What’s Right for You?

When it comes to dentists fabricating their own final restorations, more options are available than ever before. The related technologies have become much more accurate, which has resulted in restorations with better fit and workflows that are more streamlined. For dentists who are considering if it's right for their practices, our November cover story explores the benefits and drawbacks of the chairside fabrication of indirect restorations by milling and 3D printing.

In previous letters, I've mentioned that I was an early adopter of chairside milling technology. In fact, my Siemens representative told me that I was the sixth US dentist to receive a CEREC 1. I learned a lot, but as my practice evolved, ultimately, chairside milling wasn't the best fit for it. Offering same-day restorations is a great convenience for patients and can be an excellent marketing opportunity, but you have to have the staff to run the mill and handle the post-processing, and your workflow must be adapted to accommodate. That last part is key. If you aren't interested in really changing the way that you practice in order to create restorations, you shouldn't buy a mill because it will just sit in the corner collecting dust.

Regarding 3D printing, as you'll learn in the article, the technology isn't really there yet to produce final restorations with longevity. However, I'm starting to use my 3D printer more often to produce temporary restorations for my all-on-X patients. I regard the 3D printed temporary restoration as "the Cadillac of temporaries." Advances in intraoral scanning, particularly the development of horizontal scan bodies, are challenging the accuracy of photogrammetry systems at significantly lower price points, enabling 3D printers to be used to produce immediate full-arch temporary prostheses in highly efficient workflows. As this technology evolves, I predict it will draw more dentists into offering same-day full-arch restorations.

If you're truly interested in fabricating restorations but have doubts about the accuracy of the technology, don't. My partner placed an inlay in my mouth that was fabricated on my CEREC 1, and it's still in function 34 years later. The accuracy is there, and it has only improved over the years. If chairside fabrication is right for you, then jump in-just be sure to do your research!

Robert C. Margeas, DDS
Editor-in-Chief, Inside Dentistry
Private Practice, Des Moines, Iowa
Adjunct Professor • Department of Operative Dentistry
University of Iowa, Iowa City, Iowa
robert.margeas@conexiant.com