2017 CEREC Buyers Guide

Truly successful decision-making relies on a balance between deliberate and instinctive thinking.

-Malcolm Gladwell


Happy New Year from CAD/CAM HERO! The start of a new journey around the sun is a great time to reflect on the past year and set goals for the one ahead. If one of your goals this year is to add CEREC dentistry to your practice, then you’ve come to the right place. This blog post aims to provide up-to-date market information to help readers with making a CEREC purchase in 2017.

Scanners

Let’s start with scanning systems. Sirona currently sells two versions of their CEREC Acquisition Centers: Bluecam and Omnicam. You can view a comparison of the Bluecam and Omnicam below:

bluecam-vs-omnicam

What’s the functional difference between a new Bluecam AC and a used Bluecam AC?

At best, the computer hardware offers superior performance, but it’s definitely not a given. Sirona stopped making new hardware configurations for the Bluecam ACs in 2012. So any new Bluecams sold today are really no better than those sold five years ago. Considering there are many used Bluecam options available for under $10,000, purchasing a new Bluecam is akin to donating an assistant’s annual salary to a $13.3 billion dollar company. Needless to say, that would be an inexplicable waste of money.

What’s the functional difference between a new Omnicam AC and a used Omnicam AC?

Not much. As is the case with Bluecams, the only difference in technology between the Omnicams over the years are minor computer hardware updates (processor and/or graphics cards). These updates produce minimal performance enhancements that most likely go unnoticed by the casual user. However, unlike with Bluecams, there is a major shortage of used Omnicams available in the secondary marketplace. This is because 99% of used Omnicam ACs are being sold in combination with a milling unit and oven. Any solo Omnicam AC that hits the market is usually snatched up within a matter of days. Unless a new scanner is released by Dentsply Sirona in 2017, I do not anticipate this market condition to change anytime soon. If you do happen to find an Omnicam for sale outside of a package deal, expect to pay an asking price in the $40s.

How old is too old when it comes to CEREC ACs?

This question mainly applies to Bluecams, because no Omnicams are “too old”. I want to start off by saying that ALL CEREC ACs (even older Bluecams) can run the latest CEREC software without issue. This is because the Bluecam camera is less taxing on the computer system than the Omnicam camera, thus it can make do with older components. However, if you feel the need for speed you can soup up any Bluecam with a few easily installed upgrades at a cost of around $500. I recommend you add an MSI GeForce GTX 650 Ti graphics card, a solid state drive, and additional RAM.

Which CEREC software versions or licenses should I look for?

The last chargeable update that required a new license to use is version 4.4– released in September 2015. The latest service pack update is 4.4.4, which was released in October 2016. The service packs can be downloaded from Sirona for free. If you are considering an AC that needs to be updated to 4.4, the only pre-requisite license required is 4.0. In other words, as long as you have the 4.0 base license you can skip 4.2 and 4.3 on your way to 4.4. It’s not necessary to have all four licenses to upgrade.

Other licenses you should be aware of include:

Connect 4.0: allows you to use Sirona’s Connect 4.x software versions so you can send cases to approved labs for fabrication. You can download this software for free here.

inLab Stack 4.0: follow the jump for a full description here.

Ortho SW 1.0: allows you to create digital models in CEREC Ortho software for Invisalign treatment. This software only works with Omnicams.

Open GALILEOS Implant: allows you to use Sirona’s implant planning software in conjunction with a Sirona 3D x-ray to make CEREC or SICAT surgical guides.

CEREC 4.3 SW: released July 2014. Prerequisite for CEREC Guide 2. Full software description available here.

CEREC 4.2 SW: released June 2013. Expands design options to include: customized implant abutments, smile design (use a patient photo to virtually place a restoration to see how the patient looks), and a virtual articulator to simulate the patient’s jaw movements so the user can find the static and dynamic contact points.

CEREC 4.0 SW: released August 2011. Prerequisite for CEREC Guide 1. Modern era software that introduced an intuitive user interface, self-explanatory icons, and photorealistic images.

CEREC 3.8 SW: released August 2010. This is older gen software mainly geared towards CEREC 3 users. If you are considering a CEREC AC with 3.8 SW, factor in the cost to upgrade immediately using 4.x software/licenses sold on eBay.

What other factors should I consider when purchasing a used AC?

  • The prismatic lens sleeve is a consumable part that can be expensive to replace. Check for a clear lens that does not interfere with acquisition quality.
  • Be sure to ask if the seller has the camera calibration kit to include with the sale.
  • Hardware upgrades are nice, but if the upgrade was not performed by a Patterson technician then any remaining factory warranty is void.

