First Impressions Magazine

tech talk: CAD/CAM
Precise restorations in a fraction of the time.

Computer-aided design (CAD) and computer-aided manufacturing (CAM) refer to a method of using computers to facilitate manufacturing processes. With CAD/CAM, your dental customers can design and produce dental components at their practice, more precisely than ever before. The system is comprised of a software program integrated with a milling device, permitting crowns, bridges and other restorations to be specified and manufactured on the spot. For dentists, CAD/CAM is an opportunity to avoid ordering complicated lab procedures. For their patients, the technology ensures them of a well-fitting restoration in one appointment.

How does it work?
For dentists new to CAD/CAM, a 1 ½-hour appointment may seem like too short a period in which to plot, design and produce a restoration. But, essentially, the computer does much of the work. First, the computer produces a digital image of the patient’s tooth using a small intra-oral camera. The image, which contains information about the size of the tooth, the area in need of repair and the adjacent teeth, is transferred into a three-dimensional model on the computer screen. The CAD portion of the software program positions and/or rescales various components of the restoration, permitting the dentist to modify any details at his or her discretion.

Once the dentist is satisfied with the precision and appearance, the CAM module calculates the milling data appropriate for the material being used, as well as suggests the right material block size to use. While blocks may vary somewhat from one manufacturer to the next, they generally retain their material properties throughout the production process, particularly since no hand casting, soldering or mixing is required at any stage. Blocks generally are made of porcelain or a composite.

When the proper specifications have been established for the restorations, the computer program is instructed to begin the milling process. Milling is completed in five to 10 minutes. Afterward, the restoration is fit, adjusted and bonded in the patient’s mouth.

Although CAD/CAM technology is not cheap (the cost of a system ranges from about $83,000 for a compact unit to about $103,000 for a larger, faster one), most dentists can break even after about 10 to 12 uses per month. Because CAD/CAM is used for a range of single-unit restorations, including inlays, onlays, crowns and veneers, this is not difficult to achieve.

CAD/CAM systems are comprised of an acquisition unit and a milling unit. Material blocks, which often are specific to a manufacturer’s system, also may be included. Additional blocks may be purchased as needed. For the most part, the system is low-maintenance.

The future of CAD/CAM
Although some dentists may want to learn more about CAD/CAM technology and what it offers before adding it to their practice, few will dispute its convenience. And, the ability to offer patients one-stop restorations in a little over an hour makes a practice that much more attractive.

Experts expect to see CAD/CAM used much more frequently for chairside multiple restorations in the future. And, it may one day eliminate the need for a physical impression as well. If your dental customers aren’t ready to invest in the technology now, chances are they will need to do so at some point soon, in order to stay competitive. [FI]

Editor’s note: First Impressions would like to thank Sirona Dental Systems, LLC (Charlotte, N.C.) for its contribution to the article. Selling CAD/CAM
CLEAR Questions by Brian Sullivan As I sit here typing away at my computer, I have a dull pain emanating from a molar on my lower jaw. Three weeks ago, just before a trip with the family to New York City and lights of Time Square, I went to the dentist for a little tooth restoration of my own. While the local anesthetic turned me into a Mary Joe Buttafuoco look alike, I anxiously squirmed in my chair like a 4-year old child. You would have thought waterboarding was the dentist’s favorite method of tooth restoration. When the dental light went off above my head, I was relieved it was over. I had survived and wouldn’t be due back at the Guantanamo Dental Clinic for another six months for my cleaning. But wait! Just as I wiped the remaining drool off of my third chin (my numb face forgot to tell me it was there), my dentist informed me that I would have to come back in two weeks so he could strap me down again and put the REAL crown on. “WHAT? You mean there is more?” I thought. “What kind of dentist is this guy?”

So here’s the point, all of us would like to spend a little less time in the dental chair wouldn’t we? And truth is, we love the dentist who helps us keep our teeth healthy … in the shortest amount of time possible! So any product that can accomplish that goal, I believe in with all of my heart … and molar. So in 2008, make a promise to:

Learn as much as you can about the benefits of CAD
Use CLEAR questions to engage your prospects in discussion about the solution rather than spew features
Listen better in 2008 than ever before to your customers likes and dislikes.

By doing these things, you will save millions of wimps like me countless hours of sleep while helping your dentists practice cutting edge dentistry. And that will produce a lot of healthy smiles! [FI] Sidebar:
CLEAR Questions are easy to remember, making it more likely that you will actually use them when that dentist is staring at you in the clinic hallway. Rather than unloading a payload full of CAD/CAM features and benefits on the prospect, CLEAR Questions will get them to tell us how they feel about the current restoration process.

C- What is your current lab bill?
L- Have you looked at the latest CAD/CAM technology that allows you to plot, design and produce a restoration in just 90 minutes?
E- What do you find effective about the way you currently treat those patients?
A- What would you alter if you could?
R- Who as well as yourself is responsible for making decisions on products such as this?

By asking these questions, you allow the customer to tell you what is most important to them. And when they do, you can then focus your presentation on those topics.