DENTISTRY HEADS IN A HIGH-TECH DIRECTION

A computerized machine that scans teeth and makes fillings and crowns from the digitized information is the wave of the future, says a Sikeston dentist who has such a machine in his office.

Dr. Ted Lewis recently spent $100,000 on a CEREC 2, a device that uses computer scanning technology to design and "mill" restorations such as fillings and crowns in a single office visit. He said the only other Missouri dentists using this machine are in Kansas City and St. Louis.

Cristin Wagner, director of communications with the Missouri Dental Association said the expense of the CEREC 2 has kept it out of the reach of most dental practices outside metropolitan area. But she agreed with Lewis that such computer-assisted dental equipment is the way dentistry is moving.

With the CEREC 2, fillings and crowns can be done in less time, with less pain and they last longer than with traditional treatment, Lewis said.

To show the differences in treatment with the CEREC machine and traditional methods, Lewis used the example of a person whose filling has fallen out.

Because of the size of the hole in the tooth, most dentists would not want to use another traditional filling. Instead they would probably choose to repair the tooth with a crown. This involved shaving away most of the tooth to make room for the crown, making a plaster impression, sending the impression to a dental lab and, when the crown is ready in a week or so, having the patient come back to the dentist's office for the crown to be glued into place.

"The CEREC 2 provides a method to fill a large cavity without using a crown," Lewis said.

With the CEREC 2, the dentist would remove only those parts of the tooth that are damaged, leaving all of the healthy portion. The dentist then uses a mini-cam to scan an image of the tooth. Using that image, the CEREC makes a new filling for the tooth using a ceramic material, which is matched to the color of the patient's teeth. This "milling" takes 10 to 15 minutes. Then the ceramic filling is bonded to the tooth.

"The whole procedure takes about an hour," Lewis said. A traditional crown takes at least an hour for the first appointment and then another hour when the crown comes back from the lab, he said. And the traditional crown requires an injection of deadening agent both times.

Another advantage is the material used with the CEREC 2, the closest science has come in matching teeth, Lewis said.

"Traditional material for fillings and crowns doesn't expand and contract at the same rate teeth do," Lewis said. Because of this, the dental work may only last 10 to 12 years.

He said tests have shown dental work made with this ceramic material will last 30 years.

The machine is also very accurate in creating dental work, Lewis said. "It can scan to an accuracy within 50 microns," Lewis said. For perspective, he said a human hair is 300 microns wide.

Lewis said the cost for dental work using the CEREC 2 is about the same as he charges for a traditional crown. He added that generally insurance companies pays a higher percentage for a CEREC 2 filling because it leaves more of the healthy tooth than a crown does.

"With all the advantages it offers, I think in the next five years most dentist offices will have machines like this," Lewis said.

Wagner of the Missouri Dental Association agreed.

"Right now, because of the expense, there are only about 100 of these in the country," she said. "But in the future, I think you'll see more computerized equipment like this being used in dentistry."