500th CEREC lands in Australia

Sirona's CEREC chairside CAD/CAM system reached a new milestone recently with the 500th unit sold in the Australian and New Zealand market. Dr Mark Casiglia, principal of Apple Dental in Sydney's Lane Cove, is the proud owner of unit 500 and couldn't be happier.

"I've been using CEREC for a few months now and I'm continually surprised about the versatility of this remarkable system," Dr Casiglia said. "For years, I'd written off this technology as second rate based on outdated information and what I'd seen in the mouths of patients that had come into my practice.

"The catalyst for the purchase was a discussion I was having at a Prime Practice workshop when the subject came up. Two prosthodontists were there and they were raving about it - talking about how the fit came down to microns – and I thought that that's not what I'd seen in patient's mouths to date. CEREC to me meant poor fit, big open margins and dubious aesthetics.

"Given the volume of work I do, CEREC would definitely be a good fit for my practice if it really had come so far so I then started to do some more research and the technology had indeed progressed significantly. I then called Sirona and they brought a unit into my practice on a Saturday morning. We designed and milled a crown on the spot and I was so impressed with the fit that I signed up for it on the spot."

Dr Casiglia said that in practice, the new CEREC AC outperforms all of his expectations and so far, he is yet to find any limitations in what it can produce.

"I use CEREC everywhere in the mouth. When I bought it, I was conscious I may not be able to use it everywhere but that hasn't been the case. I mainly use CEREC for cases involving one, two or three units and anything larger goes to the lab.

"I run my practice in a very business-like manner and have calculated that if I have 4 or more restorations, like anterior crowns and veneers, it is more economical to send those cases to the lab. Fiscally, three restorations is about even when you consider clinical time, materials cost and amortisation of the equipment lease versus the lab fee.

"Also, before I went down the path of buying CEREC, I needed to satisfy in my own mind that a CEREC was not a compromise for my patients; I didn't want to be constantly thinking that the lab could have done a better job.

"My original opinion about the aesthetics of CERECs had been based on units I'd seen done by others a long time ago and I must admit that even though those early restorations were 'aesthetically challenged', they were still sound. The results from the CEREC 3D and the latest CEREC AC are leaps and bounds ahead. Using the stain and glaze technique makes the CEREC restoration lab quality.

"There are of course many other advantages of using CEREC - no temporaries, no second visit, no shade problems, better margins, the patient only gets numb once – but one of the more intangible benefits is the way patients think about you when they see you designing and milling their restoration right in front of them.

"I've also never had better margins and gums around crowns and inlays with CEREC. I wouldn't say that if it wasn't true."

Apart from crowns, inlays, onlays and veneers, Dr Casiglia has recently started milling implant crowns with CEREC and is continually finding new applications for the technology.

"Buying CEREC is the one clinical dentistry 'thing' I've done that's made the most impact on my day-to-day life. CEREC is more like a hobby than work. If I see CERECs on my schedule for the day, I'm excited. It's like a big toy. Patients can tell I'm enjoying myself and they feel good about it and I think I'm getting more referrals because of it. I've completed $600,000 worth of restorations with it so far, so it's also a toy that pays for itself.

"There is a learning curve with CEREC however and you either want to get into it or you don't. There is a lot of very clever automation built in that has evolved over the five generations of the system that make it very easy to use, but clinically, you have to make some changes to the way you work. The prep designs are different for example and you have to be prepared to learn and change some of your techniques to get the most from CEREC. My lab is also much happier with the new way I prep so it's not just a different way, it's a better way.

"Sirona provide excellent training and support locally and I also did online training with CEREC Made Easy who are based in Canada. That was excellent and well worth the time and money. A clear advantage of CEREC is that there is so much training and educational material out there. That's one of the reasons I chose CEREC and the other was that you only need to take a single image to capture the tooth. It's very easy to use and very well supported with third party advice on the internet as well as the local Sirona offices.

"Another thing that sold me on it was that Dr David Roessler was the clinical trainer on the second phase of my training program. He's a very well respected prosthodontist who bases all his work on sound research and proven clinical results. If he uses CEREC, it speaks volumes. I have also read a lot of the studies and computer-milled porcelain is shown to even outlast gold. So there are lots of reasons to choose CEREC and I'm so glad I did."