Milling Units

Sirona currently offers a range of milling options in an effort to cater to different needs and price points:

CEREC MC- offers indications similar to the old classic milling units. This mill is designed for practices who focus on single-tooth inlays, onlays, crowns, and veneers. It is capable of working with blocks up to 20 mm in size.

CEREC MC X- this mill occupies the role held by the MC XL milling unit up until 2013. It offers a full range of chairside indications and builds upon the MC’s capabilities by also fabricating bridges, abutments, surgical guides and blocks up to 40 mm.

CEREC MC XL Practice Lab- formerly known as the MC XL Premium Package. This mill is easily identifiable by its 4-motor milling chamber and is made for the dental practice with an onsite lab. In addition to the indications of the MC X, it can fabricate bridge frameworks, customized implant abutments, surgical guides, telescopes, bars, attachments and blocks up to 85 mm.

What’s the functional difference between a used milling unit and a new milling unit?

Sirona has made both branding and functional changes to their milling unit portfolio over the past few years.. This has created a lot of confusion among prospective CEREC owners as they attempt to compare used mills with the latest offerings. For example, the MC XL is now called the MC X, and the MC XL Premium is now known as the MC XL Practice Lab. Marketing strategies  aside, the bottom line is that used milling units have 90% of the functionality that new milling units have. The one specific capability that sets the new milling units apart is the ability to dry mill. In March 2016, Sirona equipped their latest line of mills with new precision tools and a device to vacuum up mill shavings. The resulting achievement was a dry carbide milling option in addition to the traditional wet grinding functionality. This dry mill capability along with Sirona’s new SpeedFire sintering furnace are the backbone of Sirona’s Chairside Zirconia workflow.

Can you wet mill zirconia blocks with older milling units?

Yes. Beginning in 2013, Sirona milling units came standard with carbide bur compatible motors and offered to upgrade older mills for existing users as well. Any milling unit with a serial number higher than the following will have a carbide bur compatible motor:

129001 (MC XL)

302001 (MC XL Practice Lab)

231001 (MC X)

202001 (MC)

In addition to the motor you will need a manual block chuck, carbide and zirconia burs (Shaper 25rz, Shaper 25, Finisher 10), and a sintering oven to finish the restoration.

Administrative

How does Patterson handle the transfer of ownership among CEREC users?

Your Patterson rep might give you the silent treatment for a little while until they get over the loss of their commission, but most of our customers report seamless ownership transfers. There is a one page form called the Notice of Change in Practice Ownership (the title is kind of misleading) that is completed by both the buyer and the seller. The form is then submitted by the seller to their local Patterson branch for processing. There is no fee to transfer ownership of a CEREC.

Will I be able to get service and support from Patterson/Sirona if I buy used versus new?

Yes. Sirona has a contract with its distributors that stipulates they must service and support all systems originally sold within their distribution territories. If the CEREC was originally sold by Patterson in the USA, then they are required to support that system whether you were the original purchaser or not. This is not to say that all CERECs you’ll find in the secondary market are eligible for service and support. Some US users will import CERECs from Europe because they cost much less there than in the states. In that case, you would probably get virtual support from Sirona Germany directly, but likely very little help from Patterson. It is important to get the serial numbers of the units you are considering before making a purchase and running them by the CEREC specialists at the Patterson Technology Center. If you come across any unit that does not have a serial number, then you’d be on your own if that machine ever went down.

How long does Sirona warranty a CEREC system and is it transferable to a new owner?

Sirona provides a 7-year warranty from the original date of installation if the machines are enrolled in the service club. You can enroll in the service club at any time and enjoy the remainder of the warranty, even if the original owner was not a service club member.

How much does the service club cost to join?

Doctor to doctor transfers are free of charge. That means if you purchase a used CEREC that was not active on the service club, and decide to sign up, you can do so without paying a penalty. There is a “joiners fee” (up to $2,000) for original owners who forego the service club and decide to join at a later date (like when their machine goes down or they want a free software upgrade). The monthly service club fee is $299 + tax.

Conclusion

Thank you for reading. What questions do you have? Please e-mail them to thecadcamhero@gmail.com so we can build upon this post!


If you would like expert and effective help with purchasing or selling a used CEREC system, call the used CEREC experts at (844) 385-4376.

Ready to sell your CEREC?

Learn from the mistakes of others. You can never live long enough to make them all yourself.

– Groucho Marx

In business and in life, paying for the experience of others is often money well spent. If you are reading this blog because you want to sell your CEREC, you’re in luck. I am sharing my experience for free! In this blog, I provide a summary of options for selling your CEREC system.

Option 1: Sell it Yourself (a.k.a. the hard way)

There are no shortage of options when it comes to selling things on the Internet, but when it comes to selling CERECs, eBay has no equal. I have tried everything from Facebook, Adwords, DentalTown, DotMed, Craigslist and various other used dental equipment sites. None of them offer the worldwide platform, payment systems, listing capabilities or general all-in-one sales solution that eBay provides. Now, this is not to say that selling your CEREC on eBay is easy. In fact, it is very difficult, but that’s not the result of a deficiency with eBay, but rather with the seller. Let me explain.

