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were certainly functional but not something a clinician was
going to present at their next dental cosmetic seminar and
hold up as a symbol of dental excellence. Twenty-seven years
ago, it was more about the mere fact that a restoration could
be created at all, let alone create a restoration with tight
margins and exceptional esthetics. A few talented individuals
were able to make the machines create works of beauty, but
the general dental user simply did not have the skills, desire
or patience to create esthetic and functional restorationswith
the early versions of the CEREC system.
As the system has evolved, creating inlays and onlays
has now become routine. Whether it’s a single restoration
or a quadrant, creating restorations that mimic the natural
remaining tooth structure is not only the norm, but the ease
withwhich it can be created is something that has clinicians
praising the system today. Advances in the technology and
advances in materials has made CEREC more of a main-
streamfocus instead of a technology that is fawned over
by the dental geeks.
In 2009, the Bluecam was introduced with much
fanfare. At the time, this camera allowed simplified
imaging of more than just a single tooth. The Bluecam
allowed the capture of a quadrant in about 15 seconds
or so, and allowedusers to designmultiple restorations
with the 4.0 software easily. No longer were clinicians
limited to just a single tooth, no longer did they have to
work on one tooth at a time, using software tips and tricks
to manipulate the system to allow work on multiple resto-
rations. The introduction of the Buccal Bite allowed the
clinicians to create restorations that were not only accu-
rate in form but also in function as the Buccal Bite allowed
them to precisely design their occlusion.
Material advances such as e.max from Ivoclar Viva-
dent has shown up to 10 years success in vivo. This
success opened the doors for clinicians to inquire about
in-office CAD/CAM, where in the past they may have
been fearful of placing anything all ceramic on posterior
teeth (despite the
fact that materials
such as the Vitabloc
from Vita had been
used
successfully
for decades). More
recently, nano tech-
nology composite blocks from 3M called Lava Ultimate
have offered another solution to clinicians who sought an
alternate material to use without having to use an oven.
The cumulative effect of these advances has been a system
that is easy to use and has a broad range of capabilities.
With an advanced software and a large range of materials
to use, the next hurdle was the introduction of a new intra-
oral imaging camera, the Omnicam. While the Bluecam has
performed flawlessly, its one critique was that if you had to
take larger scans or full-arch images, the technique required
a steady hand and a learning curve that was difficult for some
to overcome. Oncemastered, the Bluecamallowed simplified
Figs. 7-8: A patient presents with a missing provisional
anterior bridge. A scan with the Omnicam is taken
of the existing preparations in order to fabricate a
milled provisional restoration.
Fig. 9: The bridge restoration is designed with the 4.0
software to restore the missing teeth for the patient.
Figs. 10-11: The milled provisional is milled from a
55
mm Teliocad block from Ivoclar Vivadent. The
finished provisional restoration is contoured, the sprue
removed and polished, and prepared for insertion.
Fig. 12: The seated provisional bridge matches the existing
dentition and restores the patient to function until
definitive treatment.
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