I have a molar that needs crowning, and am trying to decide whether to
have CEREC or a traditional laboratory-made crown.

Recently, a dentist (not my own dentist) advised me against CEREC,
saying it was very ‘technique-sensitive’, and that the result would
only be satisfactory if the dentist doing it was very highly skilled.
He said a lab-made crown, on the other hand, didn’t rely so much on
the dentist’s skill, and therefore there’d be a better chance of a
good result.

This seems very counter-intuitive to me: with CEREC, the computer does
all the work to make sure the crown is accurate, so I’d have thought
the denist would need LESS skill than usual.

An opinions on this?

"sam" <> wrote in message
news:1f8e62e2-d595-40e6-ba5e-...

>Recently, a dentist (not my own dentist) advised me against CEREC,
>saying it was very ‘technique-sensitive’, and that the result would
>only be satisfactory if the dentist doing it was very highly skilled.
>He said a lab-made crown, on the other hand, didn’t rely so much on
>the dentist’s skill, and therefore there’d be a better chance of a
>good result.

The obvious problem with that theory is that with lab-made restorations
there is another important (human) "computer" in the loop; the lab
technician who sees a model of your mouth and has years of experience in
designing and producing successful restorations.

CEREC or lab made, it still comes down to the human element.

We have a certain dentist on this group who has been using CEREC for
years, but grew up around a dental lab and knows both worlds. Hopefully he
will ring in with an opinion.

Vaughn

>

>
>
> The obvious problem with that theory is that with lab-made restorations
> there is another important (human) "computer" in the loop; the lab
> technician who sees a model of your mouth and has years of experience in
> designing and producing successful restorations.
>
> CEREC or lab made, it still comes down to the human element.
>
> We have a certain dentist on this group who has been using CEREC for
> years, but grew up around a dental lab and knows both worlds. Hopefully he
> will ring in with an opinion.
>
> Vaughn

No matter which you choose, the skill of the dentist is of paramount
importance (and I guess even more than skill...ethics and concentration
during your individual treatment...IOWs, not only how well the work
*can* be done, but what 'compromise' might be acceptable and how
determined is the dentist to deliver a 'near perfect' restoration
that day for *you*).

Other factors that go into the mix include the actual condition of
the teeth being treated, the overall condition of the oral environment,
amount of opening, the tongue or cheek size making work difficult,
and patient cooperation.

IMO, if you show any signs of clenching or bruxism, I prefer metal
occlusion for molars. If you aren't a clencher, and esthetics are high
on your list, Cerec can work *if* it's done correctly.

JMO,
D

>
>
>

Dartos wrote:

>

>
> No matter which you choose, the skill of the dentist is of paramount
> importance (and I guess even more than skill...ethics and concentration
> during your individual treatment...IOWs, not only how well the work
> *can* be done, but what 'compromise' might be acceptable and how
> determined is the dentist to deliver a 'near perfect' restoration
> that day for *you*).
>
> Other factors that go into the mix include the actual condition of
> the teeth being treated, the overall condition of the oral environment,
> amount of opening, the tongue or cheek size making work difficult,
> and patient cooperation.
>
> IMO, if you show any signs of clenching or bruxism, I prefer metal
> occlusion for molars. If you aren't a clencher, and esthetics are high
> on your list, Cerec can work *if* it's done correctly.
>
> JMO,
> D
>

>

I see the main advantage of cerec being one-day restorations. I
therefore don't see a point of lab-fabricated cerec restorations.
Nothing wrong with them, but it seems to me it's just going to eliminate
some tech's jobs. And for custom staining, you'll still need the tech.
I agree with Dartos that metal occlusals are best in patients who grind
or clench.

Steve

--
Mark & Steven Bornfeld DDS
http://www.dentaltwins.com
Brooklyn, NY
718-258-5001

I will use CEREC on any tooth. You always need to equilibrate a good
restoration. If you study the occlusion every time you restore a tooth,
failures are minimal. Parafunction needs to be dealt with as well. Like
EVERY dental material, it will not hold up if used improperly or without
attention to detail.

CEREC will mill to within 60-80 microns. A human can only achieve this on
his/her very best day. A milling machine has the same accuracy every day.
The variables of the tech with a cold, a hangover, Monday "blues", Friday
"can't wait to get out of the lab", etc. are not there.

I have yet to ever have a patient tell me they would rather have an
impression and wear a temporary for 2-3 weeks, and still have to return for
a second visit.

The tech whose job you eliminate is quite likely to be working out of a
"hut" in the Pacific Rim. Check out the average age of a dental technician
in the USA. Most will be retired in the next 10-15 years. No more are
being trained. Thank goodness for immigrants from Eastern Europe or there
would be even fewer dental technicians with any skill in this country.
CEREC reduces the burden on tech's for the average everyday cases so they
can use their superior skills on the really complicated cases.

As far as custom staining,,,,,,,,,,,,,,, well you hardly ever need it with
translucent restorations. When you do need it, it adds 20-30 minutes to the
time the patient is in the office. It only takes a few minutes to add stain
and glaze to a case. It does take about 15 minutes to heat the porcelain
and cool it (assuming the oven is already warmed up). I don't need this
very often. If I did, I would simply train one of the RDA's in the office
to do it for me.

Once you stain 10-12 cases, you can do it without thinking about it. I
basically need to stain when I am making a single anterior crown on a local
citizen with darkened teeth. Matching the stains from a lifetime of tobacco
and tractor riding is very easy. Staining to match teeth on young people is
a tiny bit tougher, but still not bad. The vast majority of cases match up
right out of the milling machine, due to the translucency.


--
::::
Amatus Cremona
;;;;;;



"Mark & Steven Bornfeld" <> wrote in message
news:hJVim.2861$...

> Dartos wrote:

>
>
> I see the main advantage of cerec being one-day restorations. I therefore
> don't see a point of lab-fabricated cerec restorations. Nothing wrong with
> them, but it seems to me it's just going to eliminate some tech's jobs.
> And for custom staining, you'll still need the tech.
> I agree with Dartos that metal occlusals are best in patients who grind or
> clench.
>
> Steve
>
> --
> Mark & Steven Bornfeld DDS
> http://www.dentaltwins.com
> Brooklyn, NY
> 718-258-5001