If you are not a regular eBay user, you will be challenged with zero to little positive feedback and/or a low rating. You haven’t necessarily done anything wrong, but in the eyes of shoppers you are a high risk seller. That feedback rating is like your credit score; and nobody wants to give money to people with low credit scores. Even if you are a regular eBay user and may have great feedback ratings, chances are it is as a consumer, not a seller. Most buyers don’t care if you paid for that vintage action figure in a timely manner. They want to know what you have sold lately. How many items have you sold? What are the value of those items? Basically, buyers want to know if they can trust you with a big ticket purchase. In most cases, a CEREC machine will be far and away the most expensive thing you have for sale, if not the only thing. With the number of eBay scams involving CERECs going around these days, low feedback and a meager sales history is enough to put you at a serious disadvantage right out of the gate. Poor or scant seller feedback affect buyer confidence, which goes hand in hand with price. This is because peace of mind is a commodity in and of itself. As a result, most individual CEREC sales on eBay are undervalued.

Perform a search for the same type of CEREC you have to sell on eBay and filter the results to show “Sold Listings” only. You will find that most of the listings populated by the search were sold by dental equipment companies. If you are able to locate an item from an individual seller, I am confident you will find the sales price to be noticeably lower than its peers. With so many options available from established businesses with a solid track record of sales, many buyers don’t seem to be interested in taking their chances with an individual seller.

But for the sake of argument, let’s say that you create a visually appealing, thorough and compelling listing. You develop a solid rapport with a buyer through the messaging system and made them an attractive offer, which was accepted. Woohoo! You did it!

Well, hold on there just a minute partner- now you’ve found out that eBay charged you a $750 final value fee, PayPal took an uncapped 3.9% off the top, and 100% of the funds have been placed on hold for 21 days, pending your ability to provide proof of delivery. Now what? The CEREC system is too large and heavy for USPS, UPS or FedEx. So how do you pack it? Who do you ship it with? What’s the freight class? What on earth is an NMFC code? How much does this weigh? Do you need a liftgate? What’s considered Limited Access? How do you fill out a Shippers Letter of Instruction? How much does it cost? This is the part where experience, earned or bought, pays dividends.

Aside from the riddle that is CEREC shipping, there are common frustrations that both professional and amateur eBay sellers must deal with from time to time, including disputes with a buyer. Amateur CEREC sellers are more prone to disputes because they have a tendency to be light on the details in the item or condition description fields. Buyers typically shy away from listings that are lean on the details anyway, but if someone does purchase the system and you were a little careless with describing your item, then you have almost guaranteed yourself a problem down the road. Buyers have up to 30 days after delivery to open a case or request a refund under eBay’s Buyer Protection Policy, in spite of your claims of “no returns” or “sold as-is”. After a case has been opened, PayPal will freeze your funds (again) and give you and the buyer 3 business days to come to a solution. If you can’t, eBay will step in and force a solution upon you, which is usually not seller friendly. In situations like these, the effort you put into the listing on the front-end could be your saving grace.

To sum up the do-it-yourself option: this offers perhaps the largest potential return, but comes at the considerable expense of time, effort and risk.

2. Wholesale it to a Used Dental Equipment Company (a.k.a. the easy way)

This strategy is perhaps the fastest way to get rid of your CEREC, but it comes at a price. The dental equipment business is a high overhead business. Maintaining an inventory requires a sizable investment, so businesses have to be selective. This is especially true when dealing with CEREC. Most used dental equipment companies won’t touch the technology. A select few will, but only if the price is really attractive. Essentially, if there’s no chance they’ll hit a home run, they won’t bother swinging. Most times, a cash offer will be 50-60% or less of the resale value of the equipment. For most sellers who’ve paid $100k+ for their CEREC, selling at wholesale prices isn’t going be an appealing option. However, if you are in a situation where you have relatively little invested into the product or money is tight, sometimes speed is more valuable than return.

There are three companies known to purchase used CERECs with cash: CAD/CAM HERO (Texas), Atlas Resell (Idaho) and 4 Star Dental Equipment (Florida). I’d suggest contacting all three to compare offers, terms, the process, etc.

In summary, wholesaling to a used dental equipment company is recommended for anyone with minimal investment into the machine or those that require fast cash as a matter of preference or need.

