One of the reasons I love dentistry is the constant increase in technology to provide dental care to my patients. Same-day restorations are one of those technologies. CAD/CAM dentistry, or computer-aided design and computer-aided manufacturing, is where I can prepare your tooth for a crown, scan the prepared tooth with a special device, and computer generate and mill the restoration in minutes.
Some of the benefits of CAD/CAM restorations are: more precise fit than laboratory generated crown, seals out microbes better than traditional lab generated crowns, milled restorations are completed at chair-side, the milled materials are strong as natural teeth and natural looking, and the procedure is done the same day. Those are just a few of the benefits of these hi-tech restorations.
CAD/CAM restorations are definitely not figured into insurance fees, and will be an upgraded restoration. However, most patients choose these restorations due to the convenience of having the crown or inlay/onlay restoration cemented on the same day. Receiving a CAD/CAM Restoration usually only requires an additional 45 minutes added to the crown appointment.
CAD/CAM technology is just another way we choose to serve our patients with the best dentistry has to offer.
More to come on why we chose the E4D CAD/CAM system over the competition…

Many years ago when a patient was in need of a crown restoration to preserve a tooth, gold was it! Although gold is still used to restore teeth, we now have many types of restorations available to preserve our dentition.

Cosmetic restorations have become the norm in today’s dental offices. The two most common crown restorations done today are Porcelain Fused to Metal and All Porcelain Crowns. Within these two types of crowns are several choices, and everyone should be given the choice regardless of insurance coverage or economic situation.

Whenever one of my patients has an indication for porcelain fused to metal crown, I generally use a metal called Tilite. It is the only metal guaranteed not to react to tissue. On top of the metal coping is where the porcelain is stacked. Not all porcelain is created equal either. In my practice I have the lab use Noratake Porcelain, and they additionally do a multiple clear porcelain stack to enhance the natural look of the crown.

However, the crown of choice with today’s technology is an all porcelain crown. More specifically, zirconium or lithium disilicate. Procera and Cercon are the two brand names of zirconium I use, and the coping or foundation under the porcelain is very strong. However, they are limited to strength by the porcelain fused to the coping. Which means the porcelain is still subject to fracture depending on its strength.  Although not as strong as zirconium, IPS e.max is the lithium disilicate I choose when I need strength and esthetics. The overall strength and beauty of IPS e.max is winning the battle from premature fracture. It’s a full thickness lithium disilicate crown when created in our office with our CAD/CAM equipment from D4D. We are seeing great success with this technology, and the crowns are generally made the same day as the tooth preparation. It generally adds an additional 60 minutes to the procedure. However, you do not have to return for a cementation appointment, which is convenient and time saving for our patients. I will be posting more on this technology this month.

All of these crown restorations are way beyond the average types of crowns insurance plans base their fees upon. And each of them differs in lab costs due to material costs. However, I always give my patients the choice of crown materials they want to have placed in their mouths, and the additional fees associated with those crowns.

Often times new patients, with existing crowns in their mouths, will come to my practice, need a crown, and experience for the first time, a choice in the type of restorations offered. What bothers them the most is the fact their previous dentist never gave them a choice. This is why I believe it should be the patient’s choice what goes in their mouths when a choice exists, regardless of insurance coverage or financial position. And patients appreciate being given the choice.