Clinical Tips Part 1: The CEREC Preparation

he final result in any clinical

restoration is the culmination of
a series of steps, each completed to
conform to a specific set of criteria.
CEREC restorations are particularly
dependent upon four foundational
elements:

Preparation
Powder
Optical Impression
Computer Design

This installment in the series focuses on

the CEREC preparation as the primary
foundational element in achieving a
quality final restoration.
A typical CEREC tooth preparation for
posterior restorations is divided into two
main categories:

Inlay/Onlay/Partial Crown Full Crown

The CEREC 3 software requires that the
dentist use precisely prepared cavities.
Cylindrical instruments should be utilized
for preparation of the inner cusp slopes
with parallel walls for conservation of
tooth structure and well-defined marginal
angles. The nature of the optical
impression and milling system is such that
the dentist needs to take into account
special preparation requirements not seen
in typical laboratory processed crown and
bridge methodology.
The selection of burs utilized for CEREC
preparation are an essential element of
success as well. Each clinician tends to
have their favorite high-speed burs, but
we have found that burs that more closely
resemble those used in the milling
chamber work the best. The first choice

34 DentalTown Magazine

for inlay/onlay/partial crown restorations

is the straight diamond cylinder with flat
end. For the full crown, a round end taper
diamond seems to work very well. Of
course, a thin flame taper diamond is an
excellent instrument for trimming
unsupported enamel margins, especially
in the proximal box. Our policy is less is
best and having to change only a few
diamond burs for a CEREC prep is one
key to smooth and efficient preparation.

restorations rival the fit of any laboratory

fabricated ceramic restoration.

Proper integration of CEREC technology

requires a change in the typical operative
and crown and bridge restoration
techniques.
The highly conservative
nature of the CEREC inlay/onlay/partial
crown preparation methods lends itself to
minimally-invasive dentistry. The simple
nature of the full crown methods allows
dentists to quickly prepare and fabricate
CEREC crowns within an hour from start
to finish. And if prepared according to
the specified guidelines, CEREC

Proximal box axial walls are required

to be flared, slightly divergent

Preparation Guidelines:
Flat pulpal floor & vertical walls
Undercuts in axial walls are allowed
If axial walls are flared, they should
not exceed 6 degree divergence
Cavosurface margins should be crisp
and distinct, not rolled or blunted
Axial walls should be straight with no
steps or bevels

Thickness of ceramic material must be

a minimum of 1.2mm in all dimensions
For full crown preps, the margins should
be a modified chamfer with an ideal
width of 1.2mm and a 6 degree
taper of the axial walls
What are your concerns?
If you have a CEREC question, please
send it by fax to 480-598-3450 or send
by email to: dwvdds@earthlink.net or
carol@dentaltown.com

Douglas Voiers is a reconstructive and aesthetic dentist who has won top
honors in the annual Dental Economics' Practice of the Year Awards. He
maintains a full time practice in Avon Lake, OH and is currently a clinical
instructor for restorative dentistry at the Great Lakes
Educational Center in Southfield MI. Douglas recently
earned a fellowship in the World Congress of Microdentistry.
His other affiliations include the Pankey Institute, the Academy
of Computerized Dentistry, the ICOI and the AACD. Douglas
can be reached at 440-933-3270 or by email at:
dwvdds@earthlink.net.
Mark Morin, DDS, FWCM, graduated from the University of Detroit in 1985 and
immediately started his new practice in Southfield, MI. He became one of
the first dentists in North America to begin using CEREC I technology. He
currently places 10-15 CEREC restorations daily and continues to study
CEREC technology extensively in Germany and Switzerland with inventor, Dr.
Werner Mormann. Dr. Morin maintains a 6000 sq ft office and ExperDent
center. He is one of 10 internationally certified CEREC trainers in North
America and has had the distinction of training some of
dentistry's most well-know clinicians such as Dr. Rela
Christensen and Dr. Howard Farran. Mark can be reached by
email at: drmorin@earthlink.net or by calling 248-828-9989.
Visit his website at www.drmorin.com.

October 2001