The CEREC system

25 years of chairside CAD/CAM dentistry

Dennis J. Fasbinder, DDS

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n September 1985 at the University of Zurich Dental School, Mrmann1 placed the first chairside ceramic restoration with the CEREC 1 system (Sirona Dental Systems, Charlotte, N.C.) by using computer-aided design/computer-aided manufacturing (CAD/ CAM) technology. At the time, it was a revolutionary concept for restorative dentistry that an industrially made ceramic material could be fabricated chairside by using a milling device with the benefits of a direct restorative treatment modality. As with any new concept, there were many questions about the viability of such a radical restorative technique and its acceptance by dentists. The year 2010 marks 25 years of chairside CAD/CAM experience in dental practice. The restorative materials and clinical technique have been studied extensively as they have evolved. In a recent search of the word CEREC on PubMed, I found 402 studies referenced. In recognition of 25 years of CAD/CAM in the dental office, this supplement presents four articles that describe some of the latest techniques and innovative materials available for chairside CAD/CAM dentistry in 2010. The CEREC system has evolved through a series of software and hardware upgrades since its introduction to the dental marketplace as the CEREC 1 system. There have been several significant changes in the system since its introduction. The separation of the milling chamber from the image capture and design hardware led to a significant improvement in clinical efficiency by allowing for simultaneous design of one restoration while milling a second one. The change from a two-dimensional design program to a three-

dimensional (3-D) design program occurred as the speed and memory of computers improved. The introduction of the 3-D software substantially improved the immediate understanding of the 3-D program because dentists were able to view the designs in a way similar to what they were used to seeing with stone models. 3-D design also improved the clinical work flows of chairside system use. The most recent evolution, the CEREC Acquisition Center (Sirona Dental Systems) unit, has introduced a newly developed light-emitting diode (LED) camera called the Bluecam. This camera is based on a blue LED that replaces the infrared-emitting camera in the CEREC Acquisition Unit (Sirona Dental Systems) system. In the first article in this supplement, Poticny and Klim2 discuss the Bluecam and other work-flow improvements for chairside delivery of ceramic restorations. The evolution of the software and hardware for the CEREC system is mirrored by developments in the materials available. Ivoclar Vivadent (Amherst, N.Y.) introduced a lithium disilicate restorative material (IPS e.max CAD) that initially was designed to be used in the dental laboratory as a coping material that was more translucent than zirconia. It then became available in a variety of shades and several translucencies for use in esthetic full-contour, chairside restorations. Other available ceramic materials for chairside CAD/CAM require adhesive luting agents for bonding of the restorations to achieve clinical success. The enhanced strength of the
ABBREVIATION KEY. CAD/CAM: Computer-aided design/computer-aided manufacturing. LED: Lightemitting diode. 3-D: Three-dimensional.
JADA, Vol. 141 http://jada.ada.org June 2010 3S

Copyright 2010 American Dental Association. All rights reserved. Reprinted by permission.