3. Consignment (a.k.a. working smarter not harder)

The simple definition of consignment is the agreement to pay the supplier of goods after the goods are sold. It is a very appealing option for those with high value systems or for anyone who would prefer to let someone else do the heavy lifting in exchange for a slice of the pie. The following companies will sell your CEREC on consignment:

Atlas Resell Management (atlasresell.com)

O3 Asset Management Group (o3amg.com)

Global Imaging Resources (globalimagingresources.com)

And of course, there’s CAD/CAM HERO. We are extremely confident that we offer the most seller-friendly consignment program available (that’s why we just supplied you with links to our competitors).

Some highlights include:

  • A no cost, in-person inspection.
  • A no strings attached “handshake agreement” until your CEREC is sold.
  • A return visit by a CAD/CAM HERO representative to pack and ship the system.
  • Up front payment (some deals may involve alternative arrangements, but you will know beforehand and have the option to decline).
  • Industry low consignment fees of 10-15%.

In Conclusion

For the do-it-yourselfers out there, eBay is your best bet. Although eBay and PayPal fees will take a good chunk of change out of the deal ($1,420 on a $30,000 deal) and they will probably hold onto the money for a few weeks, it will still offer the highest potential return in exchange for considerable effort. Wholesaling your CEREC for cash is going to be the fastest and most convenient way to liquidate the asset, but you’ll also be giving up on 50% or more of the value. Consignment will be the preferred strategy for those with high-value equipment or who don’t have the time or will to do it all by themselves. No matter which way you go, CAD/CAM HERO is available to provide you with honest feedback and guidance to assist you with making the right decision for you.

Thank you for reading.


For prompt, professional and effective help with selling your CEREC system, call the CAD/CAM HERO at (844) DTL-HERO.

 

5 Tips for CAD/CAM Beginners

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).

5. Patience

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.

Please send your questions or requests for training to dentaltechtrainer@gmail.com.

Read This Before Buying a Used CEREC

Keep your eyes open and your feet moving forward. You’ll find what you need.

– Anonymous

Why You Should Read This

In my previous blog, I covered the reasons why anyone thinking about incorporating CEREC into their practice should strongly consider buying used. This post will guide you through the used CEREC marketplace and, much like a lighthouse, help you avoid the hazards.

The “B-word”

Before anything else, you want to establish a budget. I’ve often heard from consumers that they do not have a budget, which of course was not true. If you don’t have a budget, then that really means money is no object. If money is no object, then why would you buy used? Everybody has a budget- large or small. The customers “without” a budget typically haven’t put enough thought into the process and were not prepared to buy. I know the word budget often has a bad connotation in today’s spendthrift consumer age, but it is a positive step towards preparing yourself mentally to pull the trigger should an acceptable deal come along. If you establish your budget and later discover that it doesn’t quite get you what you want- rethink your budget or your expectations, but do not lowball!  I’ve never met a seller who responded well to a low-ball offer and it will significantly reduce the probability of a successful negotiation. The presence of a solid budget will help your credibility with the seller and in turn they will be more willing to work with you on getting a deal done.  If you’ve thoughtfully crafted an offer and the seller is still offended, perhaps they are simply struggling to accept the expensive reality of CEREC depreciation. I promise you, sooner or later they will come to that realization, but in the meantime keep looking.

Which CEREC is Right for You?

After you have determined how much you can afford to spend, you’ll need to identify the CEREC generation that fits within your budget and weigh it against your wants/needs. As a helpful guide, I have compiled a recent history of CEREC transactions on eBay to help produce a general price range of each unit individually or as a package:

  1. CEREC 3 with Redcam & Compact milling unit: $2,000-$7,500
  2. CEREC AC with Bluecam & Compact milling unit: $12,000-$20,000
  3. CEREC AC with Bluecam & MC XL milling unit: $25,000-$50,000
  4. CEREC AC with Omnicam & MC XL: $65,000-$120,000
  5. CEREC 3 with Redcam: $500-$2,500
  6. CEREC AC with Bluecam: $5,000-$15,000
  7. CEREC AC with Omnicam : $40,000-$50,000
  8. CEREC Compact milling unit: $1,500-$5,000
  9. CEREC MC XL: $15,000-$40,000

If you are new to CEREC, you may have little idea which generation suits your needs best. While I could replicate comparison charts and Internet research to cover that topic in depth, my intention is to write a blog post, not a novella. At the same time, I don’t want to leave you empty-handed so I will outline some basic considerations:

Milling Units

  • A chairside Compact mill, also known as a Classic milling unit, was unveiled in 2000 along with the CEREC 3 Redcam. This mill is limited to single unit restorations (inlays, onlays, crown and veneers) and can mill a crown in about 17-24 minutes.
  • In 2007, Sirona rolled out the MC XL, appropriately named as it was 37% larger and 54% heavier than the Compact. In addition to inlays, onlays, crowns and veneers, you can mill bridges, abutments and drilling guides. The milling process is also faster: the MC XL can mill a crown in approximately 11 minutes. I would suggest reading the MC XL and Compact milling unit bur charts for additional information on bur and block combinations organized by software version.
  • Recently, Sirona split up their milling unit offering into 2 models: MC X and MC XL Premium. The MC X takes the place of the earlier versions of the MC XL. The MC XL Premium comes with a touch screen, four motors and fulfills the complete chairside and labside spectrum using all CAD/CAM materials.

