CAD/CAM Restorations: Is It Really That Simple?

Last Updated: Nov 17, 2008

Dr. L. asks:
I just took a course sponsored by my dental lab on CAD/CAM restorations. The course was very instructive and being an older practitioner I was surprised at how advanced we are now in some areas of dentistry. The instructor provided some simple guidelines for preparing the abutment teeth for inlays, onlays and full crowns. All you do is spray powder on the prepared tooth and take pictures from different angles with a computer wand. The machine grinds out the restoration. The instructor said that after we get the hang of designing the restoration on the computer, the entire procedure should take about one hour. And we should have the restoration cemented in within about another fifteen minutes. Does this system really work so well? Are the restoration margins closely adapted to the cavosurface? Will these fracture or leak?

4 Comments on CAD/CAM Restorations: Is It Really That Simple?

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Dr. R.B. Stanton

11/18/2008

I am an advanced CEREC user and can tell you that I have used it from second molar crowns on bruxers to anterior veneers to implant crowns and have a 99%+ success rate. A single crown takes me about an hour from start to finish. The studies speak for themselves with regard to marginal adaptation.

doctorberg

11/18/2008

15 minutes... yeah right that will happen. I am sorry but no, the system works but the learning curve is not what they tell you and the results arent either what you would expect specially in the begining. By the way I use cad cam systems and I am not against them at all is just that you should know what you are getting into before hand. My work day is usually complemented by patients that come from recently placed cerec restorations that i will have to replace, because the operator believed that he knew and actually didnt. Very wide margins(lots of cement), broken rstorations due to poor fit or bad tooth prep, or even bad choice of cement and infiltration are a fact specially when doing this in 15 minutes.... also you cnat get the cosmetic result that one should expect when you are running. best of luck

Scott Cheever DDS

11/20/2008

I too am an advanced Cerec user. I can't imagine dentistry without it. My straight forward supragingival cases go quickly and smoothly. Contacts = perfect. I no longer do try-ins on the easy ones. Soft tissue management; a must. Use Ivoclar Multilink for bonding. Afetr your 25th unit; you'll be pretty good. After your hundreth unit, there's no looking back. Patients like 'em.

CLIFF

11/25/2008

Of course they fracture, there made entirely of porcelain, however the Emax porcelain is almost 3X stronger, but will still fracture. The D4D Cad/cam system doesn't use powder, uses a robust milling unit and takes 9 images to get a full picture of the prep to offer better margins and more detailed restorations. Also like ALL restorations they leak, but is it of clinical significance? Any restoration can have wide open cement margins, but I think that is more operator error, don't ya think so?

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