The strength and survival pros-pects of all-ceramic restorations

do not depend solely on the proper-ties of the ceramic material. Thedesign and dimensioning of the restoration and the bonding methodplay a crucial role as well.

Adhesive bonding or cementingIf sufficient tooth substanceremains, adhesive bonding is theideal technique. The adhesive bondtransforms the remaining tooth tissue and the restoration (inlay,onlay) into a single unit. The situa-tion is different with regard tocrowns and bridge abutments. Inmany cases little or no natural toothenamel remains. In this case thedentist can deploy oxide ceramicframeworks, which – due to theirinherent strength – lend themselvesto conventional cementing. By con-trast, silicate ceramics with a lowerdegree of flexural strength (between200 and 300 MPa) require adhesivebonding.

The adhesive bonding of all-ceramic restorations has meanwhilebecome a standard procedure inmodern dentistry. By applying 30 –40% phosphoric acid it is relativelyeasy to create micro retentive struc-tures on the enamel. Achievingmechanical adhesion to the dentinerepresents more of a challenge.

Dentine contains a higher concen-tration of organic substances. It ishydrophilic and hence does notbond automatically with hydropho-bic substances such as luting com-posite. The advent of hydrophilicprimers in combination with hydro-phobic bonding agents representeda real breakthrough and paved the

way for stable adhesion to the den-tine.

Less smear, better bondA further obstacle to effective den-tine adhesion is the smear layer.Dissolving this smear layer is nowstandard practice for all bondingsystems. In the old days dentists

tended to use less aggressive solvents to dissolve this smear layer,for fear that phosphoric acid etchingwould damage the pulp. This wasfollowed by the application of ahydrophilic primer and an adhesive.To simplify matters, new primerswere developed containing organicacids designed to dissolve the smearlayer, and monomers designed to penetrate the demineralized dentine. These adhesive systemsdepended on the separate etching of the enamel and the dentine. As such a clear separation was difficult to achieve, it was decided toadopt the total etching technique,under which the enamel and thedentine were etched in a single process. Unfortunately, this tech-nique was prone to errors and re-sulted in postoperative hyper-sensitivity. This prompted the devel-opment of acidic primers thatsimultaneously condition the enamel and the dentine. Today’sbonding systems deploy differentstrategies in order to dissolve/remove the smear layer. The onestrategy involves the use of self-conditioning monomer solutions.The other approach involves totaletching with the help of phosphoricacid. (For an overview of the variousadhesive bonding techniques seepage 2) ■

PD Dr. Roland Frankenberger, Polyclinic forConservative Dentistry & Periodontology,Erlangen-Nuremberg University

BONDING AGENTS. Single-bottle bonding agents offer distinct advantages in terms of handling and con-venience. But which bonding system will win in the end? Which material is best suited to which application?As far as all-ceramic inlays and onlays are concerned, the three-step total-etching technique is definitely tobe recommended.

CONVINCING METHOD

CEREC dentists andinLab laboratories areperfect partners PAGE 3

JACQUES RAYNAL

Practice profile: from ivory to CAD/CAM ceramics PAGE 4

The war of the bottles

Three-step total-etching systems have performed very well in long-term clinical trials.These systems are indicated for all-ceramic inlays and onlays. By contrast, self-adhesivecements are easier to use and create a stronger bond with the dentine. They wouldtherefore appear to be more suitable for crowns.

OPINION

Simply try it and see

One evening recently,at a meeting of theGerman Associationfor ComputerAssisted Dentistry, Ifound myself in asports hall in front ofan indoor climbing

wall. I weigh in at around 100 kilos andon the evening in question was wearinga sports jacket and ordinary shoes. Allaround me climbers were demonstratingtheir athletic prowess by surmountingdeath-defying overhangs and crawlingalong beneath the ceiling like flies. I hesi-tated until the coach standing next to mesaid, “What are you waiting for?” andpointed to a lady in an evening gownand high heels who had already complet-ed half of the course. Yes, what was Iwaiting for? The general situation wasnot going to get any better. What couldgo wrong? Perhaps I should give it a try.

How many people spend their timewaiting for something to happen? Wait-ing for times to improve, for new techno-logy, for simpler adhesive bonding tech-niques. Is it worth waiting? Not in mostcases, as experience has shown. A lot ofthings are easier than they appear at firstsight – for example, adhesive bonding.Don’t be intimidated by scientific theory.Simply try it out for yourself, perhaps ona model to begin with. Tens of thou-sands of dentists have taken this firststep and can confirm the wisdom of learn-ing by doing . By the way, the view fromthe top of the climbing wall was fantastic– as was my sense of achievement.

