Benefits of using CEREC

[BobCDT]

Just like to share our CEREC experience With the group.
Purchased the small lab unit about 12 years ago. Never ever got a quality results from the mill.
Then, again, under very heavy sales pressure I upgraded to the new MCXL. and a new scanner. And, never got a quality product out of it. We did however make some OK temps with it.
Finally decided to use it as a boat anchor for my Grady White and I must say it works well for that application.
Then bought Lava. A real mill and system that produces units that fit in accordance with ADA guidelines (unlike Cerec). Since then we have purchased many additional mills that also do what they are supposed to.
Travis, sorry, but the people on this site are way too knowledgeable in milling to agree with the BS you are posting.
Bob

 

[PDC]

To be totally fair to the patients readying my post.... many doctors can make very nice crowns with a Cerec having excellent results....and others make very ugly crowns with bad shades and a high failure rates because of bad techniques....And that is part of the reason why so may Used Cerecs are sold....Many Cerec crowns made in the dentlal office without custom staining and look as bad as temparary crowns...
I personally know people that were sold on the one hour crown that broke in less than a year, and the doctor would not replace free.

My $.02 to the patients reading this thread..

This is why the "Crowns in an Hour" will eventually fail from a marketing standpoint. So will the "Cerec" business model if bad results like this continue. Patients will remember the product name and tell their friends about the bad results of their "Crowns in an Hour" experience. These patients will probably avoid all dentists advertising as a "Cerec" practice. It's kind of like the issue a few years ago with Ford Explorer's having blowouts. The product you sell better have a good reputation because your future depends on it!

 

[JonB]

... and I'm just wondering why this topic is even in the Photography section! Shouldn't it be moved to jokes and humor?

Who was it that coined the term "Cerec... a piece of glass floating in a sea of composit!"

 

[VTDave]

This is why the "Crowns in an Hour" will eventually fail from a marketing standpoint. So will the "Cerec" business model if bad results like this continue. Patients will remember the product name and tell their friends about the bad results of their "Crowns in an Hour" experience. These patients will probably avoid all dentists advertising as a "Cerec" practice. It's kind of like the issue a few years ago with Ford Explorer's having blowouts. The product you sell better have a good reputation because your future depends on it!

I know people who get their crowns made this way and they like it because they get it fast and they can see it being made. I tell them it's not as good as a crown made at a good lab but they don't seem to care. The only person I know who had crowns break had them made at a lab. I don't know what kind they were. The dentist never told her. I asked her to ask him but she didn't. Eventually she had to have the tooth pulled after having 3 crowns on it.

 

[Jacob.smith]

This is why the "Crowns in an Hour" will eventually fail from a marketing standpoint. So will the "Cerec" business model if bad results like this continue. Patients will remember the product name and tell their friends about the bad results of their "Crowns in an Hour" experience. These patients will probably avoid all dentists advertising as a "Cerec" practice. It's kind of like the issue a few years ago with Ford Explorer's having blowouts. The product you sell better have a good reputation because your future depends on it!

Unfortunately i would have to agree with you here. Not about the quality of fit etc which i agree with (particularly on a poor prep) but patients love this kind of gadget. I moved from one practice that had it and used it for inlays etc to a practice that does not. I much prefer to take an impression and have a the inlay / crown made by a lab. In fact recently a patient came to me wanting a "crown in an hour" as she had seveal done before and liked the concept. I advised that we did not have the tech to do it that way and that i could produce a superior restoration (emax vs empress). The patient accepted my recommendation and once it was cemented she commented on how much better the restoration that i cemented looked and felt (right next to an existing cerec that looked pretty average),and then went on to say that for her the CEREC way was much easier and she preferred to have it done that way. She has stayed with me and had a few more onlays made with imps etc and has been very happy with the result but still comments on the multi visits.

 

[Andymg]

Cerec is great if you know how to use it if you don't then you will rant about it being the worst blah blah blah
in other words i think its a good system

 

[CoolHandLuke]

This is why the "Crowns in an Hour" will eventually fail from a marketing standpoint. So will the "Cerec" business model if bad results like this continue. Patients will remember the product name and tell their friends about the bad results of their "Crowns in an Hour" experience. These patients will probably avoid all dentists advertising as a "Cerec" practice. It's kind of like the issue a few years ago with Ford Explorer's having blowouts. The product you sell better have a good reputation because your future depends on it!

well, now stop and consider, labs are trying to stay competitive in the marketplace by cutting time off their schedules. the lab i work for is soon to deploy considerable information on 3-day turnaround for monolithic zirconia or gold. its ridiculous to make these insane promises as i know half the cases will just end up being remade anyway. cutting time down to 1hr is fine and good from a business standpoint, but it blares the obvious fallacy of poorly made items.

now, if CEREC could be tweaked ever so slightly (say to be designed with different software and a different intraoral scanner) then the system will be awesome.

