What's CEREC? | CEREC Cases | CEREC Zirconia Bridges | CEREC History | CEREC on TV!

'CEREC®' stands for Chairside Economical Restoration of Esthetic Ceramics. This incredible technology has been evolving since its birth in 1985. There have been over 10 million restorations placed using this technique worldwide since that time.

CEREC® allows the doctor the ability to place advanced ceramic restorations in just one visit. This cannot be confused with other 'direct' restorations placed by dentist (such as tooth colored composites, or so called ceromers). Typically, a ceramic restoration requires at least two patient visits. The easiest way to describe the CEREC® technique is to compare its approach to the traditional techniques used to provide ceramic restorations.

Traditionally, to fabricate a ceramic restoration an impression is taken on the first visit which requires a bulk of impression material, placed in a cumbersome tray, that requires a 'few minutes'to set being placed inside your mouth.

In contrast, the CEREC® technique uses a tiny infrared camera that takes an 'optical impression' in less than a second.

Next, traditionally, a dentist must place a temporary restoration to preserve the space and fill the preparation until the final restoration is returned from the lab (usually 2-3 business weeks). If you've ever had one, you don't need to be reminded about the inconvienence of temporaries that all too often don't fit well, cause sensitivity, and fall off prematurely.

In contrast, there are no temporaries with the CEREC® technique (remember the restoration is made chairside!) Certainly, many dentists make superb temporaries, but I'll let you be the judge on this one.

As stated previously, you traditionally wait 2-3 business weeks for the final restoration to be tried in and hopefully finalized. There are many steps (and potential areas of error) in the final fabrication of the traditional ceramic restoration. Someone at the lab of manufacture has to pour up the impression (whose journey can vary from the cargo hold of a transcontinental flight at 35,000 ft... to the trunk of a car to a local laboratory) to fabricate a working 'die'. This die is trimmed (hopefully under magnification, and highly variable from lab to lab) to create the'master' from which the restoration is made. Next, the fabrication begins where a technician, or group of technicians (whose skill and credentials also vary from lab to lab) make the ceramic restoration by either stacking layer upon layer of ceramic material in a special oven, or 'pressing' ceramics into yet another die made from the impression. The accuracy is a function of the least accurate step and an independent research facility recently found the discrepancy to average between 50-100 microns clinically. To be sure, this greatly simplifies the process in which traditional ceramic restorations are made. However, this fact alone further emphasizes the significance of the potential errors inherent with the many 'steps' associated with traditional ceramics manufacture.

In contrast, the magnified CEREC® optical impression is used to design and manufacture the ceramic restoration immediately after it is captured chairside. The resolution of the optical cameras 'impression' is 25 microns! It takes only 5-15 minutes to make the restoration depending on the size and complexity. The restorations color is matched directly chairside, and the materials used are only approved for usage after a unique, and vigorous selection and approval process by the founders of CEREC® technology. They are superior to their 'laboratory cousins' in physical properties and they are manufactured the under strict control of the factory environment eliminating the wide variances that logically exist from one lab to the next.

Ironically, I received an advertisement from a dental laboratory recently which touted their recent aquisition of a CEREC® machine to deliver these restorations to dentists! They were promoting the advantages as 'accuracy of fit', and 'superior materials' (4 micron ceramic particle size as opposed to 25 micron which is commonplace). I find it an amazing vindication of the system when a laboratory sees the advantage of this system (even though they will still fabricate the restoration from the traditional impression!). These patients will still require a temporary, and the other concerns mentioned above. The true advantage to a patient is receiving this technology in one visit. Again, you be the judge!

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Since 1991 Dr. Becker has delivered many thousands of CEREC® restorations. Below are a few of the representative cases that we perform on a regular basis. CEREC® technology allows us to deliver the most advanced cosmetic dentistry available today...in only one visit!

The above case shows an endodontically treated tooth (root canal) on the left side. The tooth was treated with CEREC® in just one sitting. Total procedure time was 90 minutes from beginning to completion. No anesthesia was required for this particular result.

The above case shows a typical silver amalgam on the left side. The tooth was treated with CEREC® in one sitting. The total procedure time was sixty minutes from beginning to completion including anesthesia time. Note the margins of the silver filling and the inability to 'seal' the tooth. Note the 'gap free' CEREC® restoration on the right.

