CAD/CAM Dentistry for the General Practitioner. What to Know Before You Leap

Transcription

1 CAD/CAM Dentistry for the General Practitioner What to Know Before You Leap

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4 REMEMBER THIS!!!

5 Why consider CAD/CAM dentistry?

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15 Why consider CAD/CAM dentistry? Same day dentistry

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17 Why consider CAD/CAM dentistry? Same day dentistry Control of your restorations

18 Replicate Nature

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37 Why consider CAD/CAM dentistry? Same day dentistry Control of your restorations Marketing and Referrals

38 Why consider CAD/CAM dentistry? Same day dentistry Control of your restorations Marketing and Referrals Fixed lab bill

39 Fixed Lab Bill Expenses with in-office CAD/CAM are high but, mostly fixed Traditional lab bills rise on a per unit basis Once breakeven point is reached, CAD/CAM profitability increases with every unit

40 Lab vs. CAD/CAM cost Breakeven Point Lab cost CAD/CAM cost

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52 Current In Office Systems Cerec AC with Bluecam Cerec AC with Omnicam E4D by D4D Technologies Carestream CS 3500

53 Current In Office Systems Cerec AC with Bluecam Cerec AC with Omnicam E4D by D4D Technologies Carestream CS Shape Trios- not yet but,..

54 Cerec AC with Bluecam Requires powdering teeth Chairside crowns, bridges, custom abutments CT integration and implant surgical guide milling

55 Cerec AC with Omnicam No powdering Video capture in color Chairside crowns, bridges, custom abutments CT integration and implant surgical guide milling

56 E4D by D4D Technologies No powdering! New Nevo camera faster and more portable Chairside crowns, inlays, onlays, veneers

57 Carestream CS 3500 No powdering Chairside crowns, inlays, onlays, veneers No bridges or implant applications for now USB connect- ultra portable Awaiting FDA approval

58 Things to consider...

59 Things to consider... Volume

60 Volume How many units of CAD/CAM dentistry will you produce each month?

61 Volume Can all ceramics replace the PFM?

62 Volume Can all ceramics replace the PFM? Maybe

63 Reduction Guidelines 1.5 mm occlusal, 1.0 mm axial These are the same as a PFM unless you are a chronic under-reducer Catastrophic failure vs. veneering porcelain failure

64 Not every situation is suitable for CAD/CAM use Poor isolation Tipped, worn, malpositioned teeth Inadequate occlusal reduction Dark stumps that can t be blocked out

65 Breakeven Point Lab bill + costs of a 2 nd appt = Loan payment + maintenance +blocks (assumes same doctor time each way)

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67 The Wildcard Will you do more dentistry as a result of having cad/cam? More referrals? Higher acceptance? More dentistry per visit?

68 Will you do more dentistry as a result of having cad/cam? More referrals? Higher acceptance? More dentistry per visit? 165 units 255 units

69 Things to consider... Volume Capacity

70 Capacity Chairs will be tied up longer Extra operatories Assistants

71 Things to consider... Volume Capacity Workflow

72 Workflow Scheduling Delegate Material Choice

73 Current Materials Lithium Disilicate (ex. IPS Emax)only material approved for conventional cementation; requires firing in oven 360MPa Leucite-Reinforced Ceramic (ex. IPS Empress) 160 MPa Feldspathic Ceramic (ex. Vita Mark II) 160 MPa

74 Current Materials Resin-Reinforced Ceramic (ex. 3M Lava Ultimate and Vita Enamic) Composite (ex. 3M Paradigm MZ100) Composite Temporary bocks (TelioCAD)

75 Can zirconia be milled in office? Yes!!! But, zirconia requires firing in a specialized oven for several hours Requires multiple visits

76 Workflow Prep and digitally impress Design Mill Stain/Glaze OR Polish Bond/Cement

77 Workflow Prep and digitally impress Design Mill Stain/Glaze OR Polish Bond/Cement

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79 Material? Stain or polish? Time? Bond/Cement?

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93 Plan for efficiency!!!!!

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98 Things to consider... Volume Capacity Workflow Commitment

99 Commitment Financial CAD/CAM dentistry is more demanding clinically Continuing education

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101 30 Years of CAD/CAM

102 Commitment Moore s Law- predicts a doubling of computing power every 2 years All technology has a finite lifespan Innovation doesn t come free! Term of loan vs. useful lifespan

103 Commitment Financial CAD/CAM dentistry is more demanding clinically Continuing education

104 What does the future hold? Increasing ease and efficiency Better and more realistic imaging Decreased cost Smile design Functional articulation Materials galore Cone beam integration Implant applications

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106 Case by Mike Scoles

107 Should You Leap?

108 Thank You! Cory Glenn DDS