Wellness
dentistry
crowns
on-site by Julie Estlick
Like most of us, Randy Briggs needs an occasional filling despite taking good care of his teeth. Dental work doesn’t scare him, but the announcement that he needed a crown would send shivers up his spine. That is, until he discovered the wonders of the CEREC 3D procedure at Johnston & Johnston Family Dentistry.
Briggs, who has two old-fashioned crowns (dental restorations that fully cup over the tooth above the gum line), jumped at the chance to see how the latest technology works when Dr. Ron Johnston found another tooth requiring attention last summer. Chairside Economical Restoration of Esthetic Ceramics (CEREC) is a system used to create a crown on-site at the dentist’s office in one visit, eliminating the need for a temporary crown and a follow-up appointment. Here’s how it works: Johnston uses a small infra-red scanner to take digital pictures of the tooth before and after the decay and any old fillings are removed. The pictures are then converted into a 3-dimensional model on the computer screen. He uses software to design the restoration - a crown or filling that “restores” the function of a decaying tooth – in just a few minutes and with the click of a mouse sends the data to a separate milling machine. A white ceramic block that matches the shade of your tooth is placed in the milling machine and in 10-20 minutes the crown is ready to go. Johnston makes sure the restoration has the proper fit and bite inside the mouth, then polishes it up and bonds it into place on the tooth. “The big advantage to me is that I can get a
Gina Horgen consults with Ron Johnston, DDS of Johnston & Johnston about the benefits of a new Cerec crown.
crown in one visit – that’s the beauty of it,” Briggs says. “One shot to plug up the tooth, repair it and you’re done. The whole thing took about an hour. In the past, I’ve had to take time off work on two different days – that’s significant.” The CEREC system, which utilizes Computer Aided Design/Computer Aided Manufacture (CAD/CAM), has been on the market since the mid-1980s, but advances in software and milling materials that make the restorations look natural and bond better have won over many skeptics. Currently, about 4 percent of all dentists in the country use CEREC and most agree it is the wave of the future. “When a tooth breaks we can get the patient fixed up so they don’t have to wait 2-3 weeks with a temporary and they can get on with their lives,” says Johnston, who co-owns the practice with his wife, Dr. Samantha Johnston. “The key is people don’t like to come to the dentist, so if they only have to come once it’s much better. It really does work!” Right now it takes the Johnstons on average 90 minutes to put on a crown, but software advances are simplifying the design process and making it faster so the patient spends less time in the office. Just last month the couple attended a
software update training in Scottsdale, AZ. Since Johnston & Johnston Dentistry installed the CEREC 3D system 16 months ago, people have driven four hours just to get a crown put on in a single visit and referrals keep rolling in. Samantha’s mother and father have both done it and several people have returned for additional restorations. “Everyone that gets a crown with this procedure at our office has been 100 percent pleased,” Samantha says. Traditionally, if you needed a crown your dentist would make an impression of your tooth and send it to a lab to design the crown. In the meantime, a temporary crown would be put on the tooth until your next visit when it would be chinked away and replaced with the permanent crown. Aside from the fun of multiple mouthnumbing injections, more of the tooth structure is often removed when using a temporary, Samantha notes. “Personally, I think this procedure is much less traumatic for our patients’ teeth because the tooth is prepared and the crown is bonded in one visit,” Samantha says. “This eliminates the need for a temporary crown, which can leak, come off prematurely and cause sensitivity.” Both dentists noticed that patients have less Continued on page 112
90