Of course, the meaning it has for you personally is necessarily the sum of all your past experiences, exposures to the technology, and with worldwide forums available today perhaps even seeing firsthand the wide range of results from the technology itself. Unless one has lived a very sheltered dental life these past years it seems everyone has an opinion that pops in their mind upon hearing that unique name.

There has been a continual progression and advancement of this technology, particularly over the last decade. It depends on which ‘version’ existed when your own personal interest was piqued enough to explore the technology yourself to determine which perspective composes your own present beliefs. 

With the latest version CEREC 3D, CAD/CIM technology has hit its stride in providing a true chairside delivery system of all ceramic restorations. Long past are concerns with the fit of ‘margins’, now with numerous digitized ‘databases’ from the most renowned lab technicians and companies, the restorations themselves are quite beautiful. The database libraries are built within the system itself, allowing any dentist to custom create a restoration which is not only beautiful, but ‘fits’ impeccably well.

So now that the traditional ‘problems’ which surrounded CEREC have been overcome, why does one still note a wide variance of end user results and capabilities from the technology?

Simple really, when you think about it. Just because one can easily get a well contoured crown with exceptional anatomy and fit relatively easily these days does not mean that the only requirement from the dentist is just cementing it in! In fact, I personally believe thats where the true potential of this technology actually begins.

Being able to create a well-fitting general form relatively easily CEREC allows the discriminating esthetic dentist to concentrate their efforts on ‘finishing’ the restoration to their fullest capability, instead of just struggling to get the technology to ‘deliver’ which defined the landscape previously. This is why I believe CEREC is an opportunity AND a responsibility. 

Previously with labs, before using CEREC we simply took an impression sending the case off to a lab technician to fabricate. To assist in that fabrication we often employed sophisticated communications with a lab, then necessarily relied upon the equally variable skill levels of different labs to then create our esthetic and functional result.

With CEREC …ALL of that ‘responsibility’ is now placed upon the dentist. Understanding and applying stains & glazes, even stacking ceramics if desired NOW need to be skills owned and mastered by the dentist as well. These are not difficult, or cumbersome skills to learn and master, but are required of the CEREC dentist directly instead of having a third party at the laboratory do that for you.

This is where the ‘opportunity’ arises. Being able to match your restorations to this impeccable level raises the bar significantly for the demanding esthetic dentist. The actual time spent by the very discriminating dentist normally ‘communicating’ this information to their lab is spent instead actually doing it for themselves. Arguably, the potential of obtaining the best possible match is possible with CEREC chairside instead of conveying that to a third party.

I have personally witnessed the defining and characterizing difference amongst CEREC dentists IS their level of discrimination. While one dentist might be content to simply and quickly polish the milled restoration and cement, another might cutback the restoration and add characterization from stacking ceramics, staining and glazing then cementing. BOTH are CEREC restorations which is a true testimonial of the diversity this technology enjoys.

Personally, I teach others methods of delivery with CEREC which uses what I perceive its unique capabilities to its full advantage. I believe that it possesses the capabilities of delivering the highest possible standard of all ceramic restorations. I use these methods in a real world setting each and every day in my own private practice, so I truly ‘practice what I preach’. My personal goals are to ‘raise’ the accepted standard that exists and defines these CEREC restorations by teaching others the techniques I use to that effect.

The biggest obstacle I have noted in offices getting on board with these skills, and actually CEREC itself, is their pre-conceived notions. Trying to simply ‘plug-in’ the technology to an existing practice flow and schedule will yield less than optimal results. The time to simply and traditionally cut a crown prep, take impressions, and temporize…is different than also fabricating and finishing that crown in one visit as with CEREC. Most simply want to take the same exact time they did before, and feel it a shortcoming of the technology if not possible. 

This is unfortunate, since I feel it misses one of the biggest opportunities that CEREC offers which is defining and implementing ones practice towards a true esthetics organization.

The ‘time’ spent doing CEREC is different, this needs to be understood, and appropriately addressed to allow it to deliver to its true and full potential. Regardless of the time spent, it ALL can be organized with a direct and positive effect on defining one as a true esthetic practice. This fosters a bottom up transformation of your practice image from your staff through your patient base itself in the best possible way…by actually doing it. One needs to be open minded in evaluating these times, realizing that doing it in one visit WILL be a longer visit, but ONLY one visit which is HUGE from the patients perspective. 

Review the time spent, be honest and fair. Give yourself the necessary amount to deliver the highest possible standard you desire from the technology. Its arguable that the true time spent -doing- this is no more than the ‘extra’, and typically not considered time, one would alternately spend gathering the necessary photos, color mapping, lab communications necessary to effectively achieve the same level of results.

Many doctors have decided that with CEREC 3D the system has evolved to the standard they feel compatible with their offices needs/direction. They have seen the exquisite results some have obtained with the machine, and rightfully feel they too can achieve those results. But, they shouldn’t seem surprised that Lee Culp is not able to pop out and make the restorations for them, or that the beautiful results routinely seen by others are not direct from the  milling chamber

If one realizes that spending a little time and resources to obtain the necessary understanding, skills, equipment that are widely available, they too can achieve the level personally desired. Notably, there is an organized effort from companies delivering and supporting CEREC here in the US to provide that training. Equally apparent as witnessed by training individuals of all levels, in a variety of venues, internationally is  that wide spectrum of ‘end user’ knowledge. The most notable trend of those with the least knowledge in making the necessary practice adjustments to adopt CEREC are those outside of that network. Nonetheless, much training, information IS available to everyone, these individuals are just disadvantaged to have to search it out, explore, learn and get exposed to it on their own.

With a little patience, and desire the opportunities that exist with CEREC are significant. Understanding the unique requirements, while not encumbering, also allows one to understand and address the responsibilities associated with its true potential.

I personally plan on sharing many of those revelations, experiences, mistakes I have made along the way here with the constant evolution of CEREC in my esthetics practice.

Ray Becker