CAD/CAM dentistry uses subtractive processes, Milling and additive processes, 3D printing to produce physical instances from CAD/CAM designs. Most CAD/CAM-directed manufacturing is milling based which uses rotary cutting tools to remove material by advancing a tool into the workpiece, which is usually a block/blank of material used,guided by a digitally produced CAD file. This may be done varying directions, axes, cutter head speed, and pressure.