Getting a dental crown is hardly a regal experience.
A crown — a tooth-shaped cap placed over a tooth to restore its shape and strength — usually requires an uncomfortable mouthful of impressions, and a temporary replacement worn for a few weeks until the final crown is ready.
Dental patients might have another option, however: CAD-CAM technology.
CAD-CAM stands for computer-aided design/computer-aided manufacturing. Dentists who use CAD-CAM technology can re-create a tooth or filling in a few hours instead of several weeks. The entire process takes place during one visit to a dentist’s office, and the cost to patients is generally the same as a crown done the conventional way.
Peter Holman had the procedure done recently at Emery & Emery Dental in Long Beach, by Drs. Alyson Emery and Doug Emery.
“There was no pain, no messy goop, and I would absolutely do it again,” said Holman, who came to Long Beach from Inglewood for the procedure.
Holman said he lost a previous crown while chewing jellybeans and needed a replacement. His former crown had been installed the traditional way. The Emerys, he said, convinced him to try to the CAD-CAM procedure.
“They promoted it as ‘same-day dentistry,’” Holman said. “And no taking of impressions.”
According to a study by the American College of Prosthodontists, CAD-CAM technology is used in about 15% of dental practices in the U.S. The process also can be used to create veneers, onlays, inlays and bridges. In September, the American Dental Association published the organization’s first-ever dental CAD/CAM standards.
During the CAD-CAM crown procedure, instead of taking physical impressions, a dentist uses optical or laser scanning technology to capture a digital image of the tooth from all angles. The dental practitioner uses special 3D software to design the crown and sends it to a mill located in the office. The dentist then places a block of porcelain in the mill to form the tooth. Drills in the mill carve and shape the tooth, following the pattern of the mold sent via scan.
The crown can be stained or polished to match a patient’s other teeth, which takes about 15 minutes, followed by glazing in an oven for about 15 minutes. The dentist then sets the crown on the patient’s tooth right way.
During a conventional crown procedure, the patient has to visit the dentist at least twice: first, to get impressions, then again a few weeks later to have the crown placed in the mouth after the crown is designed and made at a laboratory.
The same-day approach does all the above in about 60 to 90 minutes, Alyson Emery said.dental laser tips
Emery said she and Doug Emery have been using CAD-CAM in their practice for about one year.
The Emerys and their dental assistants went through four days of training in Dallas, Texas, from the manufacturer of the CAD-CAM equipment, Alyson Emery said.
“The learning curve was more difficult than for other dental processes,” she said. “Everything was completely different — scanning versus taking impressions, crowns built in the office instead of a lab.”
Not everyone is a candidate for the procedure.dental laser handpiece
“Some teeth aren’t scannable, so there are some instances where we still use the old technique,” Emery said.
CAD-CAM dentistry is “just taking off right now,” she said, even though the equipment has been available for more than 25 years. “It is going to be the future of dentistry. Even labs are building crowns digitally.”
Emery said that so far she has not seen any disadvantages to the process.
Holman agreed. “I haven’t had any issues, the fit is good, and the bite is right,” he said of his crown.
Coincidentally, he’s scheduled to be back at the dentist for a regular cleaning on Sept. 27.
Alas, no CAD-CAM technology is available yet to replace those metal tooth scrapers.