Cadcam systems have allowed patients to receive one visit provision of porcelain crowns and inlays. No more messy impressions and temporary crowns or a second appointment for cementation.
Our CEREC system can scan and mill your restorations while you enjoy a cup of tea or coffee. At North Wahroonga Dentist Dental all our dentists have had extensive advanced training in Cadcam dentistry and we have been providing this service to our patients since 2001.
The final bonded CEREC restoration looks almost indistinguishable in appearance and greatly improves the strength and stability of your remaining teeth.
The concept of chair side CAD/CAM restoration differs from conventional dentistry in that the prosthesis is typically luted or bonded in place the same day, whereas conventional dental prosthesis of larger size such as crowns have temporaries placed for several weeks while a dental laboratory may produce the restoration off-site. The patient returns weeks later, the temporary is removed, and then the laboratory made crown is then cemented or bonded in place. Because the CAD/CAM restoration is bonded the same day, the principles applied in preparing the tooth for a crown or other prosthesis are typically more conservative since a temporary is just that, temporary, and the cements used to hold them in place must be weak enough to allow removal. As such, the teeth need to be prepared such that the geometry allows for adequate retention of the temporary in the conventional sense. Since retention can only be achieved with increased surface area, which translates into the removal of extra tooth structure, the conventional restoration typically requires the removal of more tooth structure. With the CAD/CAM restoration, lack of temporization makes physical retention unnecessary since the permanent bonding of the restoration occurs within hours, usually while the patient waits. Consequently, less unnecessary tooth removal is usually the norm.
Process
Typically CAD/CAM restorations are milled from solid blocks of white composite resin or porcelain matching the shade of the restored tooth. After the problem is removed from the diseased tooth, an image is taken of the resulting defect. This image draws the data into a computer and proprietary software is used to create a seal for the defect within the program, essentially creating a virtual restoration. The software then sends this virtual data to a milling chamber by the dentist where the seal for the defect (the dental restoration) is carved out of a solid block of composite resin or porcelain. The resultant restoration can then be adjusted in the patient’s mouth and bonded in place. If porcelain is used, practitioners usually will treat the restoration with stains and glazes and subsequent heat treatments to both beautify and strengthen the definitive restoration prior to bonding. Following acid etching of the underside of the restoration and the topside of the tooth itself (this microscopically increases surface area on both opposing surfaces), composite resin materials are then used to fuse the resultant restoration to the tooth, completing the restoration process.
As milling accuracies are typically accurate to 50 micrometres, CAD/CAM dental restorations are comparable in fit to traditionally fabricated laboratory made dental restorations. Their uniform, monolithic nature blends extremely well with natural tooth structure in contrast to traditional dental restorations where porcelain is fused onto a metal substructure. As these dark metal substructures are not conducive to a natural appearance, milled CAD/CAM restorations are typically more aesthetically pleasing to the patient.Since these restorations contain no metal to block subsequent x-rays, dentists are able to keep track of potential decay underneath a CAD/CAM restoration whereas conventional porcelain to metal or traditional goldcrowns block x-ray radiation, disallowing such an evaluation over time.
As CAD/CAM enables the doctor to create a final seal in as little as an hour, in contrast to several weeks using traditional methods. Dentists usually discover that certain treatments for front teeth have fewer side effects such as root canals or tooth sensitivity following this dental treatment.
The accuracy afforded by this technology in dental laboratory technology is unprecedented.
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CAD/CAM Cerec restorations