivity with the durability and safety of materials.
3D‑printing facilitates synchronization of data between the clinic and the laboratory, reducing communication time and increasing the accuracy of guides for navigational surgery and regeneration planning; to achieve reproducible results interdisciplinary cooperation is necessary — engineers and technicians must work closely with the clinician to standardize printing parameters, post-processing and quality control.
When deciding on the fabrication method for a restoration, it is recommended to follow indications: for definitive fixed restorations under high occlusal loads give preference to materials with proven durability — all-ceramic or monolithic zirconia, for provisional restorations and some individualized cases — use certified additive systems with a validated post-polymerization protocol; clinical protocols should include control of internal and marginal fit, measurement of surface roughness, assessment of wear and biocompatibility. Important elements of implementation are documented SOPs for post-polymerization, regular equipment validation, quality control standards and participation in international educational initiatives — symposia and courses raise competencies and accelerate the exchange of evidence.
In conclusion, milling and 3D‑printing are not mutually exclusive technologies; a modern clinical strategy should rely on the integration of methods, selection of material according to indications, strict post-processing and clinical validation, which will allow combining the expediency of digital protocols with predictable longevity and patient safety.
Modern restorative dentistry is undergoing an intensive transformation associated with the diffusion of digital technologies and new composite materials. The
Contemporary dentistry is rapidly transforming under the influence of digital technologies and interdisciplinary approaches, altering clinical and educational practices worldwide.
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