Dr. Wilhelm Schneider Head of CEREC product marketing atSirona

CEREC is not the sort of systemthat stands around unused in a

corner of the treatment room. Quitethe opposite. Typically, dentistsbegin with relatively simple restora-tions such as premolar crowns and inlays. They then progress toonlays and tooth-conserving partialcrowns. The final step is the crea-tion of veneers, anterior crowns andimplant superstructures. CEREC isgreat fun to learn and use. This wasvery much in evidence at the recentAnterior CEREC Masters Sympo-sium staged by the South Africanbranch of the International Society

of Computerized Dentistry (ISCD)in Johannesburg last August.During this two-day event, 59CEREC users profited from the in-depth knowledge of variousCEREC experts, including Dr. Klaus Wiedhahn (Buchholz/ Ger-many) und Dr. Rich Masek (SanDiego/California), both of whomspecialize in highly aesthetic anterior CEREC restorations. Theexperts lectured on the basic prin-ciples of CAD/CAM restorations aspractised in Europe and NorthAmerica. The attendees had ampleopportunities to put what they hadlearned into practice. In an im-pressive live session Klaus Wied-hahn demonstrated how fourveneers can be created and placed in

a single treatment session. In typical “hands-on” fashion RichMasek showed a new method formilling anterior crowns with reduced labial surfaces prior to theapplication of ceramic veneeringmaterial. Both processes involvejust a few steps. The attendeesenjoyed not only their encounterswith these exceptional teachers,but also the classy surroundings of the Johannesburg convention centre.

CEREC Masters Symposium in Johannesburg

Further information about next year’s sympo-sium is available at: www.iscd-africa.com

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PUBLICATION DETAILSPublished by: Sirona Dental Systems GmbH,Fabrikstraße 31, D-64625 Bensheim, Tel.: +49 6251-16-0, Fax: +49 6251-16-2591,contact@sirona.de, www.sirona.de

Responsible for content: Dr. Wilhelm Schneider, Sirona Dental Systems GmbH

Editorial team: Wilhelm Schneider, Hans-Georg Bauer, Antje Casimir, Iris Hauer, BirgitMöller, Manfred Kern, Andrea Hamacher,Christoph Nösser, info@cerec-zeitung.de

Design and production:ergo Kommunikation, Köln/Frankfurt a.M.,www.ergo-pr.de

Printing: PrintService Vertriebsgesellschaft von Wirth mbH, Willy-Messerschmitt-Str. 4, D-50126 Bergheim

CEREC Magazine is published every three months.

i

KNOW-HOW TRANSFER. AnteriorCEREC restorations are easy to learn– and profitable

Further information and registrations:www.20YC.com

CEREC turns 20

On 17 and 18March 2006Sirona will becelebrating the20th birthday of the CEREC system at aspecial symposium (“20YC”) in Berlin.Organized in collaboration with ProfessorMörmann and the Quintessenz publishingcompany, the 20YC Symposium will be theperfect blend of science and entertainment,learning and celebration. Leading cliniciansand academics will describe how easy andprofitable it is to integrate CEREC into exis-ting dental practices. There will be amplescope for informal discussions. To this extentthe 20YC Symposium is ideal for existingCEREC users and for all those who want tojoin their ranks in the near future.

NO. 3 December 2005 International Edition

CERECZeitungPERFECT VISITING CARD

All-ceramic veneers areunbeatable in every sense PAGE 3

No. 3 December 20052

It took a little luck – and the rightpeople. The decision by Prof. Dr.

Werner H. Mörmann and Dr.Marco Brandestini to start withcomputer-aided production ofinlays rather than crowns, and toleave the detailed finishing of theocclusal surface to the dentist, hadthe effect of drastically reducingtechnology costs. By September1985 an initial CEREC prototypewas ready to be patient-tested. Asluck would have it, August Behneand Harald Burger, departmentaland regional managers in theDental Division of Siemens AG,chose to ignore the sceptics andpress ahead with the developmentof the new invention. They hadrecognized that computer-aideddental restoration would come tooccupy a firm place in modern den-tistry. Today CEREC is a standardprocedure. A number of factorshave played their part: long-termclinical studies have shown that all-ceramic inlays, onlays, partialcrowns, veneers and full crowns

without framework for the anteriorand premolar regions stay in placepermanently. Since 2003 the soft-ware has become much easier touse, following the introduction ofCEREC 3D. And the adhesive bond-ing of all-ceramic restorations has

become a normal procedure, taughtas standard in all universitiestoday. Now there are materials onthe market that can be worked aseasily as conventional bondingcements.

