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.