How are CEREC margins?
I get asked this question a lot from prospective CEREC owners and new user, the reason is that many of us have seen bad CEREC margins over the years. My answer is that this is no different than good and bad lab crowns. If I prep appropriately and take a good impression, likely the lab or my CEREC will be able to produce a good result. The opposite will be true if I don't.
The reason this site, basic or level 1 training, and level 2 training is so important for all users is that it not only teaches you to use the software, but how to prep, design and bond for success. It really doesn't take any more effort to get a great fitting restoration instead of a bad one, but it does take education.
The Dentist that did the CEREC crown on the left used a similar machine as mine, and took about the same amount of time to make his crown as I did for the one on the right. The difference is that he simply didn't know what the machine needed to give him a great result. If you're new to CEREC or not getting great results, get the education you need from cdocs and the results will be there. Sorry for the commercial, but I really believe strongly in the education available here.
On 10/2/2018 at 9:36 am, Kirsten Andrews said...Awesome! Can I use this for the Explore event I am doing in ND next weekend?
Kirsten
Absolutely Kirsten.
Dan,
Shoot another one of my patients moved to Colorado! 
Seriously, great post! Stealing your images.
Thanks for sharing
Sharpie
On 10/2/2018 at 12:28 pm, Petar Tofovic said... Great example and case Dan. I'm surprised no one has asked "What material?" yet...
Based on how hard it was to cut off, I'm pretty sure the original crown was e.max. The new crown that I made is e.max as well.
Dan,
Just curious, was this tooth symptomatic, did you find decay? I often find myself debating whether to cut these off or just monitor, I have seen PFM counterparts that are a decade or more old and still no radiographic decay. Some have had minimal decay on removal, some should have come off years earlier.....
Also, a friend on Facebook was asking about dentists in the Denver area, I sent him your way!
I enjoyed your lecture at SW18!
Thanks Jeff!
He actually came in as a new patient for this tooth. He said the crown was pretty recently made and it was sensitive to temp and flossing. I didn't find decay when I removed it.
On 10/2/2018 at 4:00 pm, Daniel Butterman said...Thanks Jeff!
He actually came in as a new patient for this tooth. He said the crown was pretty recently made and it was sensitive to temp and flossing. I didn't find decay when I removed it.
Great post Dan.
And that chief complaint is the key...if I've heard Frank Spear correctly, he is comfortable "observing" these until either a symptom or pathology arises from the tooth before subjecting the tooth to another dental beating with the handpiece (and the potential ramifications of that crown removal). We've all seen substandard dentistry walk through the door which has been in service for years/decades and without a very good reason, WHY are we removing the "everything's fine" crown? What are we actually treating? Where is the symptom or pathology? JMHO.
I thought cerec was junk before I saw the light. Actually purchased cerec about eight years ago as a skeptic. I thought this was where things where going and I wanted to have it mastered when the technology got there. Little did I know it was there. I really had the blinders on, and Dan's post shows why. I'd see a patient with a terrible restoration made with cerec and think "cerrec is junk", but the pfg's, gold work, resins, alloys, and everything else in the patients mouth was crappy too. But, I never put two and two together that maybe the dentistry was the problem, and not the means of producing it.
Great post Dan!
Just like anything else, it's the time and effort that the dentist puts into the dentistry. CEREC is a great addition to our armamentarium, IF you take the time and effort to use it correctly and update and maintain your skills - you get what you put in. That is why C'Docs is such a great resource with the workshops and these boards.
Winnie
Great case! I would like to see us post more bitewings than pictures of how colorful and shiny our crowns are ;). The mesial contact may seem a bit light but I learned with my cases that even though it looks so it still had a pretty strong snap with the floss!
Omnicam imaging still needs improvement as the margins are still somewhat hard to see. I use traxodent and black cord and take xrays before cementing as quality control checks and still see some lipping with the margins...rarely...but it can be frustrating. Seeing my work over the last few years on bitewings was humbling and it took a lot of effort and resolve to nail the margins and consistently get that money Shot with bitewings. I do however understand the frustration that none cerec users may have. Training at cerec doctors is a must as this is a whole new realm for dentists. But we must push the developers for improvement especially in the omnicam imaging.
Great post Dan! I whole-heartedly agree with the learning process with taking the levels. The takeaways are priceless and as always thank you for sharing.
