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Dr. David Ward | Is this the End of Temps? in Big Spring

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1500 Scurry St.
Big Spring TX 79720

(432) 267-1677

Family, Sedation & Laser Dentistry; Orthodontics; Implants

Is this the End of Temps?
 

Is This the End of Temps?

If you are a temporary employee, relax because this article is not about you. If you have or have had a temporary cap (crown) in your mouth this does concern you.

A little history first…before the 1980’s many crowns were actually made by the dentist himself rather than a dental lab. They were made of gold and could be contoured in wax and then cast into gold in the office. This was a time consuming procedure so an impression of the teeth was taken and a plaster model made from it, on which the the wax was contoured. A temporary crown fitted on the tooth and the patient released to come back another day because making the crown would take several hours.

For the last 30 years things have been changing. Most of the crowns became porcelain fused to metal for decent cosmetics. Almost all dentists had these made at a dental lab because much more lab equipment and time was required to make them. The patient would wear a temporary crown for 2-3 weeks while the permanent crown was being made.

Over the last 10 years or so there have been some very nice improvements in ceramics (porcelain and similar materials) that frequently eliminate the need for metal under the ceramic. This makes for much more cosmetic crowns but still with excellent strength. These include leucite reinforced porcelain,lithium disilicate or zirconium oxide, or combinations of these three. It gets confusing, but these ceramic materials have proven themselves for several years. For simplicity, most dentists still refer to them as porcelain even though they really aren’t.

Most of the above listed very strong and very cosmetic crowns have been made at labs and still are. So as for the last 40 years, most patients have had to put up with temporary crowns and second appointments. Now your dentist or assistant makes the best temp he or she can, but they are almost always a little rough on your tongue and are prone to breaking or coming off. They are made of a plastic-like material and are put on with weak cement for easy removal.

Many of the labs now use a CAD/CAM system to make the beautiful ceramic crowns. CAD/CAM means Computer Aided Design/ Computer Aided Manufacture. Instead of using wax on a plaster model to design the crown, sophisticated software enables the technician to do it more efficiently on a computer.

This computer talks to the milling computer and within a few minutes a crown is milled out of a solid ceramic block and then custom “stained and glazed” to make it really match the color of the teeth around it.

Well everything old is new again. New technology now let’s dentists who have it do all the things just mentioned in the office, plus scanning the tooth digitally. This means no impression or plaster model is usually needed. The computer design and manufacturing is usually done in less than an hour. So no temporary crown or second visit is needed! The patient can watch the design process or can have other needed treatment done while waiting. Patients love it. There are two manufacturers in the world for these systems. Sirona, a German company, makes CEREC the first CAD/CAM system for dental office use. E4D is the second system on the world market. It is made by an American company based in Richardson, Texas (my hometown!). Both systems are excellent but there are some distinct differences between them.

Even with CEREC or E4D, it’s not the end of dental labs or temporary crowns. Most dentists in this country, or around the world, do not have this in their offices. For those that do, some cases, especially those involving multiple crowns (or veneers), bridges, or those to which a partial denture will attach, still need to go to an excellent lab for crafting.

Dr David Ward practices comprehensive family dentistry in Big Spring. He is a past president of the Permian Basin District Dental Society, and is a member of the Texas Dental Society, American Dental Association, American Dental Implant Association, Academy of GP Orthodontics, and Institute for Advanced Laser Dentistry.