Written by: Holly Bernt, Dental Technology Training, LLC.
Oftentimes, the key to success relies on the most basic fundamentals. The following is a list of five easy ways to ensure a smooth start to your journey with CAD/CAM technology.
1. Practice Until Perfect and Then Keep Practicing
When I train an office, I instruct my students to first practice with a typodont so they can get a feel for the camera or wand.
Once the trainees are comfortable with the typodont, we make things interesting by selecting an unassuming staff member to practice some more.
The number one key to success with CAD/CAM is this: once you feel comfortable with scanning a tooth- practice at least ten more times.
I learned the importance of unrelenting practice from playing in a band. When we first started, we would rehearse a song until we finally performed it perfectly one time through. Once we did that, we figured we had it mastered. It only took one show to realize our mistake. You practice until you’re perfect and then PRACTICE SOME MORE!
Your first show is the first patient you bring into the office for a CAD/CAM restoration. Be ready for them.
2. Garbage in = Garbage out
Use whatever means possible to make sure that you have achieved isolation BEFORE you start scanning. This also means checking to make sure that the margin is visible and that you have achieved proper hemostasis before you scan.
Yes, there will be times when you will need to get creative (i.e. using a cord packer to push the gums of the margin while you acquire the picture), but strive to make it easy on yourself. You will save time (and money) in the long run.
3. Dental Assistant = Crown Designer
It is important that your assistant is adequately trained to scan, design and stain/glaze. I was a dental assistant for eight years before I started training offices. As a dental assistant we are often taught “how” to do things, but it is the “why” we do things that is the most important and often overlooked.
When designing restorations, assistants need to have a very clear understanding of margin, anatomy, contact, bite and contour. Once they are trained to use the machine and understand these principles, you are going to prep your crown and walk out of the room to do “dentist things” until your assistant hands you a finished crown.
This win-win scenario will increase production and build confidence in your assistants as they increase their skillset and have fun while doing so.
4. Follow The Bonding Instructions
I’m more of a cook than a baker. I prefer to use “pinches” of spice in my recipes rather than measure with teaspoons. I also have a tendency to “guesstimate” how long something should be in the oven. This works for me…while cooking. Baking, however, is quite a different story and I liken baking to cementing crowns.
You have to follow the directions religiously. This means waiting fifteen seconds if the instructions say so between etching, air abrading, light curing etc.
Bonding and porcelain materials are all very sensitive to technique and some materials and bonding cements are more sensitive than others.
For example, “Enamic” is a porcelain/resin hybrid block. In my experience the percentage of doctors that love this material compared to those who hate it is almost 50/50. I have a feeling that this might be because some doctors are “cooks” and some are “bakers”. The ones who are bakers do very well with these blocks and the cooks (you know who you are, and that wasn’t 15 seconds it was 5 ha!) get a lot of de-bonds.
That’s because “cook” dentists often invent their own way of bonding crowns that involves mixed up materials and made up times while the “baker” dentist reads the instructions and follows them to a T.
Don’t be disheartened my “cook” dentists! When it comes to prep and crown design you can experiment all you want! But just like with any experiment there is always the chance of it blowing up in your face (figuratively in this case).
Don’t expect all of your restorations to be perfect and done in under an hour, especially in the early going.
Generally, in the first couple weeks you should expect your CAD/CAM appointments to take three hours. This is normal. Don’t give up! You wouldn’t believe how many perfectly good CAD/CAM machines are sitting in a dental office collecting dust because the dentist got frustrated after one week.
CAD/CAM works! It is an amazing piece of technology and the materials are tried and true.
If you can be patient with the process and understand that you and your staff will go through growing pains then I am confident that your practice will be successful with your CAM/CAM unit.
Thank you for reading! I hope this information helps you become a proficient CAD/CAM dentist.
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