CEREC – Dental Restoration Treatment

What is CEREC?

CEREC stands for Chairside Economic Restorations of Esthetic Ceramics (or CEramic REConstruction). CEREC technology combines computer aided design with specialised manufacturing equipment, allowing for a dental prosthesis (e.g. onlay, inlay, full crown, partial crown, veneer) to be designed, milled, and fitted in a single visit to the dentist. The complete process requires 60-90 minutes.

In more advanced cases, CEREC is used to record, design and construct complex restorative work. Smile Design components of CEREC may also be used to enhance the Computer Aided Design (CAD) process, allowing the patient to view on the predicted results of restorative treatment.

How does a CEREC restoration work?

First, the dentist will prepare the patient’s tooth for the CEREC restoration work to begin. This will involve preparing/shaping the surface of the tooth to which the prosthesis will be permanently bonded. Once the tooth is prepared for CEREC treatment, the next stages of scanning the teeth and designing the prosthesis may begin.

  • Digital scanning

CEREC uses digital scanning technology to map the position of the teeth. An intraoral scanner is placed in the mouth and overlapping images are taken – from multiple angles – of the teeth in the lower jaw and upper jaw. Next, the patient is asked to bring the teeth together so that accurate positioning of the teeth can be scanned in the ‘bite’ position. This process is pain free and fast (requiring only a few minutes).

  • Prosthesis design

The dentist will use the data from the 3D scanning of the mouth to begin to digitally design the dental prosthesis (please see below for a list and description of common prostheses). Factors such as occlusion (i.e. how the tooth lines up with the opposing upper or lower tooth) and whether any areas of the proposed dental prosthesis require ‘smoothing’ so as to ensure a comfortable bite will be addressed by the CAD/CAM software at this stage, allowing the dentist to make adjustments to the final design of the dental prosthesis.

  • CEREC machine – milling the prosthesis

What is a CEREC machine? A CEREC machine is the onsite milling equipment used to create a dental prosthesis from a small block of ceramic material (depending on the dentist, other materials may also be used to create the dental prosthesis). The machine is highly accurate and works fast – there is a viewing window through which the patient may watch the milling taking place (similar to a drill).

What are the advantages of CEREC?

There are a number of advantages associated with CEREC technology including….

  • A CEREC restoration is completed within a single dental appointment

The main advantage of choosing to design and fit a dental prosthesis using CEREC technology is that the work is completed in a single trip to the dentist. This is much faster than traditional methods of fitting a dental prosthesis – which would typically require the work to be completed over a period of two-to-three weeks (involving an initial appointment, preparing the tooth, taking moulds, fitting a temporary prosthesis, and waiting for the lab to return the completed ceramic prosthesis before a return appointment is required to remove the temporary prosthesis and fit the permanent inlay/onlay/partial crown etc.).

  • A digital mould is created using 3D scanning – meaning no physical moulds

Traditional methods of creating a dental prosthesis involve taking a physical mould of the teeth (using a dental-grade moulding material that looks and feels like putty, which usually takes around 60 seconds to harden once applied to the teeth).

  • Comfortable and natural-looking restoration that restores healthy appearance

Once the CEREC machine has milled the dental prosthesis, the dentist will stain and polish the prosthesis to achieve an accurate colour match with the patient’s teeth.

How long does CEREC treatment last?

CEREC treatment is very long lasting. The skill of the dentist combined with a very hard-wearing ceramic material means that where the patient takes care of the CEREC dental prosthesis, the ‘new tooth’ is expected to last upwards of 10-15 years (with a much longer lifespan highly possible).

Types of dental prostheses explained

Depending on the nature of the dental issue highlighted by the dentist, several different types of dental prosthesis may be used in the treatment.

Types of dental prosthesis include:

  • Inlay

An inlay is comparable to a filling in that the treatment is applied to the chewing surface of the tooth and ends before the full height of the tooth. However, a traditional filling may contract or ‘shrink’ slightly during the hardening procedure, resulting in a reduced expected lifespan in comparison to an inlay.

  • Onlay

An onlay is similar to an inlay, with the distinct difference that along with treating the chewing surface of the tooth, the restoration is also inclusive of a portion of the ‘cusp’ of the tooth (i.e. the outermost tip or rim of the tooth). An onlay is also called a partial crown.

  • Full crown

A full crown is a tooth restoration in which the visible part of the tooth (i.e. the tooth above the gumline) has undergone significant decay and must be close to – or completely – restored by a dental prosthetic.

CEREC can also be used to fabricate anterior work or restorations in a single visit, including crowns / veneers and implants (please see below for further information on CEREC with Digital Smile Design).

Dr. Collins and Dr. Barry are currently enrolled in the Aesthetics and Digital Dentistry Academy (ADDA), placing both doctors among the leading experts in CEREC for Ireland and Europe.

CEREC with Digital Smile Design

The combined use of Digital Smile Design (DSD) software and CEREC Computer Aided Design/Manufacturing (CAD/CAM) systems results in fast and accurate same day restorations.

DSD involves the use of a completely pain-free intraoral digital scanner. Overlapping digital scans are taken of the teeth from all angles, including scans of the back of the teeth. These scans provide the orthodontist with a large number of practical and aesthetic analysis parameters, helping to define the prosthetic tooth’s exact dimensions.

The CEREC with Digital Smile Design process:

  1. Conventional tooth preparation (shaping the tooth)
  2. Digital impression (free from powders and dental impression putty)
  3. Design stage
  4. Milling stage using CEREC milling machine (approx. 12 minutes)
  5. Sintering stage – tooth material is coalesced into a solid mass using CEREC Speedfire machine (approx. 10 – 15 minutes)
  6. Prosthetic tooth placed in the mouth and assessed for correct fit
  7. CEREC SpeedGlaze used to finish the tooth using CEREC Speedfire machine
  8. Restoration fixed in place using conventional cement

Same day smile analysis and smile reconstruction using DSD and CEREC technology presents cosmetic dentistry patients with fast and accurate treatment plan options. The integrated DSD and CEREC systems include facial and dentogingival considerations, as well as dental aesthetic planning, ensuring same day treatment outcomes that meet with patient expectations.

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