The influence of CAD software on crown morphology, function

Dental Tribune International

Thu. 26. March 2026

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REGENSBURG, Germany: In CAD workflows, differences in software algorithms and design strategies may result in clinically relevant variations in crown morphology, fit and functional performance. A new in vitro study has demonstrated that the choice of CAD system can significantly influence restoration outcomes, highlighting important considerations for clinicians seeking to optimise both function and aesthetics.

The researchers, from the University Hospital Regensburg and OTH Regensburg, used three CAD programs for five workflows to create crown designs for the same target tooth under comparable design settings. The five design groups were:

standard library-based design in exocad with minimal manual input;
designs created in exocad based on the original tooth morphology;
artificial intelligence-assisted (AI-assisted) designs created in 3Shape’s Automate using the same preparation margin and design settings as the standard exocad design;
exocad designs completed and refined by a dental technician; and
AI design in Imagoworks’ Dentbird with minimal manual input.

The researchers compared the resulting crown designs with the original tooth in terms of overall crown morphology and occlusal contact pattern. They then milled the crowns and measured marginal fit. They next bonded the crowns and subjected them to artificial ageing and tested fracture resistance.

According to the authors, the findings highlight the measurable impact of the CAD strategy on the morphology, occlusal accuracy and mechanical performance of crowns. Although AI-assisted workflows achieved functional results comparable to those of the technician-refined designs, none of the designs accurately reproduced the natural occlusal contact situation. The standard exocad designs exhibited lower fracture resistance, whereas technician intervention significantly improved this outcome, underscoring the continued importance of human expertise. Marginal fit, however, remained comparable across all groups.

Overall, the findings suggest that, despite rapid advances in AI-driven design, fully automated workflows are not yet able to consistently deliver optimal occlusal detail. The findings suggest that current algorithms may prioritise standardisation over individualised morphology, reinforcing the value of technician input in refining restorations.

The study, titled “Influence of digital crown design software on morphology, occlusal characteristics, fracture force and marginal fit”, was published in the January 2026 issue of Dental Materials.

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CAD software CAD/CAM Dental laboratory Dental research Dental restorations Dental technician Morphology

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