Dentalcompare
Clinical Director
The Wall Street Journal recently published an interesting article about chairside CAD/CAM dentistry. Running under the headline “Are One-Day Crowns Worth the No Wait?” the article asks the question of whether or not crowns made on systems such as CEREC or E4D are quality restorations.
My take, is this article might just be the most poorly sourced bit of misinformation I have read in a long time. Here are some my thoughts on a couple of the more galling statements made in this article.
“There are esthetic limitations to the one-day crown.”
No matter how the porcelain is manipulated to become the shape of the tooth, it is crucial to pick the right shade. Further, it is important to match the level of translucency to mimic the enamel of surrounding teeth. This is true whether the crown is made in a lab or chairside in the office. One of the hardest restorations to match is the single tooth anterior crown. I have found that having the control over color, shade, and translucency allows me to better match the new crown or veneer to the surrounding teeth. This is much easier to accomplish when I have the natural teeth right there in front me rather than trying to write down all those details for a lab technician to interpret. The crown is ready to bond when it looks perfect, and there is no compromise on esthetics when a chairside CAD/CAM crown is done this way.
“More research is needed, particularly comparing lab-made crowns to those made in dentists offices, scientists say.”
First of all, who are these “scientists” drawing up these questions? Second, many labs are manufacturing crowns using the exact same materials and the exact same process. Third, if you want to compare the all-ceramic variety to a more traditional lab-made crown such as a PFM (porcelain fused to metal), there already is a ton of research on that exact subject. Take a look here for an example of the type of studies that have already asked and answered these questions.
As a dentist, I always like to see the profession highlighted in the media. The Frontline episode entitled “Dollars and Dentists” did an excellent job of highlighting the challenges associated with access to care and affordability of quality dentistry. I will admit there is a cringe factor, however, when a reputable publication such as the Wall Street Journal pushes out a dental article that is laced with inaccuracies.
Ultimately, these chairside CAD/CAM machines are just another way to manipulate porcelain into a prosthetic that can replace the both the form and function of a natural tooth. The artistry is in the hands of the dentist, and when those hands are trained in the proper skills they can make these crowns look as good as anything that comes back from the lab.