How Often Do Cerec Crowns Fail?

But if the dentist using CEREC doesn't learn how to do them well, they will fracture more easily than a lab made crown.  Not all dentists are created equal, so some homework is needed.  The right material needs to be used, the tooth preparation needs to be designed correctly and the crown needs to be bonded correctly as well.

CEREC crowns do not fail more often than traditional crowns.  Any crown will fail if it is not designed properly.  The crown must fit the bite both when the teeth are closed and in function.  The tooth must be prepared to provide enough thickness for the crown to maintain structural integrity.  The margins of the crown and tooth preparation must be matched so that a proper seal exists, even before cementation.  Home care is also an important factor, since a healthy environment around a crown promotes longevity.

Although the CEREC technology to provide a single visit crown in the dental office is limited in availability, a significant number of professional dental labs are using CEREC technology to fabricate their crowns. 

In the hands of a skilled and competent dentist, CEREC crowns and onlays/inlays work well. However, I see alot of people coming in with poorly done CEREC restorations. It seems as though there is a steep and long/tall learning curve. Some dentists do not seem to ever get thru the learning curve. Quite often they are poorly cemented with gaps at the margins or excess cement that cannot be cleaned off. I also believe there is tendency of dentists to overprescribe CEREC crowns when a direct composite filling would work fine. Typically the patients insurance will pay 80% of $150-$330 for a filling vs. 50% of $600-$1200 for a CEREC restoration. This is a huge difference in the out of pocket expense for the patient. The dentist  has $100,000 invested in the CEREC system and has to pay that overhead so it seems like CEREC is being over-utilized. The old saying..."if all you have is an (expensive) hammer, everything looks like a nail ! "

 

With todays technology, a skilled dentist using a CEREC machine will be able to fabricate a crown that is equal to any lab fabricated crown.  In fact there are many labs that are now utilizing CAD-CAM technology to fabricate their crowns.  The real factor to the longevity of the crown, if done well, is the home care and habits of the patient.

I have found over time that the most predictable type of restoration is one made out of gold.  However, many people these days dont want metal in their mouth.  Gold is almost unbreakable and can be cemented in with a traditional easy to use cement.  Cerec crowns are made out of porcelain which is in most cases not as strong as gold.  Cerec also must be bonded  rather than cemented, which means that it requires more steps that have to be followed very carefully.  It is much harder for your dentist to do a "good" cerec crown, than almost any other crown available.  So you want to make sure you are going to someone with plenty of experience with Cerec and find out if they have a warantee of any type in case something goes wrong. Also, cerec restorations tend to be more predictible in certain areas of the mouth like the front and sides vs. the very back teeth, and in people that do not grind or clench their teeth.  The beauty of Cerec is that it can be done in one visit and if done properly, under the right circumstances, it can provide a predictable, reliable result that looks great.  We have done over 1000 cerec restorations in our office and they are more reliable today than ever before.