CEREC
Essentially, CEREC uses "computer technology" to restore your tooth completely in one visit!
Only 7% of the dentists in the world use this technology of the future, and we have mastered it right here in Franklin County Vermont!
CEREC® is an acronym for "Chairside Economical Restorations of Esthetic Ceramics".
BEFORE AFTER
In our office, CEREC has become our primary restorative option for large fillings, or teeth that are so fragile that a simple filling will not suffice. We still do a few conventional crowns (CEREC is just one tool in our toolbox.), but CEREC onlays - which are essentially porcelain puzzle-pieces - are our primary expertise. After having placed over 6000 onlays now, since April of 2003, we feel absolutely confident that this is the least painful, most conservative, most cosmetic, and most economical kind of restoration being done in dentistry today.
We use CEREC technology different than most dentists. We very rarely use it for crowns. Instead, we prefer to save all the good natural tooth structure that we can, and we use this computer to make "Onlays" - the porcelain puzzle-pieces - that replace only the tooth structure that you've lost to decay, fracture or the replacement of an old filling.
This is KEY to our mastery of the technology. You may not need a crown!... an "onlay" that replaces only the damaged part of your tooth might be the best thing for your situation.
Why are Dr. Chuck and I so committed to using CEREC more conservatively?
#1 - Patients who have had both crowns and CEREC onlays done on other teeth would NEVER let us do another crown again. The CEREC procedure is simply a non-event. A conventional crown can seem like "a project".
#2 - After so many years of experience, we see how long-lasting and successful they can be.
From our experience, if CEREC onlays are done with meticulous attention to detail, using the best cements, they are simply an outstanding leap of modern dentistry.
Here are Dr. Lynda's own teeth before and after being restored with CEREC onlays..
CEREC has its critics. Many dentists who don't use CEREC worry that they will break, leak or fall out because they are glass. We have been doing CEREC onlays for more than 8 years now and have done over 6000 of them. If we had experienced any disappointing or common failures, we would have been forced to abandon the technology long ago. We have found CEREC onlays to be terrifically strong and reliable.
We are 100% certain that this is the future of dentistry and we would encourage anyone who needs replacement of numerous aging silver fillings to consider this well before deciding to have numerous crowns done.
HERE ARE SOME OTHER OBSERVATIONS THAT INSPIRE US...
*We see far fewer teeth that need root canals when we use CEREC.
*95% of patients have absolutely no post-op pain. (It's just a "non-event"!)
*The procedure takes about 1 hour - a single visit - so patients don't have to take much time off from work.
This section of our website will give you a good understanding of how we use CEREC in our practice. You can find out even more at www.cereconline.com
Firstly, why a CEREC Onlay instead of a crown or a huge filling?
• CEREC conserves all the natural enamel that's possible
• We can avoid the need for a full "crown" 95% of the time
• Treatment can be completed in ONE appointment
• It uses the most biocompatible material to date (This porcelain has many of the same properties as human enamel.)
• This technology has been clinically studied for over 21 years. In clinical studies it has proven to be as long lasting as gold.
• No messy impressions or temporary crowns to worry about for weeks after the first visit. (And no second visit!)
• Naturally beautiful tooth-colored restorations
• Unquestionably, much easier than any "crown" procedure. Most CEREC patients end their visit with a comment to us about how amazingly easy the procedure seemed, as compared to a crown.
THE STEPS IN A TYPICAL CEREC® THAT WAS DONE IN OUR OFFICE.....
The following picture is the typical kind a problem that we treat with a CEREC® porcelain filling, rather than doing a conventional "crown". In this first picture, you can see that we have a tooth with an old silver filling, but most of the tooth is beautiful and healthy. It would be a shame to shave this whole tooth down to a "stump", in order to put a "crown" on it. The main advantage of CEREC® is that it will allow us to restore this tooth without touching the part of the tooth that is still strong and healthy.
1. This tooth below has some serious problems: it has decay in-between the teeth (which can only be seen on the X-ray) and you can clearly see how "blue-gray" the tooth looks around the silver filling. We always find decay under these blue-gray areas. There is also a crack that extends from the old silver filling down the side of the tooth, at 7 o'clock. Fractures are a very commonly associated with old silver fillings. You can also see that the filling is surrounded by a black "ditch."
