CEREC can be so many things. The possibilities and capabilities are endless these days. But at the end of the day it is important to keep in mind the 90%.
By 90% I am referring to what 90% of CEREC owner do regularly and the procedure that makes up 90% of what is done. THAT IS THE SINGLE UNIT POSTERIOR CROWN.
How do I define ideal results? For me it is simple – I want a restoration that seats without any adjustment, but yet still in occlusion. It’s easy to make something adjustment free – just take it out of occlusion. But that’s not good dentistry. So we need something that seats quick and easy, that’s in occlusion, but doesn’t require lots of adjustments.
THIS IS, IN MY OPINION, THE HOLY GRAIL OF CEREC DENTISTRY.
So how do we achieve this? The answer is easy – utilize the most underutilized feature of the software – ARTICULATION.
Now many may disagree with me that articulation should be used on every case. But please let me make my case.
The word articulation and/or articulator makes my eyes drop into the back of my head and gives me nightmares. But the art of grinding in occlusion and the frustration of this is even worse. So let’s just avoid it.
Here’s a great example of how articulation saved me time and made my life easier.
Here is my initial proposal. As you can see it looks quite nice from the occlusal view and has minimal colors that would suggest a restoration that would need adjustment after seating.
Quickly turn on the articulation feature and click ‘Occlusal Compass’ and voila! We can clearly see that the buccal cusps are high. This would be exactly where you would adjust this – either immediately after cementation or a few days later when the patient starts complaining of tooth pain.
A quick turn of the model – what I call ‘looking at it down the line’ – clearly shows the buccal cusps are high.
To adjust these i don’t use the anatomical shape tool, but instead use the circular shape tool. It gives a better look of wear facets, which is what these cusps would look like in real life.
Take a look at a before and after side by side of this.
I know what you are thinking – this should have been easily caught using the ‘down the line’ view. But truthfully how many of you reading are doing that regularly?
Just to ease your mind here are a few more examples.
The above examples clearly show what we already realize after seating on second molars. The excursive movements make us grind away that beautiful anatomy.
So instead of doing it after the fact, let’s do it before we mill!
So how do you make utilize articulation? You simply turn it on in the administration phase.
Here is a video I created on how to implement articulation…