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Chairside CAD/CAM in dental schools

March 1, 2003
"We need to change. Business as usual is out. The very successes that got us to where we are today might be the shackles that keep us back from achieving in the future.

By Kevin Henry, Editor

"We need to change. Business as usual is out. The very successes that got us to where we are today might be the shackles that keep us back from achieving in the future. It takes guts to change, but if you don't, the economic end is no less certain, only more painfully time-consuming." — James Belasco, "Teaching the Elephant to Dance: The Manager's Guide to Empowering Change"

The quote above makes sense to the dental industry when you think about it; if anything, it certainly challenges the old mantra, "If it ain't broke, then don't try and fix it." As much as some dental professionals may try to fight it, change is imminent, and embracing change is the challenge — a challenge that hasn't always been easily welcomed in dentistry.

While some changes in dentistry have been obvious (digital imaging was almost unheard of 10 years ago), techniques employed a century ago are still prevalent in some form. In recognition of that fact, the ADA's recent Future of Dentistry Report called on dental professionals to establish a rapid, flexible, and effective response system for predicted and unknown changes in education and research in the future. Some leading universities have responded, and some manufacturers have supported the call.

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In October, the above clinicians attended CEREC training in Memphis (listed by university affiliation): Dr. Celeste Kong, Dr. Fred Hains — Boston University; Dr. Steven Duke, Dr. Ed Deschepper — Indiana University; Dr. Michelle Robinson — Marquette University; Dr. John Burgess, Dr. Alan Ripps — Lousiana State University; Dr. James Simon, Dr. Bryan Schmidt — University of Tennessee; Dr. Franklin Caughman, Dr. William Browning, Dr. Randall Pohjola — Medical College of Georgia; Dr. Valencia Hereford, Dr. Ralph Grossheim — Meharry University; Dr. Denise Estafan — New York University; Dr. Samer Kastali — Tufts University; Dr. Milton Essig, Dr. Perng-Ru-liu — University of Alabama at Birmingham; Dr. Edmond Hewlett — University of California; Dr. Jon Ryder — University of Iowa; Dr. Robert Kovarik- University of Kentucky; Dr. Dennis Fasbinder — University of Michigan; Dr. Edward Schlissel — SUNY at Stoney Brook; Dr. Omar Zidan — University of Minnesota

Leading dental schools across the country, from NYU to UCLA, are embracing change in their teaching curricula, a change that was prompted by a recent sizeable donation from Sirona, Inc., the company that pioneered chairside CAD/CAM dentistry nearly 15 years ago with the introduction of CEREC 1. CAD/CAM technology — long considered a new category in the dental industry — is making great strides toward mainstream dentistry in the professional arena. That mainstream mentality has recently crossed over into dental education with Sirona's latest donation of 60 CEREC machines to several leading universities in the United States.

"CAD/CAM dentistry has proven itself in the dental market; the next step is to begin teaching students about its value and efficacy," said Dennis Fasbinder, DDS, director of advanced education in general dentistry at the University of Michigan. "Integrating CEREC technology into the teaching curriculum is extremely beneficial, because it's affording students the opportunity to learn another important technique and preparing them to easily adapt to the ever-changing dental market."

Dental education has historically been a haven where students (as well as faculty) can participate in clinical research on new products, and Dr. Fasbinder is among those university educators who have accepted CAD/CAM dentistry with open arms. In fact, Dr. Fasbinder began his education with the CEREC 1 in 1992 and helped contribute to the research and eventual development of Sirona's latest model, the CEREC 3.

"Ceramic restorations are an integral part of private practice these days and the CEREC System increases the opportunities for us to teach the clinical techniques for ceramic restorations to our students," Dr. Fasbinder said.

In order to take their education one step further, dental university educators were brought to one of the leading universities with CAD/CAM experience for five days of CEREC clinical training at the University of Erlangen in Germany.
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It's a recognized industry fact that the number of practicing dentists will continue to steadily decline well into the 21st century. According to the PEW Health Professions Committee, there is a nationwide average of one dentist per 1,631 people. With an increase in the number of dentists retiring and a decrease in the number of dental students graduating, that leaves a lot of patients for today's recent graduates. That sounds like a good deal for the dental school graduate, whose average debt is $105,0001, but sounds like a bum deal for a patient waiting to get a crown fixed. That's why many leading dental schools are preparing their students to handle a larger patient load by educating them on dentistry's latest techniques.

Boston University, a dental school that prides itself on integrating innovative dental technologies into the teaching curriculum, was one of the schools that benefited from Sirona's recent donation.

"The mission of Boston University is to include cutting-edge technologies into our programs," said Dr. Celeste Kong, associate professor, director of restorative dentistry. "We also believe in lifelong learning for everyone in our community (students, faculty, and alumni). CEREC will prove to be an excellent enrichment program for senior dental students who have already achieved their minimum levels of competency in operative and fixed dentistry."

In most cases, CEREC technology is also new to the educators. In response, Sirona has implemented a training program for select educators that requires them to participate in a program to not only learn the technology, but to acquire tips on how to teach it. Experienced educators lead the two-day workshop, which consists of clinical case studies, tips on teaching students, and hands-on training.

The CEREC System has more than 15 years of clinical research and documentation to support the technology. The first patient was treated with the CEREC at the University of Zurich in 1985. Since then, the technology has been continuously enhanced through ongoing research and development. The most recent product enhancements are found in Sirona's CEREC 3 model, a compact, user-friendly, Windows-based system that is allowing a growing number of dentists to incorporate the technology into their practices. To date, more than 2,500 dentists in the United States have integrated CEREC, with more than 5 million restorations placed, including crowns, inlays, onlays, and veneers.

With students getting a jump on the technology, chairside CAD/CAM will no doubt continue to influence the future of restorative care.


  1. Weaver R. "Annual ADEA Survey of Dental School Seniors" Journal of Dental Education, Oct. 2002, 1209-1222.