I love my CEREC! And nothing irritates me more than when a fellow clinician makes the assumption that CEREC is substandard dentistry when it comes to marginal integrity.
I actually argue that CEREC gives you the ability to produce the absolute best margins.
- You are able to control and evaluate your impression immediately.
- You are able to magnify your impression and really take a close look.
- You are able to self mark your margins. Who better to determine the margins than the person prepping the tooth while it is fresh in their mind?
With the OmniCam it has gotten even better. Now you are able to better distinguish in color your margins.
This lovely patient came in for a limited exam with pain in the upper left. She recently had two large resin restorations that were quite deep and in close proximity to the pulp. It was pretty straight forward that both tooth #12 and #13 needed endodontic treatment with full coverage protection.
She ended up in our office because we offer dental sedation. She was fearful of the procedure and ‘had a tough visit for the fillings’. She wanted to remember nothing!
I believe the greatest adjunct to CEREC is dental sedation. You can complete treatment in a single visit and avoid having to sedate again for delivery or worse, making your fearful patient be non sedated for delivery.
The teeth were prepared for full coverage restorations prior to making access for efficiency. Below is a screen shot of the preparations captured with OmniCam. Please note how the preps are quite sub gingival, but yet we were able to clearly capture the restorative margin.
Endodontic treatment was completed and the final restorations bonded into place. Below is a PA and BWX of the completed restorations. Please note that following this radiograph the excess cement between #12 and #13 was removed.
So again I ask the original question. How can one say that CEREC restorations lack marginal integrity? I would argue that it represents the finest in restoration integrity and patient efficiency.