Cerec

[Floss]

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Just out of curiosity, how many schools have a Crec machine? How often do students use it?

 

[La Miraflorina]

I HATE the Cerec machine! Our office just got it a little over 3 months ago and it is more trouble that it's worth. The inlays and onlays never fit right and look terrible... The crowns look fake (as opposed to a dental lab tech's work) and the time it takes for the dentist to get a good outcome is sometimes hours.

Just as a comparison: Before, it used to take the Dr. 5 min to numb the patient, 20 minutes at the most to prep a tooth and the rest of the work was for the assistants: 5 min to pack the cord and 25 minutes to make and cement a temp. Total time: 1 hour at the very most. And delivery day is usually just 20-30 minutes max. And the end result is a beautiful natural looking tooth.

With the Cerec, it takes the doctor 25-35 minutes to get a good prep because the Cerec's camera isn't perfect, another 10 minutes to take pictures, another 10-20 minutes for the doctor to play around with the computer to get a good model and then we have to wait 20 more minutes while the machine mills out the restoration. And THEN, we have to polish the restoration, go through a lot of BS with etching it, putting a ceramic bonding solution on it, etching the prepped tooth, and using a composite material to "cement" it, usually with a matrix and then even more time to adjust the bite which is always too high and another polish. The shortest time a patient is in the chair is an hour and a half (but the Dr. is there the whole time) and the longest time we've had a patient in the chair is 3 and a half hours.

I'm telling you, it's just such a waste of time and money. And with Cerec, the doctor has to be present for most of it. Even though traditional crowns can take an hour and a half (including the delivery appt), the doctor isn't tied up for most of it so he or she can be treating other patients.

 

[TiggerJSA]

Just out of curiosity, how many schools have a Crec machine? How often do students use it?

Here is another thing with the Cerec machine... It can only make 1 shade of procelain per crown. With experience, you find most crowns need different gradations of shades. Reps of Cerec will claim you can use porcelain staining techniques. This is horse****! You cannot get a favorable esthetic result by just staining comparable to blending shades. So, for those of you in awe of this impressive machine, ask yourself if it's worth the 90K-100K for a machine that most likely will not pay for itself in the long run. The only real benefit to this machine is the ability to attract new patients just by its sheer presence in your office.

 

[v&andy_yankee]

CEREC= 👎 👎 👎

They taught it to us out of hopes to warm us up to it; methinks it backfired as I and (it seems) the majority of my class aren't so peachy with it.

I think Columbia has 2 of the upgraded/new machines, and then a few of the older models which are just sitting in a random corner collecting dust. How often they're used, I dunno, but I still think CEREC has a long way to go until I would buy it. Costs a pretty penny.

 

[DrJeff]

Do a little search into what the margins of a CEREC restoration are vs. what they are on a lab tech fabricated restoration, then think about the long term solubility potential of resin cement verses a cement such as a resin modified glass ionomer. Put everything together and then figure out if you want to drop around 100 grand on one of those machines to spend more chairtime than a traditional lab tech fabricated crown.

What I'd really like to see concerning CEREC restorations is what is the 5 years percentage of failures vs. lab fabricated crowns. And I won't even get into the estesthics issue 😱

 

[crazy_sherm]

There are two main types of CEREC machines, the one that you use in your office and the CEREC inLab machine which is used by the lab. One big difference between the two is how the image is scanned into the computer. The in office one doesn't require an impression, but you do need to lay powder down on the tooth which results in an at best margin of 50 microns. The inLab machine does require an impression and a scan is taken of the master cast, so the margin can get down to 25 microns.

We don't have a either type of machine at school here, but we are taught to cut a crown prep that's sent off for fabrication in a CEREC inLab machine. Just got back our first bisque last week, but it turns out our ovens don't get hot enough for the final glaze. Apparently, it needs to get up to 2100 F and ours only go up to something like 2000.

The only positive thing I've gotten from CEREC so far is the $100 gift certificate for sitting through their 15 min presentation at the CDA conference a few months ago.

 

[La Miraflorina]

Here is another thing with the Cerec machine... It can only make 1 shade of procelain per crown. With experience, you find most crowns need different gradations of shades. Reps of Cerec will claim you can use porcelain staining techniques. This is horse****! You cannot get a favorable esthetic result by just staining comparable to blending shades. So, for those of you in awe of this impressive machine, ask yourself if it's worth the 90K-100K for a machine that most likely will not pay for itself in the long run. The only real benefit to this machine is the ability to attract new patients just by its sheer presence in your office.

I couldn't agree with you more. Although we don't use it for anterior crowns, the premolars in people with wide smiles look like f-ing chicklets, both for the monotone color and because they are milled out so high that by the time the Dr. corrects the bite, all the anatomy is gone from the occlusal and it looks flat.

I love technology... but I'm sorry, in this instance, real live human beings do a much better job.