20YC SymposiumLooking back it is now clear thatthe advent of CEREC 20 years agoopened up a new chapter in dentis-try. This is a cause for celebration.

In association with publishersQuintessenz, Sirona invites you toa scientific symposium on 17/18March 2006 in Berlin. Here distin-guished speakers from all over theworld will present their findings onthe clinical acceptance of CEREC.Practitioners and scientists willshow how easy it is to integrate themethod into the work of a dentalpractice, and how profitable it is.

There will also be plenty of op-portunities to compare notes with colleagues. And arrangements havebeen made, in collaboration withthe ISCD (International Society of Computerized Dentistry), tohave 50 practising CEREC“experts” on hand throughout thecongress to answer any questionsabout CEREC, no matter how difficult. ■

Three-step selective etching: Thislong-established and by no meansobsolete method is applied in combi-nation with adhesives such as Syntac(Ivoclar-Vivadent) and A.R.T. Bond(Colténe-Whaledent). After the ena-mel margins have been selectivelyetched using phosphoric acid, thedentist applies one primer (A.R.T.Bond) or two primers (Syntac) inorder to condition and infiltrate thedentine. The adhesive then forms afirm bond with the enamel and thedentine. All the products belonging tothis generation can also be deployedwithin the framework of the total-etching method.

Three-step total etching method:1) Simultaneous conditioning of theenamel and dentine with phosphoricacid (maximum contact time for thedentine: 15 seconds). 2) Applicationof a hydrophilic primer. 3)Application of a hydrophobic adhe-sive. The acid not only removes thesmear layer but also demineralizesthe dentine down to a depth ofapprox. 5 mm. If the cavity is over-dried following the etching procedu-re, the collagen network in the denti-ne may collapse. In such cases re-wetting is required in order to re-store the penetrability of the dentine(but only when acetone or ethanol-based adhesives are used). Water-based systems contain enough waterto restore the structure of the colla-gen network. Next, a primer is ap-plied in order to enhance the wett-ability of the dentine for the adhesive(bonding agent). The function of theadhesive is to create a uniform bond

between the ceramic restoration andthe primed dentine. The adhesivepenetrates the demineralized den-tine, where it forms so-called “tags”in the tubuli. This creates a so-calledhybrid layer. In this way the dentineis effectively sealed. The followingproducts are designed for three-steptotal etching: Syntac, A.R.T. Bond,Gluma Solid Bond, OptiBond FL andAdper Scotchbond Multi-PurposePlus.

Two-step total etching method:The desire for greater simplicityprompted various manufacturers todevelop multi-component adhesives.These “one-bottle” systems aredeployed in combination with thetotal-etching method. Examplesinclude Prime & Bond NT(Dentsply), Excite (Ivoclar-Vivadent),and Gluma Comfort Bond (HeraeusKulzer). These products combine thefunctions of a primer and an adhe-sive. The principle of re-wetting corresponds to that of the three-steptotal etching method. Long-term in-vitro studies have revealed that thetwo-step method produces an infe-rior bond with the dentine. This isdue to the fact that the monomercompound remains hydrophilic evenafter it has been cured and hence iscapable of absorbing water from amoist environment. The adhesion tothe tooth enamel is the same as inthe case of multiple-bottle systems.

Two-step self-conditioning bond-ing systems: In this case it is no longer necessary to etch the enamelwith phosphoric acid. Two-step self-

conditioning bonding systems con-tain an enamel and dentine adhesivewhich is separate from the acidicprimer. Examples include AdheSE(Ivoclar Vivadent), Clearfil SE Bond(Kuraray), and One Coat SE Bond(Colténe-Whaledent). Together withtheir three-step total-etching counter-parts, these systems have the advan-tage that the bonding agent is hydro-phobic. As a consequence their dentine adhesion performance is deemed to be excellent. However,there is a lack of clinical data withregard to the stability of the enamelbond in cavities which are subjectedto heavy occlusal stress.

