You can put me in the category of never seeing a really well done CAD/CAM restoration. I've had patients come in showing what was done in one day by the guy right behind me who used to teach CAD/CAM for Patterson. He screwed them up so bad that the teeth had to be extracted.
Another one came in a few weeks ago with a crown that I had done 30 some years ago that came off and another office told her there was decay and needed a new crown. No decay, re-cemented. While cementing back on the crown I noticed some porcelain blob bridges with wide open margins and thin cut. I told her that they didn't look strong enough or contoured the way we would like dentistry to be done. She came back the next week joking that the broken bridge was my fault because I mentioned it. She wanted me to "fix" it. I referred back to the treating dentist who redid it the same. We'll be replacing both in the future.
I've only seen good ones in pictures.
Another one came in a few weeks ago with a crown that I had done 30 some years ago that came off and another office told her there was decay and needed a new crown. No decay, re-cemented. While cementing back on the crown I noticed some porcelain blob bridges with wide open margins and thin cut. I told her that they didn't look strong enough or contoured the way we would like dentistry to be done. She came back the next week joking that the broken bridge was my fault because I mentioned it. She wanted me to "fix" it. I referred back to the treating dentist who redid it the same. We'll be replacing both in the future.
I've only seen good ones in pictures.
------- Ash ------------------------------------ Ashley Goodman, DDS 8736 Lake Murray Blvd.#108 San Diego, Ca 92119 Phone: 619-697-6677 Fax: 619-697-6632 Email: agoodman@agoodmandds.com Web: www.agoodmandds.com ------------------------------------On 7/3/2013 9:44 AM, Dr. Ray Voller wrote:
Just saw a new patient who had 8 CADCAM designed upper anterior crowns and veneers. He was referred to me by my periodontist because he fractured off one of them. (#7)--
I will say this.
I have not yet seen a nice CADCAM designed restoration. Either it is non very esthetic or I see them to replace them because of fracture. I know that some of you on here have success with these, but I'm sorry. I just don't see any ever that are nice or aren't a problem functionally. Anatomy, always poopy, as one dentist said 'They look like wads of snot!'
This patient this morning told me almost everyone he's had, has failed at least once and none have lasted more than one year. HOW CAN DENTISTS STAY IN BUSINESS with these types of repeated failures? (I ended up building him a composite temporary crown via free-handing/sculpting it, locking it in interproximally because he was in a hurry and I didn't even cement it. It's just shrink wrapped on. I had no matrix, no nothing..I just blobbed on some composite, and he told me it looks better than any of the pre-existing porcelain 'one hour deals' he's ever had.) I think it looks like a well made CADCAM crown! UG!
SO, the CADCAM restorations fit decent on the margins in the hands of a skilled operator, but the bad name created by the operators who DON'T know how to use their respective machines, are KILLING the reputation of the better ones. It's just like anyone or anything else, I know. Depends upon the skill. But these machines need to be continually cutting restorations to pay for themselves and unless I see something on the horizon that looks more like a well-crafted, hand done restoration by one of my labs, I'm NOT sold on them.
I'm going to get the book thrown at me perhaps because of this post, but I'm just being brutally honest.
SHOW me some nice ones that have been in the mouth for several years. Maybe then I'll be convinced but until then, I'll continue to send my work to the best labs I can find and have things constructed the ol' fashioned way
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