One-day restorations: the dentistry of the future

Dentistry, like any healthcare field, has advanced in tandem with technology to speed up procedures, as well as to improve prognosis, quality and accuracy.

There are generally two types of dental restorations, direct and indirect. Direct restorations are those that are made directly on the tooth itself, e.g. a filling. Indirect restorations are those that are made outside the tooth and then placed on the tooth, e.g. veneers, crowns or inlays.

Until not so long ago, the latter were dealt with by dental laboratories, which involved the famous and hated in equal parts taking measurements with trays and silicone, the 'putty mould', which basically consisted of applying an impression material in a tray, either alginate or silicone, placing it in the mouth and waiting for it to harden before taking it out.

This was a procedure that was not only tedious for the patient, but also had certain precision problems: the material could be dragged when introduced in the mouth, the measurement could be distorted if the material was not kept properly, the manipulation could give rise to errors... and other problems.

Technological progress made up for these shortcomings with intra-oral scanners, something my colleague Fran talked about last week here on the blog. If you remember, these scanners allow a much more detailed and accurate 3D dental record to be obtained, in addition to the convenience for the patient, who was 'freed' from having to take measurements in the mouth with alginate.

The scanned files were then sent to the laboratory in STL format and the prosthetist was in charge of fabricating the restoration.

Later on, and continuing with the objective of reducing working times in the clinic and saving time for the patient, some clinics, such as ours, opted to acquire what is known as a milling machine in the clinic.

Milling machines such as the one we have at Vélez y Lozano (in our case the CEREC MC XL) work practically remotely. The dentist can design the desired restoration on the intraoral scanner itself, introduce the desired block into the milling machine, and in the set time it mills the inlay.

These blocks can be made of different materials: resin, feldspar, lithium disilicate, zirconium, hybrids...

Example of blocks

Depending on the type of restoration that the dentist determines to be ideal for the patient's problem, he or she will opt for one material or another, with ceramic being the most aesthetic material to work with, among which feldspathic restorations stand out.

The most current blocks are divided by level of translucency and can be layered, which will allow the future restoration to blend with the tooth and recreate the layers of the tooth, both dentine and enamel.

This advance has meant a before and after in the world of indirect dentistry, as what used to mean an average of 2-3 appointments for the patient now means a single appointment of 60-120 minutes.

In addition to the advantage of time, we can highlight the virtue of being able to design the restoration to the clinician's liking, being able to give the anatomy he/she considers, adjust interdental contacts or adjust the margin of completion.

With continuous technological advances, at Vélez y Lozano we will continue to update and acquire the latest developments in order to continue offering our patients excellent treatment, based on scientific evidence and with the latest technology.

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