CAD/CAM Makes Dentistry Predictable & Rewarding
Advancements in dental technology over the past several years have paved the way for dentists to be able to confidently and predictably deliver indirect restorations in a single visit. We now have so many wonderful material choices at our fingertips that we can easily employ to fabricate indirect crowns, veneers, inlays, onlays, and implant restorations—all in the convenience of one appointment.
The very first generation of CAD/CAM dentistry hit the market back in 1985 with the release of the CEREC 1. Its capabilities were limited to milling only chairside inlays. Fast forward to today, and in-office digital dentistry procedures encompass so much more. With CAD/CAM technology, the dentist is able to take a digital impression of the prepared tooth/teeth, design the restoration, and mill in a matter of minutes. The chairside design software is loaded with a large database of teeth with different morphologies, shapes, and occlusal anatomies. The program’s artificial intelligence uses this information to produce a restoration that mimics the patient's natural dentition. In addition, the dentist has an extensive choice of materials from which to choose—feldspar, glass ceramics, polymer-based materials, and zirconia. Each case can be customized to fit the patient’s unique clinical situation.
The patient’s experience also has been greatly improved by the use of CAD/CAM technology to fabricate indirect restorations. It is much more comfortable for the patient to have a digital impression taken rather than endure the traditional elastomeric “gooey” impression, while a single appointment means the patient only needs to be anesthetized once. Patients value their time more than ever before, and providing same-day delivery with CAD/CAM in-office milling versus the 2-stage lab-made delivery of restorations is highly desirable. Patients greatly appreciate not having a temporary and not having to return for a second visit.
For the dentist, the switch to digital can be career changing. That is how it was for me 10 years ago when I started using CAD/CAM. Most notable was the ability to control all aspects of the restoration design process. Color matching and adding characterizations chairside provided a more natural, lifelike restoration. Stepping back and seeing the final result blend in with adjacent teeth is very rewarding.
Ultimately, the quality of the final indirect restoration depends on the skill of the dentist and his or her understanding of the technology. I encourage practitioners who are new to this type of dentistry to attend as many training courses as possible. Once the power of digital dentistry is seen and the many possibilities are realized, it’s hard to imagine how we ever practiced without it.
Shivi Gupta, DDS
San Diego, CA