Smile for the 3-D Camera!

Smile Sarasota has always been on the leading edge of technology. This is the second in a series of three interviews with Dr. Adam Still on SNN’s show, Aging Gracefully on the Suncoast with Nancy O’Neil.  Our topic is CAD/CAM Dentistry!

So what is CAD/CAM? It stands for ‘computer aided dentistry’ ‘computer aided manufacturing’. It is by no means a technology exclusive to dentistry – is used in a lot of different industries. The most common dental application for example, would be a broken or decayed that tooth we just prepared for a crown. We take 3-dimensional images of that tooth. From those 3-D images, we go to the computer monitor and we design the crown.  Then the crown will get milled out of a solid block of ceramic material; this is a restoration that can then be placed directly on the tooth at that point. So is it like a 3-D printer? It’s similar to that concept but with a printer, instead of printing ‘nothing into something’ we are actually taking a ceramic block and milling it down into something we can use – but it’s a very similar concept to a 3-D printer.

So what are the advantages of this over dentistry from previous years? There are quite a few advantages because this is a system where the procedure is done within the office – we can actually do it one day, in one appointment. You can walk in with an issue and leave with a permanent restoration, so that is one of the great advantages. Another thing I like about it is that we tend to see less sensitivity with these restorations. When we prepare the tooth and we temporize it, we leave it kind of exposed to the oral environment for a while (waiting for our outside lab to make the crown) before it’s sealed again, whereas with this type of instrument, within just a few hours we are sealing it up again. Another big advantage that patients love about this system is that we don’t have to take an impression anymore, so they don’t have to have the big mouthful of goop that people find so annoying. We actually use a camera instead to get the same effect as an impression.

What are the disadvantages, if any? Early on with this technology, you had to really want to be a CAD/CAM dentist. When I say ‘early on’, this technology has been around for over 30 years! In the early stages, the process was really time-consuming. The software left a lot to be desired and it took a long time to get through the process. Then, when you were finally done, the final fit and the precision and the seal of the restoration was in question. But over many years, there have been many advances in the software and the cameras that we use today and this has eliminated these issues. If there really is a drawback, it is the time involved in the office for the patient – we have to do the whole process from start to finish in one appointment. We first have to prepare the tooth but since we are not making a temporary and sending the impression off to the lab, we have to actually mill the restoration and then try it in the patients mouth and make small adjustments. Then it goes into an oven where the the material goes through the final hardening process; then we finally place it (cement it) in the mouth. So there can be 10 minutes here and 25 minutes there where the patient is kind of hanging out reading a magazine or playing with their phone while they wait.

How long have you been using this particular technology? I have been using it for about the last 5 years and it’s come a long way even in that amount of time. They are constantly updating the cameras and the software, so it’s improving every day.

So your office is state-of-the-art…everything you do is current with what’s going on in the industry so of someone wants to get something done, you have it? Yes, we feel it is.

What’s your favorite thing about this technology? Well…it’s kind of fun to use! I liken it to playing with PhotoShop when you are designing the restoration. It’s really enjoyable to use, but because you are designing it yourself, the control is in your hands. I get to say how I want the bite to look and the contacts between the teeth to look, so I have the ultimate control of the outcome of the final restoration. The other thing I enjoy about it is the convenience from the patients’ standpoint and from my standpoint. If I have a patient come in who has just broken a tooth and they are leaving for Europe for the next two months, we don’t have to wait for the lab. We can take care of it right on the spot and they can leave for their trip and I don’t have to worry about them in a temporary during that period of time.

What do you see the future now that you have seen so much growth in just 5 years? We mentioned 3-D printing – that and the combination of  CAD/CAM is the future, I think. What we talk about in dentistry and in other industries is that we are watching a shift from analog to digital. In our particular application, we are taking a 3-dimensional image instead of an impression. With this digital information we can quickly transfer it from one person to the next. I can email it to a lab or to a specialist I am working with on a case and we can more efficiently transfer information and more accurately describe it because both looking at it at the same information at the same time on the computer. The way we plan cases will change for the benefit of the patient.

Have a broken tooth? Call Smile Sarasota today and learn more about restoring it in just one appointment!


Many thanks once again to SNN and Nancy O’Neil!