CEREC CROWNS have been used in dentistry for over 20 years. In the past ten years alone over 1 million all-porcelain crowns have been placed using the new CEREC technology. This has allowed dentists to create beautiful natural porcelain crowns in the office within an hour. The original technology was limited to use in the lab because it took longer to create, but as software advances have improved the technology, we now can prepare a tooth and then take a CADCAM impression using a camera that fits inside the mouth and take a picture of the preparation. The machine can then take that optical image and create a 3D model of the tooth. It allows the Doctor to design the tooth any way they like including duplicating a tooth that was already there (which is extremely helpful when creating a crown to fit underneath an existing partial denture). We can widen the tooth, add more anatomy to the top of it to make it more life-like, or we can reshape the tooth. The crown is then milled at the office and this takes approximately 12 minutes to complete. One terrific advantage to the patients is that they dont need a second appointment to come back for their crowns (specifically if they are in the back teeth) for most cases. If we are doing more than three crowns at once, or doing a bridge, or challenging aesthetic front crowns, then we still use the labs, but for the majority of the crowns we do now, Dr. LaFrom can create them and seat them in approximately an hour.

What is the typical patient response? Aside from the fact that they don't have to come back for a second time to be numbed up or wear a temporary crown which could come off, most of the time the comments we hear from our patients are along the lines of "AWESOME", "COOL", "THAT'S AMAZING", and "IT'S GOOD TO SEE NEW TECHNOLOGY ACTUALLY BENEFITING PATIENTS DIRECTLY".

How do these crowns compare to traditional porcelain crowns with metal underneath them that have been done for the past 40 years? CEREC crowns are more CONSERVATIVE. Because they are BONDED, we don't need to cut as much tooth structure away to hold them onto the actual tooth underneath. CEREC crowns are more AESTHETIC that porcelain metal crowns because they don't have any metal in them, we can make the margins ABOVE the gumline without worrying about any dark metal showing. Because the margins are above the gumline, they are EASIER FOR THE PATIENTS TO KEEP CLEAN and EASIER FOR THE DENTIST TO REPAIR if in the unlikely event it should get decay or chip at a margin, we can catch it early and easily and simply repair them without having to remove the entire crown and more tooth structure to put another crown on. They LAST LONGER as a result of this feature. THE MARGINS (where the crown fits onto the tooth) are totally sealed - using the newer cements that have benefits of both cement and composite, there simply are NOT open margins around the crowns. The CADCAM mills perfectly accurate models (avoiding the two middle steps that a lab processed crown typically needs to be made), giving us the most accurate margin fit available. ESTHETICALLY, they don't have metal in them and as a result, there isn't any metal to mask out by the lab tech which tends to make the teeth look opaque and flat. These crowns generally blend right in and especially, the even more conservative onlays or inlays, the clear cements we use seem to make the margins dissapear into the natural teeth and become one. Patients ask us if we are going to charge more for them since the machine is rather expensive. Because we don't have to pay for temporary crown material and the temporary cement and the impression materials along with having the patients come back for a second visit, we are able to keep the cost down, making it a WIN-WIN situation for both us and the patients.

Do you have to do specialized training to make these CEREC CROWNS? Dentists are required to take a 2-day course to learn the basic software and design techniques, however, the machine does 80% of the work for us. Prepping and seating the crowns are similar to the way we have already been doing it for years. This is truly one major technology advance that radically benefits both the patient and the dentist in terms of the final result, the time involved (one visit instead of two), the accuracy of the fit and overall patient comfort. Dr LaFrom has taken Advanced Training Courses from two of the original beta testers who helped develop the machine nearly 20 years ago and he has won awards for design and esthetics in the local Bay Area CEREC Study Club.