Dentistry While You Dream
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CAD/CAM and Cone Beam
What is CAD/CAM dentistry?
CEREC or Cerec (Chairside Economical Restoration of Esthetic Ceramics, or CEramic REConstruction) is a method of CAD/CAM dentistry developed by W. Mörmann and M. Brandestini at the University of Zurich in 1980 for creating dental restorations. Using CAD/CAM (computer-aided design and computer-aided manufacturing), this process allows dentists to construct, produce, and insert individual ceramic restorations directly at the point of treatment (chairside) in a single appointment, rather than over multiple appointments with laboratory work in between. The first applications were successfully carried out on patients in 1985.
CAD/CAM dentistry involves a digital impression from one or more scans (using visible light scanning, digital radiographs, CT scans, or other methods), designing the restoration on the computer (computer-aided design, leading to a 3D model), and manufacturing the restoration (computer-aided manufacturing,by CNC milling). In order to carry all of these steps out in the office – chairside – the dentist requires an image acquisition unit with an intraoral camera, the corresponding designing software, and a milling machine.
Around 38,000 dentists worldwide use the CEREC method and thus produce some 6.9 million restorations each year (as of October 2013). In Ontario, only 2 dental offices offer CAD/CAM restorations in a Dental Anaesthesia Specialist setting, here at Dentistry While You Dream and in Kitchener at Dr. Jason Wong's Dental Anaesthesia Specialty Practice. Dr. Eickmeier's specialty practice is the ONLY dental anaesthesia practice in Canada to offer the integration of a 3D Cone Beam imaging machine alongside the Cerec3D CAD/CAM machine which allows the placement of an osseointegrated implant and restoration of that implant while the patient sleeps - all in a single appointment!
During a chairside treatment, the team carries out all the steps, from digital impressions and computer-based construction of the restoration to the milling process, inside their office. The team uses an intraoral camera to take a photo of the preparation, the antagonist teeth, and the bite situation. Based on the images, the CEREC software creates a virtual model of the patient’s tooth situation. The team uses this model to construct the tooth restoration on the screen and then passes on the finished construction within the office’s network or sends it wirelessly to a milling machine. Depending on the type of restoration, it is then milled out of a color-matched ceramic block in just 6 to 15 minutes using diamond-coated milling units. The team can then add the finishing touches to the restoration by painting, polishing, and glazing it, before cementing it (the more traditional option) or adhesively integrating it, depending on the type of ceramic used.
Benefits: CEREC technology makes it possible to produce and integrate ceramic restorations in a single appointment. Unlike other materials such as amalgam or gold, ceramic is more biocompatible and boasts tooth-like physical and aesthetic qualities. In addition, digital impressions are more comfortable for patients than traditional impressions, and cause less stress on the oral environment, which is beneficial whether awake or asleep.
The digital mapping technology of CEREC that charts the inside of the patient’s mouth completely accurately and down to the last detail ensures that there is no issue with inaccurate dental impressions that lead the patient to experience discomfort with bulky molds and unnecessary debris in their mouth.
Combined with three-dimensional X-ray technology, it has also been possible to use CEREC for implants since 2009. The team can combine the CAD/CAM planning based on CEREC with 3D X-ray data in order to coordinate the prosthetic and surgical implant planning and achieve the intended treatment results. Based on this integrated implantology, the dentist is able to produce the surgical guide on the milling machine at the office using CEREC Guide. With the Cone Beam 3D technology, precise placement of the implant becomes more predictable and allows for single visit implant placement and restoration, so you can go from a gap in your smile, to a leaving with a tooth in only one appointment.
Cone Beam: In addition to the obvious benefits of implant placement, the Cone Beam machine allows for better visualization of any item that may help Dr. Eickmeier to effectively render treatment in your mouth. For root canals, better location and visualization of the canals in your tooth before ever opening the tooth helps to increase success of the root canal therapy. For wisdom tooth removal, better visualization of the location of the tooth and its proximity of the important anatomical structures (mandibular nerve that often lies close to the wisdom tooth, and other structures) help to predict and possibly avoid complications inherent to certain surgical situations.
