1.cerec 3 d1/ dental courses

AN OVERVIEW OF THE CEREC
3D CAD/CAM SYSTEM
www.indiandentalacademy.comwww.indiandentalacademy.com
INDIAN DENTAL ACADEMY
Leader in Continuing Dental Education

INTRODUCTION
TECHNIQUE
FEATURES
EDITING
SUMMARY

THE INTRODUCTION OF COMPUTER-AIDED DESIGN /
COMPUTER-AIDED MANUFACTURE (CAD/CAM)
TECHNOLOGY HAS MADE STEADY INROADS INTO THE
PRACTICE OF DENTISTRY AND REPRESENTS A MAJOR
TECHNOLOGICAL BREAKTHROUGH.
INTRODUCTION TO CEREC CAD/CAM SYSTEM

HISTORY
 1971: INTRODUCTION OF CAD/CAM TO THE DENTALPROFESSION
 1979: HEITLINGER AND RODDER MILLED THE EQUIVALENT
OF STONE MODEL USED BY A DENTAL TECHNICIAN TO
THE CROWN
 1980: MOREMANN AND BRANDESTINI TOOK A SINGLE PICTURE
AND MILLED ONLY THE INTERNAL SURFACE OF THE INLAY
 1985: MOREMANN AND BRANDESTINI INVENTED THE
CEREC SYSTEM WHICH WAS LATER DEVELOPED
AND INTRODUCEDTO THE DENTAL PROFESSION
 1985: INTRODUCTION OF CEREC-1 SYSTEM

Over the last 23 years, the CEREC system has evolved
into a predictable method for restoring diseased or
malformed teeth using computer-aided design/computer
aided manufacture (CAD/CAM) technology.
The initial investigators were working on a method
called CERamic REConstruction, hence the name
CEREC.
Studies have demonstrated the accuracy and fit of the
original CEREC restorations and rated them comparable
to laboratory-fabricated restorations in terms of both fit
and esthetics.

SWITZERLANDwww.indiandentalacademy.comwww.indiandentalacademy.com

THE CEREC SYSTEM, DEVELOPED IN ZURICH, SWITZERLAND, IS
ONE THAT IS COMMERCIALLY AVAILABLE AND PRACTICAL FOR
THE DENTAL OFFICE AT THIS TIME.
THIS CAD/CAM UNIT, WHICH WILL FABRICATE INLAYS, ONLAYS,
¾ CROWNS, 7/8 CROWNS AND VENEERS, WILL ALLOW THE
CLINICIAN TO RESTORE THE TOOTH WITH AN INDIRECT,
PERMANENT RESTORATION IN ONE APPOINTMENT, WITHOUT THE
USE OF AN IMPRESSION OR THE ASSISTANCE OF A LABORATORY
TECHNICIAN.

THE COMPACT, MOBILE UNIT CONSISTS OF THREE COMPONENTS:
A SMALL CAMERA, A COMPUTER SCREEN AND A THREE – AXIS –
OF – ROTATION MILLING MACHINE.

A FLOW DIAGRAM OF THE PROCESS OF MANUFACTURING A
RESTORATION USING THE CEREC SYSTEM

THE CAD/CAM CEREC SYSTEM HAS EVOLVED FROM THE:
CEREC-1,WHICH FABRICATED ONLY MARGINALLY FITTING
SINGLE AND DUAL SURFACE CERAMIC INLAYS.
CEREC-2,WHICH SHOWED ADVANCES IN
COMPUTING,UPGRADED SOFTWARE AND EXPANDED FORM
OF GRINDING TECHNIQUE.

CEREC-3 THAT CAN DESIGN WELL-FITTING INLAYS, ONLAYS,
CROWNS, VENEERS ETC., IN A SINGLE VISIT.

THE CEREC-3 TECHNIQUE
MOUTH PREPARATION
POWDERING
SCANNING

ADVANTAGES OF THE CEREC SYSTEM
SINGLE APPOINTMENT
NO IMPRESSION
REDUCED MARGINAL GAP
EXCELLENT POLISHING CHARACTERISTICS
IMPROVED ESTHETICS
LESS REDUCTION OF TOOTH STRUCTURE
- BETTER PERIODONTAL HEALTH
BONDED RESTORATIONS ENHANCE TOOTH STRENGTH
PREPARATION, FABRICATION, CEMENTATION AND
POLISHING NORMALLY ACCOMPLISHED IN 1 TO 1 ½ HOURS

The latest system, CEREC 3D (Sirona, Charlotte, NC), has
expanded on the concepts of computer imaging by
utilizing three-dimensional viewing capabilities.
This article provides an overview of the new system and
outlines the steps required for fabricating a restoration
using CEREC 3D.
THE LATEST INCARNATION OF THE CEREC SYSTEM IS THE CEREC
3D, WHICH PROVIDES A VERSATILE, RELATIVELY SIMPLE, USER-
FRIENDLY METHOD FOR FABRICATING ESTHETIC RESTORATIONS
CHAIRSIDE WITHOUT INVOLVING A DENTAL LABORATORY.

