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Inside Dentistry

September 2013, Volume 9, Issue 9
Published by AEGIS Communications


CAD/CAM Systems Become Accessible to All

Sirona’s latest innovations offer options for every practice

Michael DiTolla, DDS, FAGD

When CAD/CAM dentistry began in the mid-1980s, it was a complicated, time-consuming, and costly process only offered at dental laboratories. Initially, restorations produced by CAD/CAM systems were milled from ceramic or composite resin with the primary emphasis of matching the shade of the restored tooth. With today’s stronger materials, CAD/CAM restorations can be used nearly anywhere in the mouth.

CAD/CAM restorations have the advantage of being able to be cemented or bonded in one appointment compared with conventional restorations, which require patients to wear temporaries for 2 weeks while the restorations are being fabricated. It’s long been my belief that nothing good happens while temporaries are in place, but there are multiple negative scenarios that can, and often do, happen.

Although spending only 2 days in temporaries would be beneficial for dentists and patients alike, delivering same-day permanent restorations with no temporization is cutting-edge restorative dentistry. In addition to being one of the most patient-friendly procedures available today, same-day dentistry without temporization means no potential bacterial leakage and faster seat times due to less supraeruption or tooth tipping due to a temporary with light (or no) contacts and occlusion.

In the past, many clinicians cited cost as a roadblock to getting involved with chairside CAD/CAM dentistry, and because most companies only had one CAD/CAM offering, it was seen as a take it or leave it proposition. As with many things in life, one size rarely fits all, and thus the early adopters of CAD/CAM technology were those practices whose size, speed, and staffing happened to match what was being sold. The chances of one CAD/CAM unit being able to meet the needs of every dental practice are about as likely as the chances of a single make and model of car being able to satisfy every American family.

Knowing that they were missing the opportunity to work with a myriad of practice styles, Sirona undertook its ambitious “CAD/CAM for Everyone” program, with the goal of providing a CAD/CAM solution to every practice at their desired level of integration. Today, any size practice or laboratory can enjoy the benefits of a CAD/CAM system, one designed to meet the needs, experience, and budget of the user at all stages of their development.

For clinicians with strong bonds to their labs, there are now three digital impression options available—Apollo DI, the CEREC® AC Connect with Bluecam, and the CEREC AC Connect with Omnicam. These three options each allow different levels of laboratory involvement or chairside fabrication, depending on a clinician’s chosen workflow. Much like with dental chairs, for example, dentists can now decide which model and price point makes sense for them based on their habits, preferences, and practice style.

For chairside fabrication of restorations, there are three popular options available—CEREC AC with Bluecam and CEREC MC, CEREC AC with Omnicam and CEREC MC, and CEREC AC with Omnicam and CEREC MC X. Although these are the most common chairside CAD/CAM pairings, in reality, any of the CEREC AC units can be matched with any of the milling units, including the CEREC MX XL Practice Lab.

If you have had the opportunity to have a chairside CAD/CAM restoration made for yourself, you know first-hand how much better that experience is compared with two-appointment, 2-week dentistry. High-strength materials like Ivoclar Vivadent’s IPS e.max® (www.ivoclarvivdent.com) make it possible to place esthetic restorations nearly anywhere in the mouth with a high degree of confidence. More than 75% of the crowns placed in 2013 by the 300 offices of a large dental group with which our lab works were one-appointment IPS e.max crowns, whereas only 25% of their crowns were sent out to labs. It will become increasingly difficult for non-CAD/CAM offices to compete with that kind of commitment to customer service.

In the past, there has been good reason to shy away from CAD/CAM if your practice didn’t happen to fit the mold of what was needed to make the technology a success. With the launch of “CAD/CAM for Everyone,” it’s no longer a matter of trying to reshape a practice to fit the technology, but simply a matter of mixing and matching the technology to fit whatever the practice needs.

About the Author

Michael DiTolla, DDS, FAGD, has served as director of clinical education and research at Glidewell Laboratories in Newport Beach, California, since 2001.

Disclaimer

The statements and opinions contained in this article are solely those of the author and not of the editors, publisher, or the Editorial Board of Inside Dentistry.


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