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The use of the latest digital technology is bringing about a fundamental change in diagnostic planning. Apps based on mobile devices such as IvoSmile (Ivoclar Vivadent) use augmented reality to make lasting improvements to therapy decisions on the basis of 'informed consent.' In addition to significantly facilitating work and saving resources, the possibilities of interactive communication are also being expanded. Further advances in this technology will also revolutionize the integration of design results into the definitive manufacturing process.

The digital inhouse workflow consists of the components optical impression, computer-aided design (CAD) and machine manufacturing. In the sense of a time-optimized workflow, coordinated, closed systems prove to be the better solution. The company 3Shape (Copenhagen, Denmark) started with the existing Trios Intraoral Scanner and added both the software component Trios Design Studio and a number of 'trusted connection mills.' In combination with a collection of 'trusted materials,' a fast workflow with high clinical safety can ultimately be guaranteed. In order for a single-stage in-house restoration to be successfully completed, it is advisable to carry out thorough diagnostics and pretreatment; prepare the restoration by machine with a clear representation of the margin lines; organise the manufacturing process in a competent manner; and use an adhesive, target-oriented fastening strategy. Individual sections of the workflow can be delegated to specially and comprehensively trained medical staff. The increasing networking of digital processes creates very useful synergy effects such as the visualization of possible therapy results, follow-up, smile design, and the planning of implant restorations. A clinical case of a single-stage, in-house restoration with three posterior crowns is presented.

When determined by conventional jaw relation recording methods, the real position of the condyle remains largely unclear because the geometric relationship between the reference point and the position of the condyle is unknown. Sicat Function combines cone beam computed tomography (CBCT) data with digital jaw motion tracking (JMT) data and digital intraoral surface data. It is thus capable of measuring and visualizing patient-specific jaw movements. The corresponding patient-specific treatment position can be defined and integrated in various therapeutic appliances, eg, repositioning splints designed to increase the vertical dimension of occlusion (VDO).

Chairside computer-aided design/computer-aided manufacturing (CAD/CAM) technology requires an effective technical basis to obtain dental restorations with optimal marginal accuracy, esthetics, and longevity in as short a timeframe as possible. This article describes a compact, 5-axis milling machine based on an innovative milling technology (5XT - five-axis turn-milling technique), which is capable of achieving high-precision milling results within a very short processing time. Furthermore, the device's compact dimensioning and state-of-the-art mode of operation facilitate its use in the dental office. This model is also an option to be considered for use in smaller dental laboratories, especially as the open input format enables it to be quickly and simply integrated into digital processing systems already in use. The possibility of using ceramic and polymer materials with varying properties enables the manufacture of restorations covering all conceivable indications in the field of fixed dental prosthetics.

Computer-assisted technologies open up new possibilities for significantly improving the planning and realization of implant-supported dental restorations. Three-dimensional (3D) data acquired with an intraoral sensor can be merged with comparable data acquired by various radiographic imaging techniques. Implant planning with this type of support can generate data for the manufacture of surgical guides for dental implants. The guides can then be fabricated either by a third-party provider or by the implantologist directly, by using time- and cost-saving in-office systems. The use of surgical guides can improve the surgical implantation procedure considerably, and successful and reliable outcomes can be achieved more quickly.

The use of materials with elastic properties for the fabrication of dental implant superstructures seems to be a promising way to reduce the functional occlusal forces on implants. Vita Enamic (Vita Zahnfabrik, Bad Säckingen), a hybrid ceramic material for CAD/CAM technology, is available in a special form that can be relatively easily combined with titanium (Ti) base connectors for the fabrication of abutment crowns and mesostructures. Thus, an easily manageable method is available for reducing peak loads on dental implant fixtures. Representative cases are presented to demonstrate the clinical workflows for a single- element solution (Ti base) and two-element solution (Ti base with mesostructure) for implant-supported crowns.

The importance of monolithic ceramic restorations is growing, given the safe and cost-effective options for fabrication of such dental crowns and fixed dental prostheses. The optical characteristics of traditional zirconia do not suffice for this purpose. Improved restorative materials that can achieve satisfactory results in posterior restorations have been proposed to solve the problem. In the anterior region, however, even "esthetic" zirconia ceramic is unable to attain results comparable to those of glass-ceramic. Microveneering is a simple, reliable, and timesaving solution. Minimal reduction and veneering can significantly improve the results. A characteristic case is presented here.

The role and function of provisional restorations has changed significantly in recent years. The reasons include the improvement of material properties and the CAD/CAM production option using polymer blanks, which are offered by various manufacturers. Besides their classic indications in crown and bridge prosthodontics, provisional restorations are now used for soft-tissue management, preparation and adaptation in complex restorations that include changes in vertical relations, and as mock-ups in esthetic dentistry.

Restorations in the esthetic zone can now be enhanced using software tools. In addition to the design of the restoration itself, a part or all of the patient's face can be displayed on the monitor to increase the predictability of treatment results. Using the Smile Design components of the Cerec and inLab software, a digital photograph of the patient can be projected onto a three-dimensional dummy head. In addition to its use for the enhancement of the CAD process, this technology can also be utilized for marketing purposes.

Digital acquisition of the clinical situation in the mouth seems much more logical than digitizing the impressions. Intraoral scanning systems are laser supported or video based. The retraction of the gingiva plays a special part in the accurate display of the preparation border. The working procedures in the dental practice and in the dental laboratory have been changed fundamentally by this new technology. Workable solutions are already available and rapid further developments can be expected in the near future.

With the aid of an innovatively structured ceramic block, it is possible to achieve results at a high esthetic level with relatively simple means. In the three-dimensionally structured Vitablocs RealLife, translucent enamel ceramic is arranged around a conically structured, opaque dentin core. The virtual restoration can be positioned freely in all three dimensions with the aid of the Cerec/inLab software. The restorations are milled fully anatomically and only minimally glazed or characterized with stains. Results that otherwise can be achieved only with much more complex layering processes are possible.

2263 randomly selected subjects, aged 15-19, 20-24, 25-29, 30-34, 35-44, 45-54, 55-64, and greater than 64 yr, were assessed for periodontal status, caries status and treatment needs using the Community Periodontal Index of Treatment Needs (CPITN), the ratio of Gingivitis: Periodontitis: Missing teeth (GPM/T index) and the DMF/T index. The advantages of full mouth examination were compared to partial recordings. The CPITN underestimated deep pocketing especially in older age groups and in younger groups overestimated the need for scaling. Although the mean GPM/T number of periodontally affected teeth is in the range of 9-13 teeth and stable throughout the age groups there were age-dependent high risk groups for developing shallow pocketing (20-24 yr) and deep pocketing (45-54 yr), whereas adolescents were at high caries risk. The increase in the number of missing teeth was dramatic after the age of 54 yr only one decade after the high risk age for deep pathologic pockets.