My suggestion: if you can find and afford a used MC X or MC XL with less than 750 mills, it’s well worth the investment!

Acquisition Units

  • The  CEREC 3 Redcam acquisition unit was introduced in 2000 and utilizes infrared light to acquire images. It has 8 MB of image acquisition memory and can process an image in 0.133 seconds. This system uses individual images to create a 3D model.
  • The CEREC AC Bluecam acquisition unit made its debut in 2009 and utilizes blue LED light to acquire images. At 16 MB, it has twice the image acquisition memory of the Redcam and can process an image almost twice as fast at a blistering .070 seconds. While this system also uses individual images to create a 3D model, the Bluecam performs the “click” automatically. Both the Redcam and Bluecam require the use of white contrast powder.
  • The latest and greatest scanner is the Omnicam, which launched in 2012. The Omnicam allows for continuous capturing of 3D color scans. This “color streaming” results in a natural color 3D model without the need for contrast powder.

My suggestion: the Omnicam is certainly tempting, but way too new and thus is still in its peak depreciating years. If you remove the “cool factor” out of the decision and just think in terms of value per dollar invested, the clear choice is the Bluecam. Sirona also still thinks highly of Bluecam- stating they continue to sell ACs with Bluecam because it “continues to be an outstanding camera, delivering highly precise restorations in a reliable manner.” (sirona.com)

The 4 Pillars of Used CERECs

Now that you’ve decided how much you can afford and what type of system you need (or want),  you will need to know some critical evaluation criteria to help you sort through the playing field.

Pillar 1: Model Year

The first thing you want to know about every unit is its year of manufacture. Some dentists will tell you the year they purchased the unit, but that’s not good enough. While auto manufacturers and their dealers will sell you 2016 model year cars in 2015, it appears Sirona and Patterson will sometimes do the opposite: sell you 2009 equipment in 2010 for example. I’ve come across this issue often and it’s important to ask the seller for a picture of the serial sticker on the back of each unit to be sure. This is especially important when evaluating mills. There are hundreds of moving parts on a CEREC mill and those parts deteriorate over time. Seals and hoses dry up, pumps go bad, gearboxes wear down, circuits blow, spindle motors breakdown…the list goes on. Just like with a vehicle, you will want to take both the age and “milleage” into consideration as they are the primary determinants of its resale value. Look for milling units with less than 750 mills.

Tip: check for signs of leaking fluid on an older compact mill by inspecting or asking for a picture of the front panel pulled down. If you see an oily brown substance along the edges or behind the face plate there’s a good chance the hoses and gaskets are leaking. Stay away as this is not a cheap fix!

Pillar 2: Hardware

The model year is also important when evaluating acquisition units because that will give you a good indication of its hardware performance, but there is always a chance it could have been upgraded. There is a two letter code on the back of CEREC 3 Redcams and CEREC AC Bluecams on the PC frame. The higher the letter combination, the newer and more capable the motherbard, CPU, graphics card and memory will be. This is the easiest method of find out if the acquisition unit has been upgraded or not. For your convenience, I have cross-referenced some Bluecam hardware specs with their PC Hardware Series:

LQ (2012): MSI X58 Pro motherboard, MSI N450GTS graphics card, Intel Core i7 CPU 950 @ 3.07 GHz, 6 GB RAM

LP (2011): MSI X58 Pro motherboard, MSI N250GTS Twin Frozr graphics card, Intel Core i7 CPU 920 @ 2.67 GHz, 6 GB RAM

LA (2010): MSI X58 Pro motherboard, MSI N250GTS graphics card, Intel Core i7 CPU 920 @ 2.67 GHz, 6 GB RAM

KA (2009): MSI P45 Neo3 motherboard, MSI N9800GT graphics card, Intel Core 2 Quad Q9400 CPU @ 2.66GHz, 4 GB RAM

HQ (2008): MSI P35 Neo3 motherboard, MSI NX8800GT graphics card, Intel Core 2 Quad Q6600 CPU @ 2.4 GHz, 4 GB RAM

