CEREC 25 concludes its celebration of CAD/CAM

The final day of CEREC 25 once again started with break out sessions allowing attendees to pick and choose from an impressive selection of speakers on topics ranging from techniques to optimize use of Sirona’s CAD/CAM technology, to growing a practice or lab around CEREC restorations to discussions of the materials and other aspects of practicing dentistry in a high tech environment.

James Glidewell spoke about the CEREC inLab system, while Dr. Paul Feurstein canvassed the present and future of digital impression systems. CLINICIANS REPORT CEO Dr. Paul Child discussed the technology powering the movement toward digital dentistry, while Dr. Paul Homoly followed up his keynote presentation from the previous afternoon with an extended session on tactics to reach patients and get them to accept case presentations.

Dr. Tiffany Lee covered the importance of involving a practice’s dental team in the CEREC workflow, while Dr. Rich Masek showed how CEREC can be used for more than just inlays, onlays and crowns. Materials selection, handling and properties were the topics of separate presentations from William Mrazek, CDT and Dr. Russell Giordano. Dr. Giordano showed the data from a wide range of studies showing that when handled properly and bonded into the mouth, milled restorations work as well or better when compared to pressed or layered ceramics.

“Nobody thought this would work, so they did lots of studies on it,” he joked when explaining why there is so much clinical data in support of CAD/CAM restorations.

Prof. Dr. Albert Mehl discusses the tooth library used to create CEREC's Biogeneric software.

The final afternoon session began with Professor Dr. Albert Mehl speaking about the development of Sirona’s Biogeneric software that is capable of automatically designing custom crowns based on the patient’s own anatomy. Dr. Mehl began by discussing the accuracy of CEREC’s digital impression technology and presented data showing the scans are now as accurate as a physical impression.

Dr. Mehl continued by detailing the creation of Biogeneric software from studies and digital scans of a large number of actual teeth. He said genetics determines each individual’s tooth morphologies, and the software uses an algorithm that creates a suggested crown based on a range of factors gleaned from the tooth library. As he described it, the library of scanned teeth was used to find the average tooth for each place in the mouth and then those averages are customized to each specific case.

“I’m guessing this might be the largest high quality tooth library in the world,” he said.

The weekend’s final clinical presentation came from Dr. David Roessler who discussed the importance of bonding and the fact that studies show proper bonding is the real key to success when placing ceramic restorations. The entertaining Australian clinician opened with a bit of his clinical history, detailing his progression from placing anterior amalgam crowns to using CEREC for highly esthetic work.

His main message was that resin cements make ceramic crowns stronger, and more space is needed for the cement than most people use when they create their crowns. The data he used to back up his points showed that a thicker layer of resin cement creates a strong bond, durable bond, and failed crowns usually don’t cause further damage to the tooth so they can be easily refabricated and replaced.

“If the cement’s a bit thicker you’ve got a win, and you’ve got a CEREC that can make space for that cement,” he said.

The final speaker of the weekend was CEREC software designer Ingo Zimmer who gave the crowd a detailed look at the innovations coming to the CEREC system, starting with a software update that went live today. Version 3.82 of the software can handle full arch scans by breaking the scanning process into quadrant scans that are digitally stitched together.

The next innovation Sirona is busy working on is a system for digital articulation. Zimmer did not offer a timetable for this development, but he did hand out 3D glasses so he could show off a 3D movie of what that system might look like on screen. The CEREC MC XL mill was next up for future enhancements. Zimmer said they are working with augmentations that will allow for the milling of both new temporary materials, as well as small, milled models.

The inLab version of the CEREC software will soon be able to design and mill implant abutments with support for the systems from many major implant companies. Zimmer said he expects the chairside version of CEREC will eventually be capable of not only milling those abutments, but also of milling surgical guides for the implant surgeries. The final enhancement Zimmer said was on the horizon was adjustments to the software’s design tools to allow for multiple restoration designs and tools to manually adjust the restoration design by nudging, pulling and pushing the proposal to the exact shape the clinician desires.

Things got improvisational to end the weekend with a customized performance from Second City. The sketch and improv specialists offered up dental and CAD/CAM themed sketches along with a number of non-dental scripted bits and spur of the moment improvisational games. The crowd left laughing, and full of the latest information about CAD/CAM dentistry and Sirona’s CEREC system.