International Journal of Computerized Dentistry, 02/2010

Ceramics have been used in dentistry for many years. Especially during the last few years, the development of ceramic-related technology has steadily increased, and allceramic crowns are in the process of replacing traditional gold restorations on the market. Despite the relatively long experience with the material and technology, there are still only a few clinical studies on the long-term success rates. For this paper, three different ceramic systems (In- Ceram, Empress 2, and Cergo) were examined and results compared with the findings of the existing literature. Furthermore, the clinical follow-up examinations intended to determine the extent to which subgingival restoration margins influence the periodontium. Keywords: all-ceramic, In-Ceram, Empress 2, Cergo, survival rates, periodontal influence

Clinical functional analysis is the first step in the diagnostic cascade in the diagnosis of craniomandibular dysfunction (CMD). This examination comprises palpation of the muscles, auscultation of noises in the temporomandibular joint, registration of jaw mobility as well as the search for dysfunctional contact relations in static and dynamic occlusion. The structured evaluation of these findings enables an initial diagnosis to be made as the basis for further diagnostics and therapy. Because of the complexity of the material, both the referring dentists and the patients expect a meaningful examination report. However, writing it is extremely time-consuming. New software for the semi-automatic generation of such illustrated medical reports has therefore been developed to reduce internal costs and provide quality assurance. The CMD medical report assistant (dentaConcept) imports the examination data and initial diagnoses through a standardized interface from the dentaConcept diagnostic software CMDfact. The CMD medical report assistant assigns matching texts to the findings on the basis of random number generators and combines these findings-dependent texts with illustrations of the most important findings as well as standard texts. The software transfers the multi-page examination report to the standard Microsoft Word for Windows word processing program, saves the data by means of an individualizable file name generator and uses the Word functions for the color printout. Keywords: clinical functional analysis, craniomandibular dysfunction, computer-aided recording of findings, diagnostics computer-aided therapy planning, medical report writing, practice software, random number generator, compatibility

The present clinical study evaluates the clinical prognosis of Cerec®3D endocrowns over an observation period of two years. Twenty Cerec® endocrowns (VITABLOCS® Mark II, Vita Zahnfabirk, Bad Säckingen, Germany) were placed with PanaviaTM F 2.0, a dual-curing bonding composite. The control examinations took place semiannually and the restorations were evaluated based on modified US Public Health Service criteria (USPHS). The two-year survival rate of the Cerec® endocrowns was 90%. Two out of 20 endocrowns were assessed as failure because of fractures. The first fracture was observed after 12 months and the second fracture after 18 months. No recurrent caries was diagnosed during the entire examination period. Slight percussion symptoms were found on three restorations in the first weeks after placement. The results of the present study show that good esthetic and functional results similar to those of other restoration types can be achieved with endocrowns and that CAD/CAM-fabricated crowns represent a very promising treatment alternative for endodontically treated molars. Keywords: CAD/CAM, Cerec system, endocrowns

It is possible for the first time with the computer-aided overpress technique to produce all-ceramic fixed dental prostheses (FDP) largely by CAD/CAM methods. The advantage of the technology is that a workflow is created in which already acquired data are used to the maximum within the Cerec software, and thus the manufacturing depth can be increased. This happens both by production of a crown or FDP framework, and by the additional design of the crown or FDP surface. Also, no joint seam is created between the framework ceramic and the sleeve ceramic by overpressing, since the two different ceramics do not have to be bonded with one another. In addition, subsequent changes can be made to the finished workpiece without having to take any bonding materials into account. Keywords: computer-aided overpress, all-ceramic FDP, overpress technique, pressed ceramics, sandwich technique, CAD/CAM restoration, all-ceramic milled FDP

The software department of the Sirona company has succeeded in providing Biogeneric capabilities in all parts of the program with one of the largest and most comprehensive updates since the introduction of Cerec 3D. The number of changes is so varied that only a short overview can be provided in this article. The individual program changes will be discussed in detail in the next issue of the International Journal of Computerized Dentistry. Thanks to the ubiquitous biogeneric capabilities, none of the dental databases that were still necessary for designing crowns are required any longer. This also applies to the dental database for Merz Artegral teeth, which, however, can be selected in the block selection for the milling preview or for milling on the MC XL.