Single Visit Restorations

Get crowns and bridges in one day with CEREC®.

Nature Coast Dentistry in Beverly Hills is a leader, not a follower.

Photo by Jordan Pysz.

Dr. Manzur prepares the
milling machine for a same-day crown.

The dental practice was among the first in the area to offer both in-house, high-tech CT scans and digital x-rays that require 70 percent less radiation exposure. The goal of being at the forefront of technology is prominent under the leadership of Kasim Manzur, DMD. He and his staff are committed to keeping Nature Coast Dentistry on the leading edge of dental practice.
“We continually upgrade our practice with the most up-to-date equipment, techniques and technologies,” Dr. Manzur confirms. “We want to provide our patients with the best, most advanced dentistry we possibly can.”
Committed to advanced technology, Dr. Manzur recently added digital dentistry using innovative CAD/CAM technology. CAD/CAM stands for computer-aided design/computer-aided manufacturing. It has been used for many years to design and manufacture products such as tools and auto parts.
More recently, CAD/CAM technology was retooled for use in dentistry to meet the growing need for
comfort and convenience in the dental office. That fueled the development of office-based CAD/CAM
restoration-fabricating equipment such as the CEREC in-office system.
“CEREC is a technology that creates tooth restorations quickly and easily in our office, most often in a single visit,” Dr. Manzur elaborates. “It can make dental crowns, inlays, onlays, veneers and even bridges.
“The most common restorations we make with CEREC are crowns and bridges. Crowns are restorations that cover the entire tooth. Bridges are just what their name suggests. They bridge the gap where one or more teeth are missing.”
CEREC, which is an acronym for Chairside Economical Restoration of Esthetic Ceramics, uses state-of-the-art optical imaging and CAD/CAM technology to design and mill a customized restoration that fits perfectly and matches the color of the patient’s surrounding teeth.
“CEREC enables us to make the all-ceramic dental restorations right here in our office,” Dr. Manzur stresses. “With CEREC, creating a restoration is a one-appointment process. There are no temporaries involved. In most cases, we can have a patient’s restoration completed in a single visit.”

Doing Dentistry Digitally

The CEREC system is digital dentistry at work. The system consists of three main parts – the computer system, the software and the milling unit. These parts work in concert to create the finished restoration.
“The first part of the system is called an acquisition unit,” Dr. Manzur explains. “It’s essentially a computer with a special camera, called an Omnicam, that digitally takes three-dimensional photos of the patient’s teeth. These photos take the place of the impression. Then, the software on the computer enables the dentist to digitally design the restorations.

Photo by Jordan Pysz.

The CEREC milling machine fabricates crowns from a solid piece of ceramic in minutes.

“The milling unit is the third part of the CEREC system. It’s a little, breadbox-sized machine that has diamond drills in it. It fabricates the restoration out of a big, square block of ceramic material that matches the patient’s other teeth.”
Dr. Manzur notes that the ceramic material that’s used for the individual restorations varies. He chooses the material that’s best suited for the patient and the location of the restoration. He prefers having control over choosing the material rather than relying on the judgment of a dental lab.
“If the patient is a grinder or if they clench their teeth, I choose a very strong material, such as zirconia,” informs Dr. Manzur. “For teeth in the front of the mouth, directly in the smile line, I choose a material that has more glass in it, which is more aesthetically pleasing.”
With CEREC, Dr. Manzur uses high-tech, space-age ceramic materials that are much stronger than any materials available in dentistry in the past. These advanced materials give the CEREC restorations unmatched durability.
Dr. Manzur also likes that CEREC puts many of the functions of a dental lab right at his fingertips. He can use this chairside system to fabricate the restorations and make major changes while patients wait. The technology is so advanced that it can offer extensive color-matching capabilities, as well as long-term stability and beautiful, refined milling.
“With the old way of doing restorations, the technicians at the lab did their best to get the color to match the patient’s other teeth,” he acknowledges. “They worked off of standard shade guides and the input of the patient’s dentist. With single-visit restorations, I have the patient in my office, so I can match the restoration perfectly before he or she leaves the office.
“The restorations are made right here in the office before we cement them in the patient’s mouth. If something isn’t quite right with a restoration, which is uncommon because CEREC is extremely accurate, I don’t have to send it back to the lab. I can correct the issue right here and re-make a new restoration before the patient leaves. It only takes a few minutes, so there’s never the need for another visit.”

Single-Visit Sensations

Traditionally, when patients went to the dentist to get crowns placed over their teeth, they had impressions made in one visit, then had to wait two weeks to get their permanent crowns from the dental lab. They then returned for a second appointment to have the finished crowns permanently cemented into place.
“During those two weeks, the patients wore temporary crowns,” Dr. Manzur describes. “Because those restorations are placed with temporary cement, they could come off. When they did, it tended to be at the most inconvenient times. Lost temporaries could cause embarrassing and uncomfortable problems for the patients.”

“Basic bridges, the three-unit bridges that cover one missing tooth, can be fabricated by CEREC in one day.” – Dr. Manzur

With CEREC, patients come in for an appointment, and Dr. Manzur prepares the tooth that is getting crowned. Once the tooth is prepared, he scans it digitally with CEREC’s Omnicam to obtain an exact measurement of size and bite. That information is sent to the computer’s software.
“We design the crown on the computer and make sure we get the color matched and everything else correct,” notes the dentist. “We then send that design information to the milling unit, which makes the crown.
“CEREC makes bridges the same way. If patients need bridges that span more than four or five teeth, those still have to be sent to the lab. However, basic bridges, the three-unit bridges that cover one missing tooth, can be fabricated by CEREC in one day.”
One benefit of using CEREC to make restorations is that Dr. Manzur does not have to use gooey material to make impressions of his patients’ teeth. Traditionally, patients had to sit with this material in their mouths for at least 20 minutes while it molded to their teeth. It was uncomfortable for most patients and untenable for some.
“Many of my patients have a severe gag reflex, so they have a difficult time going through the impression process with the gooey material,” he observes. “With CEREC, patients don’t have to do that. Impressions are made with a simple scan of their teeth. There’s no gooey material involved.
“Another benefit is patients get their restorations in a single day. They don’t have to wear temporaries. They get their permanent restorations in one appointment, and they’re able to eat and chew within a few hours of the appointment. It’s also nice that patients only have to be numbed one time because there’s no second visit.”

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