Why You Should Read This
I posted the original iteration of this article more than five and a half years ago. Since then, it has been my most read post with almost 23,000 views! It was a good run, but I think this update is long overdue. If you are in the market for a used CEREC system, be sure to read this article in its entirety as I’m going to share what I’ve learned from eight years (and hundreds of transactions) in the used CEREC business.
Not that B word. I’m talking about a budget. The word budget has a somewhat negative connotation in the sense that being on a budget seems to take the fun out of shopping. At least I used to believe so until financial guru Dave Ramsey introduced me to the idea that a budget is actually a license to spend GUILT FREE!
A budget means that somebody has done their homework. When speaking with a prospective customer, I often ask what their budget is. Would you believe that the most common reply is that they do not have one? Of course, everybody has a budget. By definition, if you make and spend money then you have a budget. Those who say they don’t have a budget are really saying they need more information before they can make that decision.
That’s where this blog comes in. Everybody’s situation is unique, but to start with there are a few basic questions you’ll want to answer:
- What are your practice needs/trends?
- How many and what type of restorations will you be able to realistically perform same-day?
- How will CEREC impact your practice workflow?
- Will you need to modify your schedule to perform same-day dentistry?
- What new services/revenue streams will CEREC enable you to add to your practice?
- How much CEREC education will you need to invest in yourself and/or your staff to efficiently reach your production goals? (Pro Tip: Unless you are a CAD/CAM fanatic you will like your CEREC a whole lot better if you train and retain good assistants to use and maintain the equipment.)
- What will your material costs be?
- How much are your current lab bills? What impact will CEREC have on them?
- Overall, how much time and money will you save by going digital?
Drill into the numbers. I would also highly recommend you consult with your accountant and perhaps a practice management expert to help you make the most informed decision. Answering these questions will not only help you figure out how much you should spend, but discover what you truly need.
Which CEREC is Right for You?
After you have determined your budget, the next step is to identify the CEREC generation that will do the job. As a helpful guide, I have produced a general price range of CEREC components based on our recent sales history:
- CEREC AC with Bluecam: $1,500 – $5,000
- CEREC AC with Omnicam: $12,000 – $25,000
- CEREC AC with Primescan: $40,000+
- 2007-2012 MC XL (2-motor/wet): $7,000 – $15,000
- 2013-2015 MC X (2-motor/wet): $15,000 – $25,000
- 2016-2019 MC X (2-motor/dry): $30,000 – $40,000
- 2016-2019 MC XL (4-motor/dry): $30,000 – $50,000
- Ivoclar Programat CS: $2,000 – $3,000
- Ivoclar Programat CS2: $3,000 – $4,000
- Ivoclar Programat CS3: $3,500 – $4,500
- Sirona CEREC SpeedFire: $7,500 – $9,000
If you are new to CEREC you may have little idea which generation suits your needs best. The best way to figure that out is to give me call and have a discussion about your practice, but I’ll outline some basic information for you here.
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 is 37% larger and 54% heavier than the Compact. In addition to inlays, onlays, crowns, and veneers, the MC XL can mill bridges, abutments and drilling guides. The MC XL also mills faster than a Compact- it can mill a single crown in 7 to 11 minutes.
In 2013, Sirona introduced 3 versions of their chairside milling units:
- CEREC MC: the least expensive of the trio. This mill fulfills the role formerly occupied by the Compact milling unit: single unit inlays, onlays, crowns, and veneers utilizing block sizes up to 20 mm. You won’t find very many MCs on the used market as it wasn’t as popular as its more productive siblings.
- CEREC MC X: your standard chairside mill and nearly identical to the first generation MC XL. The MC X offers the entire range of chairside treatment including inlays, onlays, crowns, veneers, 4-unit bridges, abutments/screw-retained crowns, and surgical guides. This mill is capable of grinding or milling blocks up to 40 mm in size.
- CEREC MC XL Premium Package (aka Practice Lab): the most expensive chairside mill with additional labside capabilities. The new MC XL offers the convenience of four motors so you don’t have to change burs when going back and forth from milling to grinding, a touch screen display, the “extra-fine” grinding option, the ability to use all CAD/CAM materials (plastic, ceramic, and metal), and milling or grinding blocks up to 85 mm. In addition to inlays, onlays, crowns, veneers, and 4-unit bridges, the MC XL can produce abutments/screw-retained crowns, surgical guides, copings, frameworks (up to 12 units), bars, attachments, and telescopes.
