Filling of carious teeth, capping or crowning of teeth comes under restorative dentistry. Traditional restorative dentistry requires several visits by the patient, who must endure extensive drilling, the rubbery impression material in his mouth, a fragile temporary restoration, and a two to four week wait for the laboratory to fabricate the crown.
CEREC (Chair side Economical Restoration of Esthetic Ceramics), a computerized dental-restorative system, takes as less as an hour. It allows the dentist to quickly restore damaged teeth with natural-colored ceramic (porcelain) fillings, saving patients time and inconvenience.
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CEREC uses CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) technology, incorporating an intra-oral digital camera, computer and milling machine in one instrument. The dentist uses this special camera to take an accurate picture of the damaged tooth. This optical impression is transferred and displayed on a color computer screen, where the dentist uses CAD technology to design the restoration. Then CAM takes over and automatically creates the restoration while the patient waits. Finally, the dentist bonds the new restoration to the surface of the old tooth.
The whole process takes about one hour.
A tooth-colored restoration means no more silver fillings discoloring smiles; the filling is natural looking, compatible with tissue in the mouth, anti-abrasive and plaque- resistant. Dentists no longer need to create temporaries or take impressions and send them to a lab. Because of this, the traditional second visit has been eliminated. The CEREC has over a decade of clinical research and documentation to support the technology. The restorations have been proven precise, safe and effective.
The patient benefits by saving time and enduring lesser pain, while the dentist benefits as the procedure is simple, precise and completely under operator control. It saves time, reduces lab costs, processed completely by chair side, and is dependable.
Cosmetic dentistry
Computerized cosmetic dentistry gives the dentist and the patient a chance to get a detailed look at the teeth, and view the potential results of dental procedures in advance.
Cosmetic imaging
Cosmetic imaging software allows the dentist to show clients how their teeth would appear as the result of one or more procedures. The dentist takes a picture of the patient's smile with a digital camera, and then customizes the results on the computer screen to lighten, straighten and/or reshape teeth. Patients can customize the smile to their specifications. The process takes about 30 minutes. These software are excellent for patient motivation and more and more dentists are investing in such systems.
Dental radiography
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Panoramic X-Ray
The digital panoramic X-ray unit is more comfortable and convenient for patients than conventional machines. Developed by Siemens, it uses the most advanced low-radiation technology. Because the X-ray shows the mouth seamlessly from all sides, the dentists can actually see 70% more than with multiple single X-rays, allowing them to localize problems with teeth, sinuses and jaws. The process itself is much more comfortable because no film is put in the patient's mouth.
Digital X-Ray (Radiovisuography)
Compared with conventional X-rays, the dose of radiation has been reduced by about 80%. Digital X-rays are viewable in seconds on the computer screen, and allow the dentist to enhance the image for the greatest diagnostic effect. Some systems, like Denoptix, capture information on storage-phosphor imaging plates and use its high-speed scanner to convert the data into electronic files for viewing on a monitor using the VixWin software program. Others like the Schick CDR (Computed Dental Radiography) are computerized imaging systems that utilize an electronic sensor where dentists would normally use film. The sensors produce sharp and clear X-ray images that appear almost instantly on a computer monitor. Acquisition of CDR images uses up to 90% less radiation than conventional film X-rays. In addition, CDR is compatible with virtually all X-ray tubes
Orthodontics
Usually PC-based planning software programs are used for two-dimensional cephalometrical analysis and documentation. These software take normal frontal and profile photographs as well as special X-ray images to enable the cephalometry by
comparing profile values with standard values.
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A 3D CAD system has recently been developed for the diagnostic setup of casts in orthodontic diagnosis and treatment planning, and its preliminary clinical applications. The system comprises a measuring unit, which obtains 3D information from the dental model using laser scanning, and a PC to generate the 3D graphics. When measuring the 3D shape of the model, to minimize blind sectors, the model is scanned from two different directions with the slit-ray laser beam by rotating the mounting angle of the model on the measuring device. For computed simulation of tooth movement, the representative planes, defined by the anatomical reference points, are formed for each individual tooth and are arranged along a guideline descriptive of the individual arch form. Subsequently, the 3D shape is imparted to each of the teeth arranged on the representative plane to form an arrangement of the 3D profile. When necessary, orthognathic surgery can be simulated by moving the mandibular dental arch three-dimensionally to establish the optimum occlusal relationship.
Compared with hand-made setup models, the computed diagnostic cast has advantages such as high-speed processing and quantitative evaluation on the amount of 3D movement of the individual tooth relative to the craniofacial plane.
Trial clinical applications demonstrated that the use of this system facilitated the otherwise complicated and time-consuming mock surgery for treatment planning in orthognathic surgery.
Dental practice management
Several fully-automated 32-bit charting software available now, are powerful and cost effective. They allow the dentist to fully integrate the clinic with most front-office practice management programs. These programs provide effective patient marketing and legal documentation while saving time and money.
Dr Sanjeev Kumar (maxillofacial surgeon) with Dr Susmita Saxena (oral pathologist)