Sameer Puri D.D.S. One of the best feature of the CEREC is the ability to make the clinician more efficient. If you think about the typical dental patient, they don’t want to be in our office. In fact they will do anything to stay away from the dentist. With that in mind, you have to look at everything that you do in your practice with the goal of patient comfort and convenience in mind.
Think root canal- how many patients want to come to your office to have a root canal done? Take it one step further and ask how many if given the choice would rather spread that procedure out over multiple visits instead of a few visits as possible? This is where CEREC shines. The patient below came to the office with a chief complaint of pain. Radiographic examination showed apical pathology on the premolar requiring endodontic therapy.
Now everyone has their favorite endo technique but there is no doubt that the only way to proceed after the endo is to make sure all cusps are covered. The literature is very clear on this fact- posterior teeth need full cuspal coverage in an effort to survive long term.
For the patient below, we gave anesthesia and prepared the tooth for the crown first. If there is adequate tooth structure to do so, my recommendation is to prep the crown first, take your images and design and send the restoration off to the milling unit.
While the restoration is milling, proceed with the endo. Think about the time savings.
It's a more efficient use of your time to do the endo while the restoration is being milled.
It's easier to find the canals while the tooth is prepped for a full coverage crown. In the example below, you notice that I while I prepped for full cuspal coverage, I managed to save a significant amount of tooth structure axially but not preparing the tooth there.
In this particular case, no build up needed, no post needed- just lots of enamel saved to help with the retention and resistance of the case. While the restoration mills, finish the endo.
Granted we can’t do this in every case. There may not be enough tooth structure to prepare first- we may have to finish the endo and do the build up prior to image and design. There may be active infection that needs to be resolved before finishing the endo. But I would argue that more often than not, clinicians have the ability to finish the endo while the crown is milling which saves time for the clinician and the practice.
Try this technique and watch your production and efficiency soar.