In 2016, Sirona updated their mill lineup with dry milling technology to speed up the processing of zirconia. This was accomplished by adding a dust vent on each side of the milling chamber and a suction unit to remove and store the zirconia dust. According to Sirona, there is no difference in accuracy or quality between wet and dry milling. Also, there is no difference in the time it takes to wet or dry mill, except for the elimination of the pre-drying time during sintering of zirconium oxide (about 10 minutes in the SpeedFire).
In 2020, the company now known as Dentsply Sirona introduced the Primemill, which you can read all about in another article I wrote here. Essentially, the Primemill adds a block scanner, RFID chipped burs, a “super fast” milling mode, a smaller 0.5 mm milling tool, updated electronics, and redesigned mechanical components. Think of a smarter and faster MC XL.
My suggestion: As of this writing, I have yet to see a single Primemill available for sale, so for now I will not consider it an option. However, I will offer a word of caution about the Primemill. Judging by online chatter among Primemill owners, it seems that the Primemill has a few “bugs” that need to be worked out. This is to be expected with new technology and I imagine Dentsply Sirona will eventually resolve them via software updates. For the time being I would recommend a 2016 or newer MC X or MC XL over the Primemill because of its tried and true production history and superior ROI. For those who don’t intend to mill zirconia, 2015 and older MC Xs and MC XLs are great value options as well.
- 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 as a result can process an image nearly 2x faster at .070 seconds. While this system also uses individual images to create a 3D model, the Bluecam performs the image capture, or “click”, automatically. Both the Redcam and Bluecam require the use of white contrast powder.
- The CEREC AC Omnicam was launched in 2012 and reigned supreme until 2019, when the Primescan was released. 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.
- The CEREC Primescan is the latest and greatest scanner from Dentsply Sirona. The Primescan’s camera utilizes high-resolution sensors and shortwave light (what DS calls Smart Pixel Sensor technology) to capture up to 1 million 3D data points per second at depths up to 20 mm. Other new features include: continuous self-heating for fog free scanning; an increased field-of-view; 3 optional camera sleeves; instant data transfer; ergonomic touchscreen controls; and hours-long battery operation. By all accounts, the Primescan performs well and looks good while doing it. Primescan users report fast and accurate scanning without many complaints…except for the segment of users who still prefer the track ball instead of the touchscreen controls.
My suggestion: The Primescan is undeniably the superior scanner, but to me the more thought-provoking question is HOW much better? And is the upgrade worth the cost? I think that’s debatable.
A strong argument can be made that a 2012-2015 stock Omnicam running Windows 7 and 4.6 or older CEREC software seems very outdated when compared to the Primescan. But what about an Omnicam with a modern PC (same CPU/GPU as Primescan, 2 TB SSD, 32 GB of RAM), the latest CEREC 5.1 software, and a touchscreen?
With a set-up like the latter, the Omnicam makes up significant ground in performance while remaining 70% cheaper than its successor. Not so obsolete now is it? If I’m a dentist/owner trying to decide if a Primescan is worth $40,000-$50,000 more than a modernized Omnicam, the math would have to be pretty controversial to justify that purchase. This is especially true when you consider that from a production standpoint, you’re really not getting much more from a Primescan than you are from an upgraded Omnicam. My vote goes toward the upgraded Omnicam.
The 4 Pillars of Used CERECs
If you’ve made it this far, hopefully you now have a better understanding of which CEREC generation would be the best fit for your needs and budget. Next I will lay out some critical evaluation criteria to help you sort through the gems and the junk.
Pillar 1: Model Year
The first thing you want to know about every unit is its year of manufacture. Don’t allow a seller to get away with simply telling you the year they purchased the CEREC. Oftentimes, Patterson or Henry Schein will sell their oldest inventory first, so it’s possible the seller purchased a 2015 CEREC in 2016 (I’ve seen differences of 3-4 years before!). Also, it is common for sellers to forget when they purchased their equipment, oftentimes being off by several years.
The only way to be sure about the model year is to ask for a picture of the serial sticker on the back of each unit. 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 “mill-age” into consideration as they are the primary determinants of resale value.
Pro Tip #1: 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 an easy fix!
Pro Tip #2: Ask for a picture of the milling chamber. Is it clean? A clean milling chamber is a pretty good indication that the recommended maintenance was performed on a regular basis. If the spindle motor housing is bright and shiny versus being caked in block dust, this could be a sign that the motors have been replaced recently. You’ll also want to look at the bottom rear of the milling chamber lid near the tension springs for signs of cracks/leaks. If the seller reveals that they haven’t used the CEREC in a while, ask for a picture of the inside of the water tank. If the tank was not completely dry prior to being stored, expect it to be coated with black mold. This is not only gross, but the contaminated water could also be present in the hoses and impeding the flow of water to the burs.