All-in-one adhesives: These so-called “all-in-one“ systems (self-conditioning primer-adhesives) areapplied in a single solution. Examplesinclude Adper Prompt L-Pop (3MEspe), One Up Bond F (Tokoyama),and iBond (Heraeus-Kulze). Theseproducts contain a combination ofhydrophobic/hydrophilic esters andacid esters and perform the functionsof an etching agent, primer and adhe-sive. The dentist can dispense entire-ly with phosphoric acid etching andhence saves time. However, clinicalstudies describe the adhesive perfor-mance of these products as variable.According to the respective manufac-turers, these products are not inten-ded for the adhesive bonding of all-ceramic restorations.

Self-adhesive cements: RelyX-Unicem is an easy-to-use self-adhe-sive cement. As is the case with theall-in-one adhesives, the strength ofthe enamel bond is subject to varia-tion. By contrast, the dentine adhe-sion performance of this product isvery promising. In other words,RelyX-Unicem is suitable for bond-ing all-ceramic crowns, includingthose with a flexural strength of lessthan 200 MPa. In this case dentine

adhesion plays a crucial role.According to initial findings,RelyXUnicem competes effectivelywith other more complicated bond-ing systems.

To sum up: dentists should decideon a case-by-case basisThe three-step total etching methodhas performed very well in long-termclinical studies. It is the recommend-ed method for all-ceramic inlays andonlays. The clinically proven multi-ple-step procedure should be used indifficult cases, especially when theenamel margin is not clearly defined.Simplified bonding systems (inclu-ding all-in-one adhesives) are a con-venient and labour-saving alternativein less demanding applications (e.g.small filling volume, low mechanicalload, low retention requirements, lowaesthetic demands.). However, themultiple-bottle systems have the bestlong-term clinical data. ■

PD Dr. Roland Frankenberger

SETTING A STANDARD. It is 20 years since the launch of CEREC 1, thefirst computer-aided system for preparing all-ceramic inlays. At the timefew scientists or industry experts thought the new technology had afuture.

ADHESIVE BONDING METHODS. Various methods are currently inuse: three step, two-step and all-in-one.

CEREC is grown up

One, two or three

CEREC Club members savemoney and are always up todate.

CEREC 3 is undergoing continu-ous development. In the springwe regularly issue new updatesdesigned to boost efficiency andenhance the user’s job satisfac-tion. For example, we have exten-ded the spectrum of clinical indi-cations, simplified the user inter-face, introduced new tooth data-bases and automated the design

process. However, each of theseupdates costs money. This is whyit’s definitely worth joining theCEREC Silver Club. For a fee of?99.00 (£75.00) per monthmembers are automatically enti-tled to all new software updatesand upgrades, as well as all newtooth databases. One thousanddentists in Europe have alreadyjoined the Silver Club.

The acceptance of new technologies follows a classic S-curve. First of all, the availabletechnology and the initial applications have to come together and learn to negotiatethe market in question. The technology and the applications then mature, the technolo-gy becomes easier to use, and the concept has to demonstrate that it can replace tradi-tional methods. Towards the end of this phase the technology reaches full maturity andcatches on more generally. CEREC is now in this last phase.

CEREC Silver Club

Authorized CEREC dealersi

CEREC Zeitung

CEREC is now recognized as a standard procedure. More than 16,000 CEREC systems arecurrently in use worldwide.

Number of CEREC systems sold

Acceptance of new technologies

20.000

15.000

10.000

5.000

0

1985 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005

CEREC 1

CEREC 2

CEREC 3

CEREC 3D

Maturation phase

Time

Acce

ptan

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Learning phase

The secret of success

Adhesively bonded restorations are permanently joined (“force-locked”) tothe hard tooth substance. As a result tensile forces cannot act on the under-side of the restoration. This prevents cracking. The restoration is significantlymore durable. Preconditions for adhesivebonding are as follows: the etching ofthe tooth enamel; the conditioning of theceramic surface (etching with hydro-fluoric acid followed by silanization); andthe application of a luting composite. Toprevent postoperative problems theexposed dentine must be sealed bymeans of a dentine adhesive. In addition,dentine adhesives also contribute to theoverall stability of the bond.

Char

ts: S

irona

No. 3 December 2005 3

Where does my practice stand?

