John Pasicznyk This case is one of my favorite things to do with the CEREC machines because it is a service that no one without a CEREC could ever imagine doing in such an efficient way. It is also extremely predictable, and cost-effective for the patient to boot. This is a patient that has floated in and out of the practice, never really getting comprehensive treatment done, but always with some sort of restorative need. Today was an extremely busy surgical day, so when I saw her show up on my schedule as an emergency appointment, I wasn't really sure what I could do to help her. Luckily we could work her in and deliver definitive treatment to the area today.
Patient presents with an existing occlusal alloy in tooth #19 with recurrent decay that undermined the distal marginal ridge. The tooth cracked around the alloy in such a way that direct replacement with resin would prove to be very time consuming, and clinically deficient. A full coverage restoration would be extremely aggressive treatment. I presented the patient with a treatment plan of replacement of the alloy with a milled hybrid composite inlay. 
I removed the alloy, prepped with draw, and imaged. No opposing model needed
While the model was processing, I removed the last bit of decay that would have caused an undercut, knowing it will fill in with bonding cement. I also prepped the buccal pit that was stained. Perfect initial proposal, got it in the mill and moved on with my day. 15 minutes later, the restoration was ready to bond, I sat down, bonded it, checked occlusion and left the room. Total time with the patient, 45 minutes.
I love doing these hybrid inlay restorations, as it shows the patient how we really are focused on the best treatment for them. I never looked at the tooth and said, hmmm should I try to save it and do a resin, or should I just prep for a crown? In my previous practice lifestyle, I would have immediately started considering prepping for a crown and never looked back. Now this patient has a minimally invasive restoration at a fraction of the cost. I love sharing these cases with docs during trainings; you can see the lightbulbs turn on in their brains. The CEREC system has done a number of things for me, but most importantly, it has reprogrammed my brain to look at restorative situations in a much different light.
