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CEREC: A Case Study

Bill G. called the office on a Wednesday morning, in a bit of a panic. He had just broken a back tooth, and he was leaving for a two-week trip to the Far East on Friday. Bill was worried about having to be out of the country with a broken tooth, or with a temporary crown, which could come loose, get rough, or become sensitive. Lucky for Bill, we have the ability to make crowns in one visit.

Bill came in to the office, and a careful examination revealed that his broken tooth was at risk of further damage if it wasn’t protected. This is a common situation in teeth that have large, older fillings, or for patients who grind their teeth. Bill decided that a crown was the best long-term solution, as a large filling would leave the tooth vulnerable to further breakage, which might mean he would need a root canal, or even lose the tooth altogether.

Restoration with CEREC: How It Works

After Bill’s tooth was anesthetized, I made a digital picture of the shape of his tooth and stored it in my CEREC computer. The tooth was then shaped in a way that would allow me to protect it from further damage. Since I was making the permanent crown immediately, I could remove less tooth structure and retain more healthy tooth. This is a big advantage of one-visit crowns.

At this point, I made another digital picture of the tooth. For the next five minutes, Bill watched me design his crown on my CEREC computer software. He said that some of the processes were similar to architectural CAD design software or Photoshop.

When the design was complete, I put a block of ceramic in the milling chamber and began to make the crown. We have a variety of different colors of ceramic, so we were able to custom-tint Bill’s crown to match his existing teeth. The crown took about eleven minutes to mill, at which point we tried it in and verified that it fit perfectly.

The last step was to glaze it in the oven at 900 degrees to obtain a smooth, glassy finish, like natural enamel. After cooling, we bonded the permanent restoration to Bill’s tooth, and he was all done. He left on his trip knowing that his tooth was completely protected.

I first started using the CEREC CAD/CAM system to make crowns for my patients back in 2006. Ever since, I have done one or two single-visit crowns a day. The technology is precise to 15 microns, and the results are beautiful. My patients love the convenience and appearance, and I love providing such a wonderful restoration. Until recently, I was the only dentist in Petaluma to offer this service, and it is very popular with my patients.