TECHNIQUE
Fabrication using an optical impression.
This impression can be accomplished in a single visit,
eliminating the need for an elastomeric impression, an
interim restoration, and payment of a laboratory fee.
.

The restoration is designed and carved form a solid block of
porcelain or composite. These blocks are available in an
assortment of shades that can be custom-stained and glazed.

After the optical impression is made, restorations are
designed on the computer using one of two modes,
Correlation of Dental Database. Correlation utilizes a
preoperative optical impression of a Wax-up of the
unprepared tooth, while Dental Database utilizes the
software’s virtual library of tooth morphology to create
the anatomy and contours of the restoration.

The prepared tooth is captured in a single optical
impression, along with as many of the adjacent teeth as
possible. Multiple optical impressions are possible for
quadrant dentistry. From this impression, a “Virtual
model” is created on the screen.
To create proper occlusion more accurately, both modes
can utilize an additional optical impression of a bite
registration and create an antagonist tooth model

Features :
The 3D feature of the software allows the model to
rotate 360 degrees in every plane.
Creation of virtual die
An alignment tool is visible on the screen to help reorient
the image after rotation.
The software also displays a view window on the screen
that makes arrow icons available and allows the operator
to view the preparation and subsequent restoration from
six predefined views: occlusal, cervical, mesial, distal,
buccal, and lingual.

After creating a virtual die, the next step is to outline the
margin line on the die.
In CEREC 3D, the margins are created automatically by
the software, reducing the chance of operator error.
The software makes this a user-friendly process
through an automatic margin finder.
.

The ability to view the die from any angle allows the
dentist to correct the outline more accurately.
Once the dentist is satisfied with the margin line, the
software will design the restoration and place it on the
die for viewing.
The contact tightness should be
evaluated and adjusted by clicking
on the contact button, which also is
displayed in the window. The
purple line represents the height of
contour, while the red, yellow,
green, and blue areas all identify
different degree of contact
tightness.

Editing :
The restoration now can be modified in a variety
of ways. Below the design window is an edit window,
which offers the dentist six different tools: Edit, drop,
Scale, Shape, Position, and Rotate.
Clicking the edit button gives users the ability to
modify the edit lines.
Clicking the Drop button opens a new wax-up
tool, allowing the user to add “drops of wax” to any
area of the restoration and giving dentists the ability to
alter a small area of the restoration by increasing the
tooth’s contour in increments of 50 µn.

Broad areas of restoration can be modified using the
Scale tool; this feature allows dentists to add to the
contact area in increments of 25 µm, making it possible to
adjust contact tightness at the design stage, rather than
having to overbuild and subsequently reduce the contact.
The shape tool allows the operator to add or subtract
material from any outlined area or any line drawn.
The Rotate tool allows the operator to rotate the
restoration on the preparation in an occlusal, cervical,
mesial, distal, buccal, or lingual direction.
The position tool can shift the restoration in any of the six
directions. When either the Rotate or Position tools are
used, the software compensates automatically so that no
open margins are created.www.indiandentalacademy.comwww.indiandentalacademy.com

SUMMARY
There are distinct advantages to using the CEREC
3D as compared with its predecessors (CEREC 1,
CEREC 2, and CEREC 3). These advantages have
decreased the learning curve that normally which are
involved with an individual’s adaptation to new
technology. The primary difference is the software,
which requires far fewer steps than the CEREC 3 and
makes it easier for the dentist to proceed.
While time and research are necessary to
demonstrate whether the CEREC 3D will provide
restorations with better marginal adaptation than its
predecessors, it is likely that more and more dentists will
be attracted to the technology. There is no question that
the software now is much more user-friendly and will
decrease the learning curve dramatically.www.indiandentalacademy.comwww.indiandentalacademy.com

REFERENCES
1. FRANCOIS DIAME REKOW: CAD/CAM IN DENTISTRY. A
REVIEW OF THE STATE OF THE ART. JPD, 1987; 58: 512-
516 ESTAFAN et. Al.,:.
2. DURET et. Al: CAD/CAM IN DENTISTRY. JADA, 1988; 117: 715-
721.
3. A NEW APPROACH TO RESTORATIVE DENTISTRY.
FABRICATING CERAMIC RESTORATIONS USING CEREC
CAD/CAM. CCED, 1999; 20: 555-560.
4. MORMANN WH, BINDL A. : THE CEREC 3-A QUANTUM LEAP
FOR COMPUTER-AIDED RESTORATIONS INITIAL CLINICAL
RESULTS. QUINTESSENCE INT., 2000; 31: 699-712
5. FRANKLIN GRACIA – GODOY: ALL CERAMIC CHAIRSIDE
COMPUTER AIDED DESIGN. DCNA, APRIL 2002; 46:405-
426.

THANK YOU……www.indiandentalacademy.comwww.indiandentalacademy.com

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