Pillar 2: Hardware
The model year is important to know when evaluating acquisition units too, but nowadays it’s not always indicative of what might be “under the hood”. There is a PC Hardware version sticker on the removable PC housing, visible by removing the lower rear vent panel. The higher the code in the series, the newer and more capable the motherboard, CPU, graphics card and memory will be. Aside from the CEREC running Windows 10, this is the easiest way to find out if the acquisition unit has been upgraded or not. For your convenience, I have cross-referenced some Bluecam and Omnicam hardware specs with their PC Hardware versions:
HQ (2008): MSI P35 Neo3 motherboard, MSI NX8800GT graphics card, Intel Core 2 Quad Q6600 CPU @ 2.4 GHz, 4 GB RAM
KA (2009): MSI P45 Neo3 motherboard, MSI N9800GT graphics card, Intel Core 2 Quad Q9400 CPU @ 2.66GHz, 4 GB RAM
LA (2010): MSI X58 Pro motherboard, MSI N250GTS graphics card, Intel Core i7 CPU 920 @ 2.67 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
LQ (2012): MSI X58 Pro motherboard, MSI N450GTS graphics card, Intel Core i7 CPU 950 @ 3.07 GHz, 6 GB RAM
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 (2016-2017): 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
v.5.2.1 (2020): AMD RX 570 Graphics Card, Intel Core i7 8700 CPU @ 3.2 GHz, 32 GB RAM
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). 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 changed and the milling time may not accurately reflect that machine’s actual use. In cases like these, we recommend you use your best judgment and consider the milling unit’s overall condition in comparison to its unit counter.
The number of mills on an MC, MC X, or MC XL is more clear cut. After accessing the Machine Data Type screen from within the service program, you will see a “Unit Counter” value. What you see is what you get, no math required. Keep in mind that a mill counter can be reset if someone knows the password. Again, we recommend you examine the milling chamber to determine if the unit counter seems authentic.
FYI: In 2007-2012 MC XLs you will sometimes see an impossibly high mill time value such as 45,039,943 minutes, but the unit counter value is only 548 (this is an actual example). Trust the unit counter value. We have found that mill time values often become corrupted following software updates and thus are not as reliable as the unit counter value.
With the compact, MC, MC X, and MC XL mills, you are sure to get many thousands of mills out of the machine with regular maintenance. The single most important wear-and-tear item to be aware of are the spindle motors. They cost around $2,000 per side to replace and last around 1,500-2,000 mills depending on maintenance and materials milled.
Pillar 4: Software Version
The importance of software when evaluating a CEREC varies with the type of acquisition unit you are considering.
In order to conserve space, I elected not to include Redcam or Bluecam software considerations in this version of the article. If you’d like information on Redcams and Bluecams, you can read my original article here.
As for Omnicams, you will typically find them running CEREC SW 4.4, 4.5, 4.6 or 5.1 (latest). A stock Omnicam with Windows 7 is limited to running 4.6 software or older. In order to make the jump to 5.1 software, an Omnicam will require a Performance Package hardware update or a brand new PC with Windows 10 (more on that here). This upgrade can be pricey depending on the Omnicam’s current PC Hardware and its CEREC Club status, ranging in price from $1,000 all the way up to $11,500. The potentially high cost of upgrading to 5.1 is now playing a major role in influencing used Omnicam values.
Pro Tip #1: Before you fork over $5,000 (non-club price) to Dentsply Sirona for a software update, you can usually find various software versions, license keys, dongles, and vouchers for sale by secondhand sellers on eBay.
Pro Tip #2: In order to run CEREC SW 5.1, you will need an SVD (Single Visit Dentistry) license in addition to the CEREC SW 5.1 license.
Pro Tip # 3: The CEREC Pro Module license for CEREC SW 5.1 enables production of CEREC Guide 2 and 3, Smile Design, a complete individual articulator, and several settings for the high-end use of the CEREC workflow. Additionally, the CEREC Pro module license includes the Open GALILEOS Implant license.
Look at you! You made it to the end and are now 3,000 words the wiser in the art of CEREC shopping. Armed with this new treasure trove of CEREC knowledge, you are well on your way to scoring that killer deal! If you need help along the way, feel free to reach out to me through my contact page or give me a call at (844) DTL-HERO. Now go forth with confidence! And a budget. ;)