The Omnicam uses a number-based system; here is what I found on its hardware:

v2.2.1 (2012): 2 graphics cards- NVIDIA GeForce GTX 550 Ti & NVIDIA GeForce GTX 570, Intel i7 CPU 3930K CPU @ 3.2 GHz, 16 GB RAM

v2.2.3 (2013): 2 graphics cards- NVIDIA GeForce GTX 650 Ti & NVIDIA GeForce GTX 660 Ti, Intel i7 3930K CPU @ 3.2 GHz, 16 GB RAM

v2.2.4 (2014): 2 graphics cards- NVIDIA GeForce GTX 650 Ti & NVIDIA GeForce GTX 660 Ti, Intel i7 3930K CPU @ 3.2 GHz, 16 GB RAM

v2.2.5 (2014): 2 graphics cards- NVIDIA GeForce GTX 650 Ti & NVIDIA GeForce GTX 760, Intel i7 3930K CPU @ 3.2 GHz, 16 GB RAM

v2.2.6 (2015): 2 graphics cards- NVIDIA GeForce GTX 650 Ti & NVIDIA GeForce GTX 760, Intel i7 4930K CPU @ 3.4 GHz, 16 GB RAM

v2.2.7 (2015): AMD R9 285 Graphics Card, Intel i7 4930K CPU @ 3.4 GHz, 16 GB RAM

v.3.2.1 (2015-2017): AMD R9 285 Graphics Card, Intel i7 5820K CPU @ 3.3 GHz, 16 GB RAM

v.3.2.2 (2017-2018): AMD RX 470 Graphics Card, Intel i7 5820K CPU @ 3.3 GHz, 16 GB 2133 MHz DDR4 RAM, 2 TB SSHD

v.4.2.1 (2019): AMD RX 570 Graphics Card, Intel i7 7800X CPU @ 3.5 GHz, 16 GB 2133 MHz DDR4 RAM, 2 TB SSHD

Pillar 3: Number of Mills

Without a doubt, the most critical piece of information when evaluating any CEREC system is its number of mills. The number of mills on a compact milling unit is expressed in “minutes”. To determine the general number of mills on a compact, we divide the number of minutes by 24- the maximum amount of time it takes to mill a single unit. Like I mentioned before, you should ideally try to stay under 750 mills. When looking at the Milling Info screen, be sure to pay attention to the serial number shown in the top bar to make sure it matches the serial number on the back of the unit. If the numbers do not match, this means the board inside the milling unit has been swapped out and the milling time does not accurately reflect that machine’s actual use. Also, be aware that part of the 30,000 minute service involves resetting the minute count. If you see a mill with a low minute count, but the unit shows some obvious signs of heavy use – i.e. the bur shanks are pushed up against the gearbox – then the timer has likely been reset.

The number of mills on an  MC XL is more clear cut. After accessing the Machine Data Type screen, you will see a Unit Counter value. What you see is what you get, no math required. With both the compact and MC XL, you are sure to get several thousand mills out of the machine with regular maintenance.

Pillar 4: Software Version

This is perhaps the least important criteria when evaluating a CEREC system because it is the easiest to change, but there are several key things you should know. The CEREC 3 Redcam is compatible with XP or Vista operating systems only. Starting with CEREC 4.0 and later, this software requires a Windows 7 64-bit operating system. So that means 4.0 SW and above will not work with your Redcam. Most CEREC AC Bluecams and Omnicams come pre-loaded with Windows 7 64-bit Pro operating systems from the factory, but it doesn’t hurt to double check anyway. CEREC 3D 3.8 Biogeneric software will run on Windows XP, Windows Vista and Windows 7 operating systems either in 32 or 64-bit. This software does not require the use of a dongle and is obviously platform flexible. CEREC 4.0 and above on the other hand require a USB stick with an activated license key that can be moved from AC to AC as needed. It is important to note that when it comes to any of the 4.x software versions you cannot go backwards. For example, if you installed 4.3 and want to go back to 4.2 or 4.0, you will unfortunately have to perform a clean install of your operating system in order to do so. Fortunately, this problem does not apply to the 3.x software versions so you can still use 3.8 and any 4.x software on the same machine. Various software versions, license keys and vouchers are usually readily available on eBay.

Happy Hunting

Look in the mirror, you are now a master used CEREC shopper. Armed with these four pillars of CEREC knowledge, you are well on your way out of the bottom 93% of non-CEREC using dentists while also saving beaucoup cash! If you need help along the way, don’t be afraid to reach out to me through the contact page or call (844) DTL-HERO. Good luck!

Considering CEREC? Why You Should Buy Used

I had always hoped that the acquisition costs for CEREC hardware and software could come down, so that CEREC would become a more easily affordable standard equipment for every young dentist. So far, this has not happened, much to my disappointment.