Dentists have CEREC; dental labshave inLab – i.e. a clinically,

aesthetically and economically convincing method for producingall-ceramic restorations. Launchedin 2001, the inLab system deploysthe same CAD/CAM technology asCEREC and hence embodies twowhole decades of acquired CERECknow-how. Together, the two systems cover a complete spectrumof clinical indications. “It’s in-credible what the small inLab system is capable of,” says Dr.Bregler from Offenburg. In his dualrole as dentist and dental technicianhe is ideally qualified to assess theextent to which inLab has pushedback the frontiers of computerizeddentistry.

3D software delivers extremelyhigh precisionThe software component Frame-Work 3D is intended for the fabrica-tion of crown copings and bridgeframeworks. If high-strength zirco-

nium oxides are used, it is possibleto create bridge frameworks with an anatomical length of up to 40millimetres. WaxUp 3D is the idealchoice for complex restorations(e.g. implant superstructures andstress breaker attachments design-ed to compensate for differinginsertion axes in multi-unitbridges). In this case a conventionalwax model is created, which is then

scanned by the inLab system.Before the milling process com-mences the software checks that therestoration complies with the pre-scribed minimum wall thickness,thus eliminating any potential weakpoints. Unveiled at IDS 2005, theAbutment 3D software componentallows the technician to design cus-tom abutments for the StraumannDental Implant System. After

finalizing the design on the com-puter, the technician logs into theweb portal www.infiniDent.de andorders the abutment from theStrauman CARES production cen-tre.

The right material for everyindicationFor many years Sirona has main-tained a close working relationshipwith two leading material manu-facturers. VITA Zahnfabrik andIvoclar Vivadent supply fine-struc-ture feldspar ceramics as well asinfiltration and oxide ceramics witha higher degree of flexural strengthand fracture resistance. The inLab3D software now includes the MerzDental artegral® tooth database.This means that dental labs canoffer prefabricated anatomicallyshaped resin-based tooth restora-tions. Last but not least, Sirona co-operates with BEGO Medical in thearea of metal alloys. Two differentproducts are available: the high-gold alloy Bio PontoStar++ and thecobalt-chrome alloy Wirobond C+.Frameworks made of these materi-als – as well as their high-strengthceramic counterparts – can be de-signed “in-house” and then orderedfrom the infiniDent productioncentre in Bensheim. At presentinfiniDent is available in Germany,Switzerland and Austria. In thecoming months the service will beextended to France and the USA.On the basis of more than 12 mil-

lion successful restorations, dentists can rely implicitly on theclinical performance of the CERECceramic materials – regardless ofwhether these are processed in thedental practice or in the laboratory.Numerous clinical studies haveconfirmed that crowns and bridgesmade of zirconium oxide – correct-ly fabricated and bonded – are easily on a par with conventional materials in terms of longevity. Theextension of CAD/CAM technologyto dental laboratories has enhancedthe clinical applications spectrumof CEREC, especially with regard tolarge-sized restorations. inLab isthe perfect solution for CERECusers who are under time pressure.And in cases where the highest aesthetic standards have to be met,the dental technician has the optionof applying manual layering tech-niques after the restoration hasbeen milled.

CEREC practices and inLab labora-tories are an unbeatable combina-tion for aesthetic, clinically provenand cost-effective dentistry. Thedentists and the dental technicianapply the same basic technology.This provides the basis for a perfectdivision of labour: the dentist is responsible for chairside restora-tions and assigns more complextasks to the laboratory, secure in theknowledge that he or she will re-ceive tried-and-tested CEREC quali-ty every time.

In pursuit oftotal quality

All-ceramic veneers are un-beatable in terms of function

and form. They offer a permanentand tooth-conserving therapyoption in the case of multiple,defective fillings, malpositionedteeth, fractures, gaps, misshapenteeth and staining (e.g. after theadministration of tetracycline).Veneers can also be used for theintraoral repair of crowns andbridges. The spectrum of indica-tions has expanded in recent yearsand now includes palatinal veneersfor the canines, interlocking restorations following orthodontictreatment and – last but not least –the use of occlusal veneers for biteadjustment in the premolar region.

All-ceramic veneers are popularwith patients, as they allow dentiststo conserve as much of the naturaltooth tissue as possible. A keyadvantage of the CEREC procedureis that treatment can be completedin a single session. There is noneed to fit temporaries. All-ceramicveneers are durable and retain their pristine appearance. Aboveall, they are “gum-friendly”. Gingi-val retraction and discolourationcan be practically ruled out.

