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Dentistry Ohio

'Living' Article April 2011

Landen Living

April 2011


I’m having such fun with continued discoveries and new modes of treatment related to our CEREC restorative system.  I’ve written in past months about this remarkable computer driven equipment that allows for same day design and milling of ceramic crowns and onlays within our office.  Our patients love that they are not dealing with impressions and temporary crowns.  I love that we are able to design restorations with margins, contours, and shades exactly how we want them.

Donna, my Expanded Functions dental assistant and I recently returned from additional CEREC training at the Scottsdale Center for Dentistry.  Until now we had thought of our CEREC system as something helpful only for individuals who had teeth compromised to the extent that they needed crown or onlay coverage for proper protection of remaining tooth structure.  But we have arrived home armed with a CEREC driven treatment option that will benefit our patients who have lesser quantities of tooth decay! 

Years ago I made the decision to stop utilizing silver amalgam filling materials within my office.  It was obvious that concerns regarding potential mercury toxicity and the poor esthetic qualities associated with these materials were not going to go away.  The amalgam filling materials were replaced by composite resin filling materials, a tooth-colored blend of glass-like filler particles held together within a resinous goo.  But the composite resin materials were not without their own new set of limitations.  Successful placement procedures are highly dependent on isolation from saliva and blood and the materials are also haunted by shrinkage!  The materials arrive from the manufacturer in either a flowable or putty-like consistency that allows for adaptation to the anatomy of any given cavity preparation.  Once placed an intense blue light stimulates a chemical polymerization reaction within the materials to create the hardness necessary for survival in the mouth.  The problem is that during that phase change from ‘putty’ to ‘hard’ a shrinkage occurs within the material.  Without careful and intentional awareness of that shrinkage we run the risk of leaky margins or residual stress within the filled tooth.    In addition it can be difficult with composite resin filling materials to establish a firm contact with adjacent teeth.  Weak contact between teeth usually results in food trapping. 

So now, like Lassie or the Lone-Ranger, our CEREC technology has arrived on the scene to save the day!  Once we have shaped the tooth and removed any decay we can image the tooth with our 3-D CEREC camera and design a filling with appropriate shape and contours to ensure proper contact with the neighboring tooth, proper seal of the margin at the gumline, and proper anatomy at the biting surface.  The 3M Company now offers Paradigm MZ-100, a solid composite resin block made for our CEREC milling machines.  We are able to mill an inlay/filling from a solid material no longer challenged by the shrinkage associated with previous phase-change composite resins.  Better designs, better margins, solid contacts, no shrinkage!  It just doesn’t get any better than that.  OK, call me a ‘tooth nerd’ if you want to.  This stuff is exciting! 

Tagged In: Matchbox Toys, Amalgam, Anthropology, Antibiotic Premedication, Artificial Joints Dental Care

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Dr. Davis is especially good with kids. And his staff? Helpful, compassionate, and caring. They take care of business for you. Thumbs up. 10 on a scale of 5.

-Steve K.
Mason, OH