 

[PDC]

Unfortunately patients don't have the same perspective that we as lab techs do. If the doctor's waiting room is full of patients waiting on their "crown in an hour", what do you think happens in the event the doctor has an open margin on a milled crown. Remember...this is only supposed to take an hour. Does he remill and eat the cost of another blank plus lost chairtime...patients are waiting!? Hurry up! or is the decision: I've got more "1 Hour" patients and the bonding resin will cover that open margin. I think I know what the answer would be but will the patient understand what just transpired. Funny how remakes are handled depending on who made the crown. :hmmmm:

 

[charles007]

Unfortunately patients don't have the same perspective that we as lab techs do. If the doctor's waiting room is full of patients waiting on their "crown in an hour", what do you think happens in the event the doctor has an open margin on a milled crown. Remember...this is only supposed to take an hour. Does he remill and eat the cost of another blank plus lost chairtime...patients are waiting!? Hurry up! or is the decision: I've got more "1 Hour" patients and the bonding resin will cover that open margin. I think I know what the answer would be but will the patient understand what just transpired. Funny how remakes are handled depending on who made the crown. :hmmmm:

If you will post this on DT, I will watch from a safe distance....lol

 

[RileyS]

well, now stop and consider, labs are trying to stay competitive in the marketplace by cutting time off their schedules. the lab i work for is soon to deploy considerable information on 3-day turnaround for monolithic zirconia or gold. its ridiculous to make these insane promises as i know half the cases will just end up being remade anyway. cutting time down to 1hr is fine and good from a business standpoint, but it blares the obvious fallacy of poorly made items.

now, if CEREC could be tweaked ever so slightly (say to be designed with different software and a different intraoral scanner) then the system will be awesome.

the tweak here would have to be a huge tweak (do i catch any sarcasm here? your asking to change 2 of the 3 components of the system). The system is only capable of milling a crown on a "Sirona Approved" prep; this means huge chamfered/shouldered smooth margins, perfectly degreed walls, and perfectly rounded tops. I have done +/- 10,000 crowns and copings on the system and the only time it comes close to an acceptable fit is under those circumstances, other wise I'm spending 10+ minutes seating it to the die. I will say that I can design a crown to come out of that fitting with one or two adjustments to contacts, contour and occlusion which I loved.
Don't remember who said a few posts above that "you have to know how to use it," thats absolutely true, a doctor committed to making perfect preps will have some success.

 

[paulg100]

"Don't remember who said a few posts above that "you have to know how to use it," thats absolutely true, a doctor committed to making perfect preps will have some success."

And their lies the key.

This system should NEVER have been sold as a lab system.

In the right clinical hands (and thats a serious minority) DR's have half a chance of producing quality dentistry, but labs have no control over prep design which is why this system should stay chair side where it (arguably) belongs.

theres a ton of other reasons why its craplab but weve been over that so many times now.

 

[Slipstream]

Dental forum | Benefits of using CEREC

Same idiot - same spiel - but read the last post

 

[disturbed]

Dental forum | Benefits of using CEREC

Same idiot - same spiel - but read the last post

pathetic. period.

but good for a laugh!

 

[Davethedentist]

Well. I'm a dentist (previously a mechanical engineer specializing in cnc machining for 13 years) and I have 2
Cerec systems in my practice (one inlab system)
I've been using them for about 5 years and experienced the learning curve.

I've silently read the posts for years about Cerec and agree with both sides except on one point.

If your Cerec is well calibrated with correct parameter settings for your use, appropriate tooth preps and correct choice of material for the occlusion and location in the mouth then it can produce a restoration of equal quality to your average lab.