All-ceramic veneers are scientifi-cally recognizedClinical studies extending over aperiod of up to 15 years have provedthat all-ceramic veneers are long-lived. The survival rates accordingto Kaplan-Meier are in excess of 90percent. As a result all-ceramicveneers have been officially recog-nized by the German Society ofDental, Oral and Craniomandi-bular Sciences (DGZMK). After 9.5years CEREC chairside veneersmade of feldspar ceramic displayeda survival rate of 93 percent. Theadhesion to natural teeth is betterthan the adhesion of intraoralrepairs to crowns and bridges.(Wiedhahn, Int. J. Comp. Dent.2004).

The milled veneers can be individu-ally characterized in the dentalpractice. It requires relatively littleexperience to create natural andaesthetic results. One particularlyeasy option is to apply compositestains to the rear surface of theveneer. The translucency of theceramic material leads to a natural,deep-seated shading effect. After afew trial runs dentists soon realizethat the secret lies in choosing theright degree of brightness. The so-called “chameleon effect” of thesilicate ceramic material compen-sates for any small differences inthe colour shade.

Large numbers of CEREC usershave included veneers in their stan-dard treatment portfolio. Design-

ing veneers is child’s play, thanksto the three-dimensional visualiza-tion of the preparation and the restoration on the computer moni-tor. In addition, the CEREC soft-ware boasts several user-friendlyfunctions such as a veneer databaseand the mirroring of contralateralteeth. The practical benefits areobvious – and are evident as soonas the patient smiles. If the out-come is convincing, patients willbe more willing to pay more forhigh-quality treatment services –and recommend the dentist to theirfriends and family.

OUTSTANDING AESTHETICS. A perfect smile is the ideal adver-tisement for your dental practice.Harmonious anterior teeth testifyto the dentist’s commitment tototal quality.

www.AG-Keramik.dei www.dgcz.orgi

WIDE-RANGING INDICA-TIONS. Inlays, onlays, veneersand all-ceramic crowns are typicalCEREC applications in the dentalpractice. But CAD/CAM technologyis capable of a lot more besides.With the help of inLab dental tech-nicians are in a position to createcrown copings, bridge frameworks,telescopic crowns and implantabutments in tried-and-testedCEREC quality.

CEREC Zeitung

www.sirona.comi

Veneers – the perfect visiting card

Before: Anterior teeth prior to treatment. The CEREC procedu-re is performed in a single treatment session.

After: The finished product. Harmoniously and aestheticallydesigned all-ceramic veneers.

The dental lab takes care of the more complex restoration assignments – for example,multiple-unit bridges (here: zirconium oxide)

Building bridges with dental labs

Phot

os: S

irona

Phot

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r. Kl

aus W

iedha

hn

It is not always easy for dentists toassess the quality of their treatment

services. Many work on their ownand have no basis for comparison.There is a lack of reliable bench-marks and statistics. In addition, thehealthcare systems in most countriesimpose serious financial constraintsthat run counter to the provision oftop quality services. Against thisbackground the German CeramicDentistry Working Party (“AG-Kera-mik”) has developed a special qualityassurance system for CEREC users –a system that involves only a mini-mum input of time and effort. Eachparticipant selects a group of 30patients and monitors a predetermin-ed set of parameters relating to theinitial restoration as well as its sub-sequent performance. The dentist re-examines the patients at regularintervals and sends the findings toAG-Keramik. This data remainsanonymous. The dentist can easilycompare his results with the averagevalues recorded for his colleagues.In the case of deviations he can deter-mine to what extent his treatmentprocedures differed from those of theother participating dentists and takecorrective action if necessary. Thisservice is already available inGermany, Austria and Switzerlandand will soon be extended to all theother European countries.

No. 3 November 20054

From ivory to CAD/CAM ceramics

Available as an option since 2001, the CEREC method is very popular with JacquesRaynal’s patients. Raynal charges between 200 and 650 euros for a CEREC restoration,depending on complexity.

