I have an existing metal/porcelain crown on a back molar, with a bridge (tooth removed) next to it and then a connection to the next tooth. Said connection has allowed decay underneath it to the point I need a root canal. I tried a new dentist (I live in a rural area so have to drive at least 1 1/2 hours to find options in health care) and he suggested a CEREC crown/bridge/crown situation after doing the root canal. My concern is the possibility of a need, later on, for cavity or root canal work to be done on the back tooth. Can a dentist drill through the Cerec crown to do the work without removing the crown/bridge/crown apparatus? If so, does the crown need to be refilled with something specific (like CEREC material) or is a “normal” filling going to work — i.e., would I need to go to a dentist that has the CEREC machinery and training if that back tooth needed further work after the crown was replaced with a CEREC one? Or should I go for the cheaper metal/porcelain option for the crown/bridge/crown fix, expecting at some point to have to remove the whole thing to get to that back molar?
- MA from Arizona
Dear MA,
CEREC is nice. It’s definitely nice not to have to deal with the temporary and the second appointment.
The CEREC material is difficult to drill through – it would probably require a diamond bur, and maybe more than one because CEREC is hard even on diamond burs. But if done right, a dentist should be able to get through it without damaging the bridge. And the filling material wouldn’t have to be anything special – just regular composite should do. So you wouldn’t need to go to a dentist with special CEREC technology to have additional work done.
But having said that, there is nothing higher quality about a CEREC bridge replacing a molar. (I use the word “bridge” to mean the entire restoration: two crowns with a false tooth, called a pontic, suspended between them.) In fact some dentists would be uneasy about that, that the extra chewing forces might be too much for a pure ceramic restoration and they would prefer the porcelain fused to metal bridge. I think in my mouth I would prefer the porcelain fused to metal in that situation. I’m confused about why the CEREC would cost more. The dentist, by using the CEREC technique, is eliminating the need for a dental laboratory technician, so the laboratory cost is zero. He does have to amortize the cost of the machine, but the idea there is that the costs should balance out.
In other words, don’t assume because the porcelain fused to metal is less expensive from your dentist that it is lower quality. If the metal is a semi-precious or a precious metal and not a base metal, the porcelain fused to metal bridge would be of equal or slightly higher quality, depending on the situation. And in other dental offices the fees would be similar, or in some cases the CEREC would even be less.
This blog sponsored by Colorado Springs cosmetic dentist Dr. Joseph Rota.