CEREC vs. E4D for Same-Day Crowns
Since the invention of CEREC equipment in the mid 1980s, dental patients have been able to enjoy the benefits of same-day crowns. However, until 2007, patients and dentists had only one option for this type of ceramic restoration. Now, Sorona’s CEREC has competition from D4D Technologies in the form of the E4D CAD/CAM system. CEREC has established a long track record for successful, long-lasting dental restoration based on the experience of thousands of dentists and dozens of clinical trials.
E4D may also prove to be a quality system that can deliver excellent results for patients. The D4D company spent years working on the technology before finally releasing it. Plus, they had the advantage of learning from all the improvements in the CEREC system over the past several decades. However, because the E4D is so new, there is little clinical data to evaluate. There are also no large scale head-to-head clinical trials comparing the two systems. This simply means information on the benefits and drawbacks of E4D vs. CEREC comes mostly from dentists who have used one or both of these technologies in their practice. Here’s what we can learn from their experiences.
What Do CEREC and E4D Have in Common?
Both systems are designed to deliver same-day ceramic restorations. They can be used to create:
Basically, both sets of equipment can be used for all the same types of dental work. It all depends on how the dentist prefers using the system. For example, some dentists might not choose to use the same-day crown equipment to create a temporary bridge because that’s a very complex job. It’s a good idea to pick a dentist who has used the equipment many times for restorations like the one you need.
Materials for E4D vs. CEREC
CEREC and E4D offer multiple material options including the Ivoclar Vivadent Empress and IPS e.max CAD Impulse. These lithium disilicate class ceramics are prized for having a natural opalescent appearance and high strength. The CEREC can be used with a wider array of materials including feldspathic porcelain blocks from VITA. Some dentists prefer this material for its translucent appearance in highly visible restorations such as veneers. However, ceramic can also be stained to make it look like tooth enamel. E4D is still adding new materials to its line. So eventually both systems will probably offer a similar range of materials. When you discuss your same-day dental crown with your dentist, ask what type of material is being used and why. The importance of durability, wear and tear on surrounding teeth and aesthetics must all be balanced in making this decision.
Ease of Use for Dentists
Both CEREC and E4D use is typically learned during a two-day training event. According to one study conducted by Bluestone Center for Clinical Research at the New York University College of Dentistry, dentists who tried the E4D found it to be reasonably easy to learn to use – even for dentists with no CAD/CAM experience. Restorations took about 45 minutes to create. This puts the E4D on a par with CEREC as far as the amount of training required for use and how easy it is to learn the system. Of course, many dentists do state that learning how to use either system well is quite challenging. Fortunately, there are many advanced courses dentists may take to improve their skills with CEREC or E4D. Since CEREC has been around longer, more dentists are comfortable with this system. That can make a big difference in patient outcomes. When you are picking a same-day crown dental provider, you should ask about:
- How long they’ve owned and used their CAD/CAM equipment
- What training they’ve done (and how recent their last class was)
- How many procedures they’ve done with the system
- The percentage of restoration failures they’ve seen over the years and the most common causes for those problems
The CEREC vs. E4D Imaging Debate
One of the most noticeable differences for patients is in the imaging process. With CEREC, the tooth must be coated with a reflective powder spray prior so the camera can take an accurate picture. Detractors of this method claim:
- The process of powdering the teeth is uncomfortable for the patient and time consuming/painstaking for the dentist.
- Inaccuracies in imaging might result from an application of powder that is too thick, too thin, etc. The treatment area must be kept dry or the powder will be ruined.
The E4D uses a laser to capture an image of the tooth rather than CEREC’s blue LED light technology (or the earlier infrared light version). This means the 3D image is formed by the laser beam bouncing off the tooth surface rather than from light being reflected by a shiny powder coating. Whether this really makes a difference to patients remains to be seen. Spending a little extra time with the powdering process may not be a deal breaker if you are still getting your crown done in a single visit.
Other Considerations Besides Equipment Brand
With both the CEREC or E4D equipment, the quality and longevity of your same-day dental restoration depends on a number of factors:
- The training and skills of your dentist (this is always the most important consideration)
- The type of restoration material used
- How well your teeth fit together (your bite affects wear and tear over time)
- The extent of the restoration (larger areas of decay are more challenging to repair)
- How well you care for your teeth after restoration (your diet and oral hygiene habits may lead to further decay and restoration failure)
If all goes well, a same-day crown should last as long as one that’s fabricated in a traditional dental lab. Pick a highly trained dentist and take great care of your teeth at home for best results!