Pros and Cons of CAD/CAM Technology for Infection Prevention in Dental Settings during COVID-19 Outbreak

Abstract

The purpose of this commentary is to update the evidence reported in our previous review on the advantages and limitations of computer-aided design/computer-aided manufacturing technology in the promotion of dental business, as well as to guarantee patient and occupational safety. The COVID-19 pandemic led to an unprecedented focus on infection prevention; however, waves of COVID-19 follow one another, asymptomatic cases are nearly impossible to identify by triage in a dental setting, and the effectiveness of long-lasting immune protection through vaccination remains largely unknown. Different national laws and international guidelines (mainly USA-CDC, ECDC) have often brought about dissimilar awareness and operational choices, and in general, there has been very limited attention to this technology. Here, we discuss its advantages and limitations in light of: (a) presence of SARS-CoV-2 in the oral cavity, saliva, and dental biofilm and activation of dormant microbial infections; (b) the prevention of SARS-CoV-2 transmission by aerosol and fomite contamination; (c) the detection of various oral manifestations of COVID-19; (d) specific information for the reprocessing of the scanner tip and the ward from the manufacturers.

Keywords: COVID-19; SARS-CoV-2; aerosol; dentistry; digital technology; fomite; guidelines; intraoral scanning; reconditioning; safety.

Figure 1

Casts by traditional and digital technology. (a): examples of microbial cast contamination (see bluish-black hairy colonies probably from fungus species) using a traditional technique. The casts represent a hazardous reservoir due to DHCP hand touching; (b): an example of lower cast microbial contamination using traditional impression and then digital technology; ((c), down): epoxy resin cast for full digital prosthesis on implants; ((d), down): epoxy resin cast for the onlay fabrication by full technique; ((c,d), upper): packaging of disinfected personalised medical device (crown and onlay).