– Dr. Werner Mörmann (inventor of CEREC)

Welcome

I’m happy you found your way to CADCAMHERO.com and my inaugural blog post! My name is Jhuri Lamica, I’ll be your CAD/CAM HERO- hopefully until 2052 or so. I look forward to sharing this journey with you as we navigate the past, present and future of the used CEREC marketplace. I anticipate filling these virtual pages with advice, guidelines, how-tos and market analysis in my quest to create the world’s premier used CEREC  resource. Before this current endeavor, I served as Vice President of what was heretofore the world’s only used CEREC specialty dealer. For more on my background, I invite you to read my About Me page. Without further ado, let’s get to the feature presentation.

The Numbers

Out of more than 40,000 CEREC systems sold throughout the world, 14,000 are in the hands of American dentists. These individuals are part of an elite group that make up less than 7% of the active U.S. dentist population. With a current retail price that would rival the average mortgage debt in America, it is not difficult to understand why so few dentists employ new CERECs in their practices- they can’t afford it! What’s curious is that 14,000 dentists allegedly can…or can they?

Dr. Martin Abel wrote that the average annual revenue generated by a general practice is $525,000 with $350,000 in overhead (not including the dentist’s salary). These figures corroborate data reported by U.S. News & World Report stating that an American dentist earned an average annual income of $164,570 (almost precisely the total of all payments on a financed CEREC by the way). One must also consider that the average dental student graduates with $241,097 in student loan debt and can expect to spend around $500,000 to start their own practice. Dr. Michael Schuster opined in a piece titled, “Tied to the chair,” that today’s dentist will be saddled with student loan and start-up debt until age 45 or older. So after spending 8-12 years going to school to obtain the necessary degrees and licensure, young dentists can expect to spend the next 15-20 years working to pay their creditors instead of building wealth. It is no surprise then that Dr. Schuster concludes his article by stating 90 percent of all dentists will still be “tied to the chair” by age 50-60 after having generated little wealth relative to their annual incomes.

After reading this, it’s hard to imagine any  dentist jumping at the opportunity to take on more debt in the name of CEREC, let alone 14,000; yet they do in droves and some will even re-up with the latest releases in the technology before they’ve had a chance to pay off their current system. I suspect the condition of “Doctoritis” has infected some within the CEREC ranks; this is known as the “inflammation of a doctor’s ego which leads to overspending, poor financial decisions, and ultimately, wealth destruction.” I’ve personally heard dentists refer to the Omnicam as a fun new “toy”, themselves as a “techie” and act like ordering their new CEREC is the equivalent of Christmas coming early. Well, you know what they say about Christmas: “‘Tis the season when you buy this year’s gifts with next year’s money”.

An investment in CEREC should be viewed for what it is: a significant capital expenditure on a strategic business asset in which return on investment and benefit to the patient, not emotion, are the motivating factors. CEREC has clearly demonstrated its benefit to the patient through the convenience of a single visit and aesthetically pleasing, yet durable restorations. But can the cost be justified? Is there a happy medium? How can millennial dentists mired in debt and established dentists who refused to bet the farm provide the benefit of CEREC technology without going broke? The answer to these questions is simple- buy used.

Benefits of Buying Used

Have you ever heard the statistic that your car loses at least 10% of its value the moment you drive it off the lot? It doesn’t stop there- your vehicle is only worth about 37% of its original price tag after five years.  How is this relevant? Both cars and CERECs share the unfortunate distinction of being depreciating assets; in fact, CERECs tend to lose their resale value faster and more dramatically than cars. That 2010 Bluecam and MC XL duo that sold for more than $120,000 (pre-tax) five years ago is worth about $40,000 on the used market if it was used less than 10 times per month. Does it have a factory warranty? No. Can you get service and/or join the service club? If it’s a US model unit that didn’t leak out into the market from a trade-in program and you have a Change in Ownership form, yes. Will it have scuff marks, scratches or other minor cosmetic imperfections? Probably. Is it riskier than buying a new unit from Patterson? Well, if you do your due diligence by calling Sirona with the serial number to find out where it came from and its serviceability, vet the seller to make sure it’s not some Turkish Internet scam and ask all the right questions to eliminate any surprises, I’d say it’s less risky than personally guaranteeing a $145,000 loan.

As is the case with taking on debt to purchase any depreciating asset, you run the risk of losing the benefit of the item, but keeping the debt. New cars get totaled, new CERECs sometimes go unused and then abandoned in the storage closet. Don’t believe me? Just thumb through the dentaltown classifieds or look on eBay. Those same dentists who expected to perform 35-50 restorations a month often did less than that on an annual basis. I’ll list just a few of the reasons I’ve heard a dentist say they want to sell their lightly used CEREC:

