I finally did a Cerec Crown

Hey.
I know what you were thinking?
Where the heck have you been?
Well here is my excuse....Friday I was writing a blog, I was going pretty good.
I went to see a couple of patients and I came back and it was gone. I was so ticked.
This website use to save the blog as I was writing but for some reason not any more and it was gone.
Now, remember I am coaching football again and the practice is at 3:15 and I don't have time after work to write.
So I couldn't write again, so I said forget it.
Monday came along and it was just a busy day. I take the kids to school in the morning at 8:15 and pick them up at 3:15 (I pick Noah up at 1pm) and it seems that this 7 hours goes like lightning.
I lost track of time and next thing I knew I skipped another day.
Oh, by the by, there was practice after school on Monday too.
I am an assistant coach. It is so much easier. I don't know if I told you about my head coaching days. It is really tough on me. I wouldn't sleep because I was so into it.
(I know I have problems, you don't have to remind me. )
We had our first game yesterday and we got creamed. It is a lot of fun.

I am reading this book called Beautiful Boy right now and I am almost done. I am going to write a whole blog on it...maybe Friday. It a true story about a man who has a son. Basically at 18 the kid was addicted to Meth.
So it starts from this kids birth and how this kid grew up. It talks about how the dad found pot in his backpack at the age of ELEVEN. It talks about the rehab and how the fathers love for this kid saves him. But it talks about how a family was destroyed because of it.
Amazing stuff. I have to tell you about it.

I have seen some movies...Rendition...pretty good. And I have just started Expelled.
But with TV going strong, movies are on the back burner. I am behind on my TV and haven't watched in a couple of days. Most of my Saturday is all about college football.
Speaking of...Noah turns five on Saturday and I am taking him and Luke to a "real" Gator game.
It is going to be great.

Okay, I have to tell you about my CEREC experience.
The local Patterson CEREC rep has been trying to get into my office. She came one week with my Patterson supply rep.
My supply rep has told her not to talk to me about money. I have told them in the past that I think leading with, "this thing can make you so much money" is a turn off for me. Talk to me about how good it is for my patient's oral health. Talk to me about how it is good for them and then we can talk about money.
So she leads with, "I know I am not suppose to talk to you about how much money this can make you..."
But she came in and told me anytime I wanted I could have a patient come in and she will bring the CEREC and the milling machine to the office and we will do one together.
That very day I saw this 20 year old with two of those Stainless Steel crowns on her permanent molars. (I think when a tooth comes in all mottled and a dentist didn't know what to do, they would just cut it down and slap one of those on there, Maybe it was a pediatric dentist. It is not a bad restoration, just not a permanent one).
I told her everything about the CEREC machine and if she lets me do this she can save $300 off the cost of the new onlay.
She said okay.

We set up a date and I removed the stainless steel crown and prepped this tooth for an onlay.
Simple prep because there wasn't any decay.
The rep was there the whole time. I was prepping and she was making phone calls. When I was ready for her she kind of took over.
She did the spray and I took the picture (impression).
Now she spent the next 5-10 minutes with the CEREC computer telling it what to do. So she would say out loud but not necessarily to me, "...that is too much contact..." click, click, click.
Then say, "...lets take this out..." and "...lets move this..." click, click, click. "...we can just do this.." click, click, click.
Every once and a while she would say to me, "You see what I am doing here? I am reducing the height of contact.....blah, blah, blah"
Now as a dentist without the CEREC I take all the laboratory does for granted. I haven't thought of this stuff, dimensions of a crown, since school.
I usually take an impression or five and send it off to the lab and expect it to come back perfect.
She asks me, "where do you want the height of contact?"
Duh, I don't know.
"Where do you want this cusp tip?"
Duh, I don't know.
"Do you see here, that the thickness of the crown is going to be a little on the thin side, what do you want to do?"
Duh, I don't know.
She continued talking, but not necessarily to me "Lets move the height of contact up to the occlusal one third but you see then it is going to make this cusp look to bulbous. So lets do this..." click, click, click.
It was amazing to watch. My head was spinning.
Now I have heard from users that there is a learning curve. Now I can see why. I can see why someone would call up Patterson and say, "take this back." Now because of the product but because of the intenseness (is that a word) of the machine.
It is a lot of stuff.

But for me, she did it all.
This did take a lot of pressure off of me and it was nice to just sit and watch her work. Don't forget that she has been doing nothing but CEREC restorations for 3 straight years. She is good at it. I don't even want to think about learning the stuff that she has already forgotten.
And I imagine the only way to get good at it is to start working on it in someones mouth and I think this is were it might suck real bad.
Okay...back to the crown...
I told her I wanted the Lee Culp anatomy in this crown. She said no problem and 400 clicks later she was done.
Then it started to mill and 7 minutes later...Viola.
I put the thing on and man was it good. REAL NICE.
The margins were so good.
(I forgot to tell you a part of the story. She had 3 of these SS crowns on her molars. A couple weeks before I prepped one of them and on the day we were going to do the CEREC one, we were going to cement the regular porcelain onlay that I have already made.
So this was good because I got to compare the CEREC crown with the porcelain crown I was doing on another tooth.)
I have to say the margins on both were exceptional. The CEREC crown got the edge though because it was like glass, I kid you not. I was impressed.
Here is where the porcelain crown won. The color.
This particular block that the CEREC crown was made was not very translucent.
Although the margins were great and the occlusion was great and it looked good. The final look was surpassed by the regular, I can adjust the translucency, crown.
Now there could be more blocks of porcelain that are more translucent that the rep and I didn't talk about.
That was the only thing.
The kid and her mom were thrilled. I was thrilled.

Now I don't think I could justify this machine right now, considering I am doing 1 onlay every two weeks or so but it was cool.
I can see what people love about it. Now if I did 5 a day I might really consider getting one.
But because of where I am at, I think I will continue to stay a interested observer.
It was fun, a great experience.

I will talk to you on Friday.
Hope everyone is having a good week.
john