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CEREC is one of the most cutting-edge innovations in dentistry today. Dr. Johansen was one of the first dentists in the Salt Lake Valley to employ this technology. CEREC is an acronym for Chairside Economical Restoration of Esthetic Ceramics. With this technology Dr. Johansen can repair damaged teeth in a single appointment using a bonded porcelain restoration.

How does it work?

Cerec uses CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) technology, incorporating a camera, computer, and milling machine in one instrument. Dr. Johansen uses a special camera to take an accurate picture of the damaged tooth. This optical impression is transferred and displayed on a color computer screen, where Dr. Johansen uses CAD technology to design the restoration. Then CAM takes over to automatically mill the restoration out of a solid block of ceramic. The restoration is then bonded to the damaged tooth. The entire process takes about 90 minutes to complete.

How does this innovation benefit our patients?

Many dentists offer only two main methods to esthetically restore damaged teeth. If the damage is extensive a crown is used, if the damage is small a composite or resin tooth colored filling is used. Unfortunately some dental problems are not large enough to justify a crown, but are too large to restore with a composite filling. This is a typical situation in which we use CEREC and restore the tooth with a restoration known as a ceramic onlay. An onlay is similar to a ½ or ¾ crown. The advantage of an onlay is that we only remove the broken down, decayed, or weakened parts of the tooth. The remaining tooth structure is left and the porcelain is bonded (fused) to it. With CEREC we are able to produce ceramic onlays in one appointment. We eliminate impressions, temporaries and second visits to bond the onlay to the tooth. When a crown is necessary CEREC can be used in a very effective and conservative way. We are able to make a copy of your tooth, improve the anatomy, and then mill the crown out of a solid block of porcelain. We then stain and glaze the porcelain to match the shade of the existing tooth structure. Here is an example of two CEREC restorations. One is a crown and one is an onlay.

Click on the pictures below for an enlarged view.

I have many old Silver Amalgam fillings. What should I do?

Over the years there has been a lot of controversy about silver amalgam and whether it poses a health risk. The ADA has repeatedly stated that patients are not at risk from amalgam fillings and the mercury they contain. I firmly stand behind the ADA in this statement. It is dishonest and in my opinion unethical for a dentist to claim otherwise. He or she would be making a declaration that is not supported by scientific evidence. Silver amalgam however, does have serious drawbacks. First it is very unaesthetic. Teeth are obviously not silver. Therefore when you smile, silver fillings put your entire dental history on display. Second, silver fillings do nothing to strengthen the damaged tooth. When decay is present the dentist must clean out the tooth and prepare it for a filling. Basically a hole is created. Silver amalgam fills the hole, nothing more. 

With a large cavity, the strength of the tooth is compromised, and yet it is still functioning under the tremendous amount of stress and force that is created in the mouth. This will often times cause cracks and fractures in the remaining tooth structure. If left untreated cusps will usually be the first to break off. Unfortunately due to the nature of silver amalgam, when it is used as a filling material a certain amount of bulk is necessary to prevent it from breaking. This often times required dentists to remove healthy tooth structure in order to provide the necessary bulk. The moral of the story is that many teeth that have been restored with silver amalgam have a lot of tooth structure that is missing and their strength has been compromised. 

The BEST way to esthetically restore these teeth is with bonded ceramic onlays and crowns that help restore the structural strength of the tooth. Composite (tooth colored resin fillings) are the best choice for small cavities with little damage to the tooth. With improvements in technology composites are continually getting stronger, but due to the shrinkage that occurs when they are cured (hardened) they should only be used in restoring smaller cavities. If composites are used in treating severely damaged teeth, the chances of sensitivity is increased and the longevity of these restorations is much shorter than ceramic. CEREC produces strong ceramic onlays and crowns that blend in naturally with the existing tooth structure. That is why we have CEREC in our office. It enables us to restore broken down teeth in a conservative, esthetic and durable manner. Therefore, if you are looking to restore your teeth to a natural appearance, in many cases there isn’t a better restoration than what can be produced with CEREC.