Phot

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s Ray

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French dentists pioneered the useof natural enamel-coloured

materials for dentures. As early as1723 Pierre Fauchard wrote a stan-dard work on dentistry in two vol-umes entitled “Le chirurgien den-tiste, ou, traité des dents”. Becauseit contained detailed treatmentinstructions, the book was alsotranslated into German and French.Fauchard showed how a mobiledenture made of ivory could be attached to the remaining jaw struc-ture by means of a metal socket.His contemporary Claude Mouton, official dentist to the French King,published his “Essay d’odonto-technie” in 1746. Here he describedthe manufacture of gold crownsand the treatment of root canals. Inaddition he suggested the appli-cation of an artificial enamel coating to the labial surfaces of his metal constructions. EtienneBourdet, another royal dentist,experimented with artificial teethmade from ivory. And in 1790 the

Parisian dentist Nicolas Dubois deChémant enlisted the aid of apo-thecary Alexis Duchateau to firedentures in porcelain. Dentistry hascome a long way from ivory to silicate ceramics: but French den-tists have always been receptive totechnological innovation.

Raynal opts for the CEREC systemJacques Raynal opened his dentalpractice 20 years ago, after gradu-ating from the University ofMontpellier. Over the years heextended his range of treatments to include fissure seals for children,periodontal treatments, endo-dontics and surgical proceduresinvolving implants. From the outsethis main concern was to offer hispatients biologically sound and clinically tested dental care. In 2001Raynal decided to add all-ceramicrestorations to his range of treat-ments. Having compared a numberof different CAD/CAM options, hechose the CEREC system, as it ob-

viates the need for in situ impres-sions and temporary restorations.In recent years he has achieved asuccess rate of 99.4% with the newmethod (taking into account thestart-up phase).

Patients and practitioner alikebenefit from the new method. Today the CEREC procedure is anintegral part of Raynal’s practiceconcept. His patients appreciate theaesthetic benefits and the per-manence and durability of the ceramic work, while Raynal likesthe reduced lab costs. The moneysaved here is used to expand thetechnical facilities of the practiceand allow him to offer additionalmodern treatment methods. Thisis, of course, good news forRaynal’s patients, who are sprea-ding the word fast throughout thelocal region. As a result, the CERECmethod is becoming more popularby the day in the département ofHérault. ■

Perfection, profes-sionalism and speed

Auskunft erteilt: klaus.mustermann@sirona.dei

27/28 January 2006 CEREC Advanced Training Course (with live treatment sessions) |Bensheim | Course conducted in English | Dr. Helmut Götte | Details from: Birgit Moeller,Tel. +49 6251 16 2096, birgit.moeller@sirona.de

17/18 March 2006 20 Year CEREC Anniversary Symposium | Berlin | Conference language English with German translation | More information at: www.20YC.com

8 April 2006 CEREC Veneer Course | London | Course conducted in English | Dr. Alessandro Devigus | Details from: Birgit Moeller, Tel. +49 6251 16 2096, birgit.moeller@sirona.de

One day’s training on the CERECsystem and one day’s training

in the cockpit of a racing car: the Goodwood meeting offeredCEREC-trained dentists in the UKthe perfect blend of work and plea-sure.Two days, one motto: “Perfec-tion, professionalism and speed”.On day 1 the CEREC practitionerslearned about the professionalbonding of inlays and onlays. Formaximum security dentists areadvised to use traditional adhesivesfor this purpose. As the discussionbetween participants and speakersshowed, CEREC practitioners wereall agreed that all-ceramic crownswithout framework can be self-adhesively bonded in place with noclinical risk. And this method alsosaves dentists a lot of time. Anothersection of the program looked at theappeal of CEREC veneers for

patients. CEREC practitioners wereencouraged to tackle the pre-paration of veneers with increasedconfidence: it’s much easier thanone might think! And of coursethey were given lots of helpful hintsand tips, which is exactly whatCEREC dentists want: one smallpointer can make a huge difference, particularly in terms of making thesoftware easier to use. On day 2 the emphasis was on fun and re-creation: time to hit the race track,with a choice of Ferrari, Maserati,Porsche, vintage car or full-blownracing car. Whatever the vehicle,the driving challenge is always thesame – to find that ideal linethrough the bends that gives youthe perfect lap. And it was like the day before: most people discover that they have hiddentalents. ■

CEREC Zeitung

BUILDING CONFIDENCE. Fifty UK dentists who regularly carry outCEREC treatments attended a special refresher course at the old FormulaOne racing circuit at Goodwood.

C O M I N G S O O N

PRACTICE PROFILE. Jacques Raynal, a dentist practising in Lodève, upholds the best traditions of French dentistrywhile also being receptive to modern treatment methods. He has offered CEREC restorations since 2001.