Same Day Dentistry – CEREC and E4D

Same day dentistry refers to an innovative new brand of treatment that condenses some traditional procedures into a single office visit. Thanks to in-office dental CAD/CAM technology, patients can receive milled metal-free crowns, veneers, onlays and inlays in one office visit, while they wait. If your dentist uses a CEREC or E4D Dentist System in the dental office, same day dentistry may be a treatment option for you.

The Technologies

CEREC: The CEREC in-office dental CAD/CAM equipment by Sirona includes a digital infrared camera for obtaining an optical impression of the damaged tooth, 3-D CAD software for designing the restoration, and CAM technology (milling unit) that uses high-speed burs to mill the restoration.

E4D Dentist System: Developed and manufactured by D4D Technologies, the E4D Dentist System uses laser scanning technology to capture the optical impression of tooth preparations. In most instances using the laser eliminates the need for the reflective powder agents required for some digital impression or CAD/CAM systems. The E4D Dentist System also includes 3-D CAD software for designing the restoration, as well as CAM technology (milling unit) that uses burs to mill the restoration.

Procedure Details

After your dentist has examined your teeth and determined a same day CAD/CAM restoration is a treatment option, the area surrounding the affected tooth or teeth will be anesthetized and prepared for your metal-free restoration.

A digital impression is taken using an optical or laser scanner and entered into a computerized system. This system is used to create a virtual model of your teeth and design your crown, veneer, inlay or onlay. This process involves identifying the appropriate color, shape and biting/chewing surface for your restoration.

The design then is sent via cable or wirelessly to a milling unit in the dentist’s office that will fabricate the restoration in approximately 20 minutes. The metal-free materials used for CAD/CAM restorations include blocks of porcelain, composite and lithium disilicate.

The mill uses burs to cut the block to the precise shape of your specific restoration. When the milling process is complete, the restoration can be polished or stained and glazed to create a life-like appearance that will match and blend with your natural teeth. If stain and glaze are used (which can take anywhere from 15 to 20 minutes, depending on what’s required), the restoration will be fired in an oven (similar to pottery) for approximately 15 minutes or less. The total process may take as little as 60 to 90 minutes.

Once the restoration is finished and inspected, it is placed and checked for fit, then cemented. The result is a permanent treatment completed in a single office visit.

Recovery and Follow-up Care

After your veneer, crown, inlay or onlay has been placed, your dentist will provide information about caring for your new restoration. In general, maintain proper oral hygiene habits by brushing twice daily and flossing with dental floss or interdental cleaners (specially designed brushes and sticks) once a day to remove plaque and help prevent dental decay and gum disease.

Avoid chewing hard foods, ice or other hard objects, since these could damage your restorations. It also is important to avoid biting your fingernails and grinding your teeth, which could significantly shorten the life-span of your restoration. If you clench or grind your teeth, your dentist may recommend wearing a night-time mouth guard to help protect your restorations while sleeping.

Benefits of Same Day Dentistry

With in-office CAD/CAM dentistry, multiple appointments for the same treatment are no longer necessary, which saves time. Instead, needed restorations are identified, created and cemented in the same day when appropriate.

Additionally, you may only need to receive local anesthetic once for any necessary tooth preparations, the effects of which can be minimized with an anesthetic reversal agent like OraVerse.

Because in-office CAD/CAM restorations usually are designed based on digital impressions obtained with optical scanning technology, traditional impression materials and trays are not used to duplicate tooth form and anatomy. As a result, there is no need for the traditional, distasteful materials previously used for impressions and therefore less likelihood of discomfort or gagging.

Same day CAD/CAM dentistry also eliminates the need for temporaries, since the permanent and clinically proven final restorations are placed in one visit. This reduces concerns about tooth sensitivities that could otherwise result when wearing temporary restorations, or about the temporaries falling out at inconvenient times.

Cost of CEREC or E4D Dentistry

All-ceramic restorations, including those fabricated using CAD/CAM technology, tend to be a more expensive restorative option. However, even though the materials for CAD/CAM restorations might cost more, the expense incurred by the dental laboratory and/or the dentist may not be passed onto the patient. Also, there is no additional fee or cost to have a restoration placed in one visit as opposed to two.

Therefore, costs for CEREC or E4D same day dentistry will depend on the normal and customary fees charged by dentists in your area, the extent of treatment required and your dental insurance. Insurance reimbursement for in-office, same day dentistry is similar to reimbursement for restorations created by a laboratory.

It should be noted that the initial very high cost of the equipment to the dentist may affect the cost of the restoration for the patient.