I am so excited to talk about CEREC. As a general dentist, I have been offering CEREC single visit crowns for 4 years. My intention of this blog is to inform people, and show people, the wonderful service of CEREC crowns. I will get into the technical aspects of how CEREC works, software, milling, materials, bonding, etc. in future posts. For the first post, I would just like to show a case I literally just finished. The patient has had massive silver amalgam filling when the patient was younger, and now the teeth are starting to breakdown and fracture. A tooth really needs a crown when the size of the filling is equal to or greater than 50% of the biting surface. The reason is when a filling gets to be this size or larger, the tooth is half as strong and the risk of a cusp fracturing is very high (especially in back teeth). Where they will fracture we do not know. The worst case scenario is the tooth fracturing into the root, when this happens the tooth is hopeless and would require extraction. A CEREC crown will act like the rings around a barrel. It will hold the natural tooth together preventing further fracturing. So, lets get to the case. As you see above the large silver fillings are actually showing through the natural tooth, this is a cosmetic concern as well.
An image from the biting surface reveals very large silver fillings. We planned on placing two CEREC single visit crowns and one tooth colored composite filling on the tooth in the middle. Under a local anesthetic we removed the silver amalgam. Using the CEREC aquistion unit we then made optical images of the teeth. The optical images will be made into computerized models of the teeth on the computer where the CEREC crowns are designed. After designing the CEREC crowns on the computer the appropriate shade of tooth is selected and the CEREC crown is milled out of a solid block of porcelain. This can take anywhere from 5-12 minutes depending upon the size of the CEREC crown. After the CEREC crown has been milled, it is tried in the mouth to ensure a proper fit. Then we glaze the porcelain to achieve a smooth shiny finish. The crown is then bonded to the tooth. As you can see by the image below of the bonded CEREC single visit crowns the aesthetic result is great. The precise fit of the CEREC crowns are, in my opinion, superior to lab fabricated crowns.
Now for a side by side comparison of before and after of the CEREC single visit crown. P.S. this procedure start to finish took me two hours. Feel free to post any comments or questions, etc.
