Cerec crown v standard dental crown

fisgon

Looking for a bit of advice for a decision I have to make. My dentist only offers Cerec crowns, but there are other dentists near me where I can get the more traditional dental crown.

Which is likely to last better? I have about a quarter of a molar missing on the upper jaw, second last tooth. I just had a white filling there which broke off after about 8 months, possibly taking more of the tooth with it. My dentist says the Cerec is better as it's a one day thing, and for a non-Cerec crown you have to take more of the tooth away to fit it, so further weakening the tooth.

I have no knowledge in this area, would appreciate some knowledgeable advice.

work

Dentists will have diffeent opinions but consider the following:
There are numerous crown types and they have various pros and cons. There is no one size fits all and a surgery offering you one type of crown only is either malinformed or making a business decision. However please note I do not know your clinical situation and a cerec restoration might be fine for you (the profession is quite divided on these and I am no fan). Quick almost never equals better.
I personally would advise against going to a clinic that offers only one type of restoration, so ask on this again and consider getting a second opinion locally.
Regards

Big_G

Here's where second opinions may be valuable. I love cerec. I think the confusion arises here in that your dentist is comparing an onlay with a crown. It's not like with like. An onlay is more conservative of tooth structure.


This idea of only offering one type of restoration being a business decision I would respectfully disagree with. Being familiar and having used and placed both, they each have their little quirks. I would say a well made lab made crown is the equivalent of a cerec or better. Cerec requires a certain style of tooth preparation and some not insignificant training and experience in order to get good results. I would stand a cerec crown up against a standard crown (PFM vs milled emax for the dentists watching this thread) when made by someone well trained and experienced who understands the limitations of the materials they are using and the design parameters.

Cerec is fairly versatile and can make standard full coverage crowns, onlays and intracoronal (completely or partially surrounded by tooth) restorations.

I would be quite happy to have a cerec in my mouth. The current iteration of the machine (4.0) is an amazing piece of technology no doubt. It is a tool however, to be wielded by a well trained craftsman (woman).

Previous criticisms of poor marginal fit and milling accuracy levelled at cerec are out of date and pertain to cerec 1.0, 2.0 and to a certain degree 3.0. With the advent of cerec 3d you could theoretically design a restoration with perfect (0 micron) fit. Conventional casting techniques can't really approach this. Practically you can achieve a 20 micron fit which is equivalent to really really good casting but this is where the experience of the clinician comes into play.

Short answer I think is that you may pay extra for Cerec for the convenience of a single visit. I think some dentist would charge similar for an all ceramic lab made crown. I think it is disingenuous to suggest cerec is inferior. I don't think it is. But the jury in the dental world seemingly is still out.

I hope I don't sound like a sales pitch for cerec. I do like it a lot. But then I'm a bit of a tech geek anyway.

btkm8unsl0w5r4

It's anoint what you do it's the way that you do it...

Ceres is a good technology it depends on whether you want ceramic on your back teeth, an inlay is a sort of fancy filling a crown is for really badly damaged teeth and a different type of restoration. It depends on what best for your tooth really which your dentist can advise.

Big g a lot out there placing Ceres and not glazing them only polishing, the micro cracks from milling would alarm me. If my own tooth needed a filling I would rather a inlay but if it needed a crown I would rather a layered crown as the aesthetics are superior or a pfm on a back tooth for strength.

hg03 eyu

From a dentist's point of view is it true that cerec requires more chairside time than traditional two visit lab based preps and fit?

Big_G

Off topic but initially yes, as time goes by and you get more practice the chair side time decreases. And if you stop yourself from fiddling too much in the design phase.

I had a long post about my likes and dislikes of the system but I think it's better suited to the lounge. I always subscribe to the idea that you must know and understand any system before you can get the best out of it. There are valid criticisms of the cerec system but similarly there are valid criticisms of the traditional methods.

After a year of not using it I realise how much I miss it. For the prosthos in the room with the new omnicam full colour powderless streaming images, full arch articulated (MIP only, no excursions) impressions and apparently occlusal analysis (obviously not as good as a t-scan but it's only a matter of time).

I should probably start a thread in the lounge now...sigh.

uck51js9zml2yt

My wife got a cerec crown done recently on a pre molar by a dentist who only does cerec.
the prep time was about 3 hours. she got her crown fitted on the 2nd visit which took a few more hours.
He has the machine in his clinic.

Shes happy with the work and it fits well.

btkm8unsl0w5r4

When it can mill PFM I will buy one.....:) Any dentist that only does cerec need their head examined...a lot of patients grind and ceramic doesn't like that at the back of the mouth espically.

georgieporgy

Cody Raspy Ketchup wrote: »

My wife got a cerec crown done recently on a pre molar by a dentist who only does cerec.
the prep time was about 3 hours. she got her crown fitted on the 2nd visit which took a few more hours.
He has the machine in his clinic.

Shes happy with the work and it fits well.

didn't the dentist first suggest a gold crown for her? Or was that a different dentist? ( or different wife ?? )

Seriously though, 5 hours for a cerec crown or any type of crown, is rather a long time.

helimachoptor

Gold Cerec georgieporgy

btkm8unsl0w5r4

georgieporgy wrote: »

didn't the dentist first suggest a gold crown for her? Or was that a different dentist? ( or different wife ?? )

Seriously though, 5 hours for a cerec crown or any type of crown, is rather a long time.

Georgie...dont be silly, that includes a single visit root canal, then waiting 3 hours to ensure it was successful before sealing permanently it with a bonded all ceramic crown....that best practice didnt you know.

uck51js9zml2yt

If I or anyone else made comments like mods have made on this thread about me, we would be accused of derailing the thread and making unhelpful comments which would result in warnings and ban.

Fity..if you bothered to read my post, you would have seen it was all over 2 visits..but it looks like your more interested in scoring points.

btkm8unsl0w5r4

Cody Raspy Ketchup wrote: »

If I or anyone else made comments like mods have made on this thread about me, we would be accused of derailing the thread and making unhelpful comments which would result in warnings and ban.

Fity..if you bothered to read my post, you would have seen it was all over 2 visits..but it looks like your more interested in scoring points.

Yeah but the second was to fit the crown, best practice is 2 visit endo, wait for healing (3-4 weeks minimum), then prep for post and fit, then impression for crown and then fit crown. 5 visits. Not a single visit endo, prep etc then fit the next day...thats asking for trouble.

Tatranska I know more about this than you, as for scoring points...I am glad you think that making reccomendations to people who know little on this subject is a game, there are right and wrong answers not opinions.

Oral Surgeon

Mikaela Narrow Freight wrote: »

Yeah but the second was to fit the crown, best practice is 2 visit endo, wait for healing (3-4 weeks minimum), then prep for post and fit, then impression for crown and then fit crown. 5 visits. Not a single visit endo, prep etc then fit the next day...thats asking for trouble.

Tatranska I know more about this than you, as for scoring points...I am glad you think that making reccomendations to people who know little on this subject is a game, there are right and wrong answers not opinions.