The above case demonstrates the remarkable transformation possible when CEREC® ceramics are utilized in full mouth reconstructions. Even though a significant amount of time goes into the preparation of these cases, including diagnostic wax-ups, esthetic profiling, and necessary consultations, the actual case was prepared and delivered in just 2 days! These cases could be delivered in one day, but note the incisal layering which required in-house ceramic firing. The lower teeth are scheduled for treatment also to complete the esthetic transformation.

Dr. Becker has pioneered and developed a unique technique for fabricating multiple unit zirconia bridges with CEREC®. His technique utilizes the extremely accurate milling of the CEREC® machine to interlock extremely strong zirconia blocks into a conventional bridge framework. The blocks used in this technique have proven to be the strongest variant of zirconia available (which is the strongest ceramic variant). Unfortunately, they are limited in size. With this technique the size limitation is overcome while 'carrying' the strength of the block across the connector (contact area). There are many exciting advances in this area of prosthetics and the future of zirconia bridges seems to be an area of great interest for dentistry.

This technique allows anyone with a CEREC® machine the capability of delivering the most advanced metal free all ceramic bridge available today!

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Click on the image holding the mouse down 'rotate' the image 360 degrees to view it from ALL perspectives! ENJOY!

The above bridge replaces an existing 3 unit porcelain fused to metal bridge. The patient already has a replacement 3 unit zirconia interlocked bridge on the upper right. He was so happy with the esthetics and results, he updated this bridge with an interlocked framework bridge as well.

These systems allow for a high degree of esthetic control in the final product. It does require more active involvement of the dentist in 'creating the result', but the rewards far outweigh the additional effort! Dr. Becker is currently teaching this version of interlocked zirconia framework bridge to dentists throughout the world. He is very pleased to be instrumental in helping as many dentists as possible achieve the above results in their practices!

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CEREC® made its debut in 1985. The brainchild of Dr. Werner Mormann and Dr. Martin Brandestini. They envisioned the combination of CAD/CIM technologies available and dentistry to create the first CEREC® machine. The first machine dubbed the 'hydro' unit used pressurized water to drive the single diamond disc. Simple inlays, onlays, and veneers were possible with this machine.

The CEREC® 1 ('E' Drive) model appeared around 1990 and with the advent of the electric motor, precision, speed, and effectiveness were markedly improved. Inlays, onlays, and veneers were still the principle restorations of this machine. Dr. Becker was one of the first CEREC® users in this area having purchased a CEREC®1 ('E' Drive) in 1991. Shortly thereafter the ACD (Academy of Computerized Dentistry) was formed. Dr. Becker was present in Zurich for the beginning of this organization and is a charter member.

The CEREC® 2 arrived around 1994 in the United States and with the advent and improvement of the 'crown' software over the next few years, an all ceramic crown performed in one visit became a reality. The CEREC® 2 machine has a diamond bur in addition to the diamond disc found on the CEREC® 1 machine. The additional bur and improved processor/software combination greatly enhanced the technologies capabilities. Inlays, onlays, veneers, and now crowns are possible with this machine. Dr. Becker acquired a CEREC® 2 in 1999.

The CEREC® 3 arrived in 2000. The software, hardware, and milling unit underwent major renovations. The speed and precision in which the dentist is capable of delivering inlays, onlays, crowns, and limited bridgework makes the CEREC®3 an extremely effective tool. Dr. Becker acquired one of the first CEREC® 3 machines in North America.

Dr. Becker has placed well over 10,000 CEREC® restorations since 1991.

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Dr. Becker has been featured on 3 separate occasions on news segments relating to CEREC® technology, usage of computers in dentistry, and advanced cosmetic care. This particular segment discussed computers and CEREC® technology. Please click on the forward arrow to play the movie.

Depending on your connection speed this file will take anywhere from a few seconds-up to a few minutes to download (3.4Mb). It is the entire 5 minute news segment in streaming video format!! (it won't take up any permanent room on your hard drive). It's best to allow it time to completely download before viewing-it's worth the wait!.

The segment was viewed by millions of viewers and provides a very concise and worthwhile look at CAD/CIM (CEREC®) technology as well as computers in dentistry. Please note Quicktime® is necessary to use streaming video technology. If you don't have it already click the above link it's free, its the ISO standard, and covers a multitude of different multimedia content making it a very 'worthwhile' download to have. PLEASE NOTE: Prior to playing the video below you will want to stop the streaming audio. Using the 'controller' located below the navigation oval to the left 'click' on the 'pause button' to pause the audio. You can resume playing after the video by clicking in the same controller.-ENJOY!!

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