1. I’m too busy.

2. My assistant who knew how to use it left (for more money elsewhere).

3. My associate who used it left.

4. I couldn’t find a place for it in my practice.

5. I couldn’t get the results I wanted.

6. I can’t keep up with the changes.

7. The practice I purchased came with a CEREC and I have no use for it (read: I want to pay down my mountain of debt!).

Just like when you buy that cute (and expensive) Teacup Poodle at the pet shop and promise to love and care for it forever and ever. Someday when the cuteness effects wear off, the frustration from its refusal to potty train, constant barking and tearing up your expensive furniture and favorite shoes gets to you; then the next thing you know you find yourself at the SPCA giving it up for adoption because you’ve finally decided it wasn’t worth keeping anymore. It’s sad, but it happens. If you haven’t noticed, all 7 of those examples represent a lack of personal commitment to being a CEREC user. That’s okay. It’s not for everybody; but until you are 110% sure that you will own and use the heck out of that CEREC for at least 10 years, do yourself (and your wallet) a favor and buy a used system instead. That way, if it doesn’t work out after a few months, a year or even a few years, you can resell the system and recoup most of your money back once it’s past its peak depreciating years.

To Trade or Not to Trade?

If you think the effects of depreciation are offset by trading up to a new system at every upgrade opportunity utilizing Sirona’s ludicrous trade-up programs- think again. For the uninitiated, these trade-up programs offer three to four times market value in trade-up credit for your old equipment as part of their effort to push new CEREC sales. First of all, you probably paid  $54,000 for your Bluecam acquisition system and now Sirona says they only want another $40,000 from you to upgrade to an Omnicam. You are not saving $25,000 on an Omnicam, you lost $29,000 in depreciation on your Bluecam and rather than licking your wounds you are coming back for more! If you want to save $25,000 on an Omnicam, go on eBay and buy a 2013 Omnicam for $40,000, then sell your Bluecam for $10,000. Five minutes of research on Sirona and Patterson’s investor relations pages will reveal just how important these trade-up programs are to their financial success; translation: they make more money when you trade, not less.

If you’ve ever wondered why there aren’t more used CERECs for sale, it’s because Sirona acquires thousands of 5-10 year old systems every year (many of them still working) through these trade-in programs and ship them to companies to be scrapped. Wait…what!? You read that right, rather than sell these old units that were sold for $100,000-$130,000 once upon a time to the remaining 98% of the world whom can’t afford new CERECs, Sirona throws them in the recycling heap never to be seen again. You see, keeping used CERECs off the street is critical to Sirona and Patterson’s business model: to make sure you’re using the latest and most expensive CEREC system possible and forever making payments to Patterson Financial Services, all the while promoting the elitist culture of CEREC and hiding their product’s horrendous depreciation rates. Despite those efforts, there are still many quality used CEREC systems available from dentists jumping ship and moving on from CEREC entirely- most in good working condition; many with less than 500 mills; and even some with warranty remaining.

What about the tax benefits of buying new?

In previous years, the maximum Section 179 expense deduction was $500,000. As of this writing, the 2015 limit is only $25,000 and there’s no guarantee the previous limit will be restored by Congress. Also, there is no 50% bonus appreciation on new equipment in 2015 either. Since the Section 179 deduction applies to both new and used equipment and there is no bonus favoring new, you would benefit more from writing off a larger percentage of a less expensive used CEREC. It doesn’t make sense to spend $145,000 (+ $20,000 in interest) to save $25,000. If using the regular depreciation method, you can deduct 1/5 the cost of both used and new CERECs every year until fully depreciated. If you purchased a new CEREC for $145,000 and realized $29,000 in tax savings year 1, your net worth would still have dropped $36,000 because the street value of that CEREC after a year is no more than $80,000. In the end, I just don’t see a justifiable tax motive for buying a new CEREC vs. used. Even if there were, trading 5 years of indebtedness for 1 year of tax relief seems a bit short-sighted to me.

Conclusion

Throughout parts of this blog it may seem like I am anti-Sirona or anti-CEREC, but really I am pro-CEREC, anti-debt and support sound financial decisions. I’ve read the economic debate regarding CEREC vs. the Lab and I believe that the solution of buying a used CEREC is the nuclear bomb to end all arguments (at least from a financial standpoint). If you commit to this technology it will reward you over and over again and to the nth degree if you buy used. That is not to say that all used CERECs out there are created equal; you will have to sort the gems from the junk, but the reward is entirely worth the effort. When it comes down to it, you can choose whether you want to be on the paying (new) or saving (used) end of the equation. Some people must have everything new- new cars every 5 years, new phones every 8 months and new debt to go along with it. If you are reading this article, I am willing to bet that you are not one of those people. If you are one of those people, perhaps I have persuaded you to reconsider that mentality…at least when it comes to a product with this many zeroes on the price tag.

What questions do you have? Send them my way through the Contact page or call (844) DTL-HERO. Be sure to look out for my next blog, in which I show you how to evaluate a used CEREC system.