Are you Using CAD/CAM Technology to Fabricate Implant Frameworks?

Not only have we not cast a framework in over 5 years, with the level of precision of modern CAD/CAM technology and the current price of gold, I can't see why anyone would. I can take an approved setup for a final restoration, scan and design a framework in 30-45 minutes, and have it delivered to me in 3-4 days with 100% passive fit.

Casting has many inaccurancies and make it very difficult if not impossible to get an accurate fit. Cad/Cam allows milling from a solid peice so you get a stronger and more accurate fitting prosthesis. I have been using Dentsply ISUS for screw retained hybrid frames and bar overdentures and the metal work looks like jewelary and fits passively and accurately

The most critical frame designs I believe occur with a Zirconia and a complete coverage ceramic tooth formation. This is because of the crucial and unforgiving uniformity thickness which the layering veneer requires so as not to develop microcracks. We have found CAD CAM in this instance to be extremely difficult to work with because it is quite difficult to three dimensionally visualize the final form of the frame and the critical space requirements for the veneer. As to fit of the interface CAD CAM is unquestionably accurate so long as the transfers are accurate. While not an impossibility to use CAD exclusively it is far easier to wax the frame and then scan rather than to 3D CAD design on software. There is a long experience and training curve to do this by CAD alone.