It is of course not the quality of a GOOD lab on the majority of things. I therefore charge the patient to suit this.
Good Cerec is vastly better than a large direct composite. But not as good as quality lab work.
For Example:

5 surface direct posterior composite $280 (1 hr)
Cerec crown single visit $850 (1 hr 45min)
Lab crown 2 visits $1600 (1hr 30min)

The patient gets all 3 options and understands (as best I can describe) what there is to choose from.
Not all patients can afford the $1600 crown but Cerec crowns are a better option than a direct composite.
(And I don't mean a crap rushed blob of composite, full anatomy restorative and it takes TIME..)

My point is that Cerec does have its place and if you know how to use it and are prepared to put the time
in then it's not the crap that some say.
I did set the Cerec systems up in my home ( wife not happy !) and milled a good 25 units as trials before I dared place one in a patient.

I use 3 labs and none of them can (or have ever for that matter) place correct occlusal balanced contact points where requested, I always have to adjust the crowns from my labs (perhaps I need to look for another lab (number 4!)

But lab materials are better and margins (in general not always) and I find myself increasing spacer thickness to ensure closed margins at the expense of insertion fit.

I'm just starting to test mill multishaded 3D monolithic Zirconia , and learning the sintering process. It will add another material to the Cerec in house option where strength is insufficient in some occlusal situations.

It makes my day more interesting and I love restorative dentistry that I'm proud of. I'm never proud of charging $ . Only proud of the work (if it's good

 

[Davethedentist]

Unfortunately patients don't have the same perspective that we as lab techs do. If the doctor's waiting room is full of patients waiting on their "crown in an hour", what do you think happens in the event the doctor has an open margin on a milled crown. Remember...this is only supposed to take an hour. Does he remill and eat the cost of another blank plus lost chairtime...patients are waiting!? Hurry up! or is the decision: I've got more "1 Hour" patients and the bonding resin will cover that open margin. I think I know what the answer would be but will the patient understand what just transpired. Funny how remakes are handled depending on who made the crown. :hmmmm:

Yep, this happens but I just take an impression and send it to the lab or re scan the model and have the patient come back in.
My first crown becomes an expensive temp but everyone and then this happens.
I would rather than go fishing than have to live with the thought of a poorly fitting crown, sometimes it's not the margin, it's the occlusion but it's the same fix and that's a re-make.

 

[paulg100]

"If your Cerec is well calibrated with correct parameter settings for your use, appropriate tooth preps and correct choice of material for the occlusion and location in the mouth then it can produce a restoration of equal quality to your average lab."

great if you have control over those factors, the biggest problem with cerec from the lab end is they tried to sell it to labs!!!

secondly, you were a cnc engineer for 13 years and you feel a machine with a specced +_50um and a scanner that they wont publish spec on (or didn't used to last time I looked) is acceptable.... really surprised you think that. Id have thought as an ex CNC engineer you would of been more inclined to have your work milled on a proper industrial mill that's more like sub 5um than anyone.

 

[Affinity]

davethedentist, (davedadentist has more of a ring to it) Why do you charge a pt $1600 for a lab crown, and $850 for a cerec crown? Certainly the patient would want the faster cheaper crown... but why is it half the cost? Ive never heard of anyone ever charging $1600 for a crown prep btw.

 

[rkm rdt]

I use 3 labs and none of them can (or have ever for that matter) place correct occlusal balanced contact points where requested, I always have to adjust the crowns from my labs (perhaps I need to look for another lab (number 4!)

so the question is, are these occlusal points verified on the working models or just in the mouth?

 

[TheLabGuy]

Well. I'm a dentist (previously a mechanical engineer specializing in cnc machining for 13 years) and I have 2
Cerec systems in my practice (one inlab system)
I've been using them for about 5 years and experienced the learning curve.

Thanks for posting, great insight and I agree Cerec has come a long ways. I think why you find so much angst from Lab techs isn't so much about the loss of work as it is how patterson and sirona rolled this cerec out in the early days. You had cerec sales people going to Dentists saying, "this will replace your lab". Granted, those red cams were a mechanical migraine, the blue a lot better, and omni has improved on that but when you're a lab owner and your Docs call you saying, "Hey Rob, just so you know, I bought a cerec to replace you"...then they find out they just bought a 80k coat hanger, it tends to leave some of us shaking our head moving forward. As others have asked though, why do you charge such a considerable difference between your lab crowns and cerec crowns? Also, I'm really curious what you state is 'correct balanced occlusion'...please share some pictures if you have a second, I think a lot would learn a lot from that. Thanks

 

[Affinity]

so the question is, are these occlusal points verified on the working models or just in the mouth?

And were those models from triple tray quads or full arch..