2. The photo below was taken immediately after the silver filling was removed. You can see the brownish-orange decay that we found under the filling. This is a common finding under fillings that have been in place for more than 25 years. Unfortunately, the decay is not often evident on X-rays because X-rays can't pass through metal. For this reason, in our office, we do not wait to repair a tooth like this. The blue-gray hue around an old filling is enough to tell us that trouble exits. And so far, after doing more than 5000 CEREC restorations, we have not found an exception to this rule of thumb - A bluish-gray hue around an old filling means trouble.
3. The photo below shows how the tooth was shaped after we removed all the decay. This picture is a photo of our computer screen. You can see that we have left more than half of the tooth untouched and we have only removed the tooth structure that was decayed or left too thin. After this photo was taken, the CEREC® milling machine will fabricate a precise piece of porcelain that restores the tooth to its original shape and strength.
4. The photo below shows the finished, nearly invisible, restoration. The procedure took less than one hour. The "drilling time" was less than 4 minutes. The whole process was completed in one visit without putting the patient through messy impressions or temporary crowns. For many people, the experience is simply a "non-event" and as quickly as the next day they feel as though nothing happened!
How does it work?
With just three simple steps!
STEP 1.
To be sure that you are perfectly comfortable, we will use a uniquely gentle technique to numb the tooth that needs repair.
Then we will remove only the defective filling and decay. (This is much more conservative than a conventional crown. With CEREC® Technology, we can leave all of your healthy enamel untouched. For a crown, the tooth must be shaved down to a stump.)
After we are finished with this step, your tooth will often be missing something shaped like a puzzle piece.
STEP 2.
With a very small camera connected to a computer, we acquire a picture of your tooth
The computer then searches its database of thousands teeth, and it determines how your tooth should be shaped if it was back to it's earliest healthy state. A 3D image of your tooth, perfectly restored, will appear on the screen. The doctor approves of this or edits it slightly.
Once finalized, the information is then wirelessly sent to a machine on-site that uses diamond-coated instruments to precision mill the restoration out of a small ceramic (porcelain) block. This milling process takes 7 to 12 minutes.
STEP 3.
After milling, the new restoration is checked for perfect fit. (Within 50-100 microns: this is close to the width of a human hair.)
We then bond this restoration to your remaining tooth with a unique light; a process that unites porcelain and tooth to the maximum extent possible.
Lastly, we complete a final polish that ensures a natural appearance making the porcelain blend with your tooth.
A FEW OTHER CEREC® CASES FROM OUR OFFICE......
This is a typical failing filling that we would always replace with CEREC Onlay instead of shaving the tooth down for a crown. We know there is decay under the filling because the tooth has a "blue-gray" hue all around the edges of the filling. There is also a crack at 9 o'clock and another at 6 o'clock.
As predicted, this is the extensive decay that we found under the filling. (It did not show up on the x-ray.) After this picture was taken we removed all this decay and the cusp that was left even more fragile.
This is a picture of our computer screen after we have finished drilling. The decay is gone, edges smooth and we are ready for the computer to make a precise puzzle piece that will fill in the missing part of the tooth. (It will take about 10 minutes.)
This is the final onlay, seconds after being cemented in place. The tooth is dehydrated now so the onlay is visible, but in 2 hours, we often can't even see where the CEREC starts and stops.
*** This is why we happen to have all these CEREC pictures. We take a step-wise series of photos like this for every restoration, so that at later visits, we will know what we started with.
1.The filling ...... 2. The decay... 3. The preparation 4. The final CEREC®
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1. The filling...... 2.The decay ..... 3. The preparation.. 4. The final CEREC®
MORE CEREC TRANSFORMATIONS.....
Another typical CEREC Onlay procedure. Here again, the premolar in our starting picture (upper left) is clearly got that "blue-gray" color. The decay was found under the filling (upper right). An onlay was designed after decay was removed (lower left). And the final onlay was invisible (lower right).
Same principles apply for this second molar. It was obviously cracked at 6 o'clock. The final onlay was invisible.
Another "blue-gray" tooth (upper left) tells us there is a big problem under the filling. The final onlay was again - invisible.
Another step-wise success story!
This is one of our favorite kind of uses for CEREC onlays. To easily and quickly replace a broken filling (upper left picture) on our emergency schedule. The patients are always pleasantly surprised.
And another "oldie but a goodie" after we restored with CEREC.
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We have literally hundreds and hundreds of photos like these of our patients' teeth, before and after repair: every possible configuration of CEREC restoration. Please call for an appointment if you would like us to evaluate the state of your older silver fillings. If they were placed more than 20 years ago, it is likely that you have a number of teeth in this condition. We have intra-oral cameras in every room which we will use to show you your teeth in an effort to partner with you for the best possible outcomes.