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J Prosthet Dent. 2014 Feb;111(2):107-15. doi: 10.1016/j.prosdent.2013.08.006. Epub 2013 Dec 17.

An approach to biomimetics: the natural CAD/CAM restoration: a clinical report.

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Assistant Professor, Department of Prosthodontics and Dental Materials, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address:
Private practice, Rio de Janeiro, Brazil.
Clinical Faculty, Division of Restorative Sciences, The Herman Ostrow School of Dentistry of the University of Southern California, Los Angeles, Calif.
Oral Design Beverly Hills, Beverly Hills, California.
The Don and Sybil Harrington Professor of Esthetic Dentistry, Division of Restorative Sciences, Ostrow School of Dentistry of the University of Southern California, Los Angeles, Calif.


Those in the dental field have always pursued the perfect dental material for the treatment of compromised teeth. Gold, amalgam, composite resin, glass ionomer, and porcelain have been used. Tooth-like restorative materials (composite resin and porcelain) combined with an effective hard tissue bond have met the growing demand for esthetic or metal-free restorations in the past 15 to 20 years. However, none of those materials can fully mimic the unique properties of dentin (compliance and crack-stopping behavior) and enamel (wear resistance, function). The aim of this article is to report the restoration of an extensively damaged tooth with a natural restoration obtained by milling an extracted third molar tooth with a computer-aided design and computer-aided manufacturing (CAD/CAM) system. The main benefit of this novel technique is the replacement of lost tissues by actual enamel and dentin, with the potential to recover mechanical, esthetic, and biologic properties. The indication for extracting third molars and premolars because of impaction or for orthodontic reasons makes these posterior teeth readily available. The innovation of the method presented here is the optimal use of the extracted tooth substrate thanks to its positioning technique in the CAD/CAM milling chamber.

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