CAD/CAM Same-Visit Dentistry

CAD/CAM means we design your restoration on a computer and mill it here, in the office, while you wait. There is no putty impression, no temporary crown for two weeks and no second appointment for most cases. At Pearl32 Dentistry and Wellness in Laguna Hills, crowns, inlays, onlays and some short bridges are made this way in Suite 450. Milling takes 15 to 30 minutes. Some cases still go to a laboratory, and we explain why.

What can be made in one visit?

Crowns are the main one. An inlay or onlay, which replaces part of a tooth rather than covering all of it, is also made this way and preserves more of your own enamel. Short bridges of three units are possible in some cases.

Veneers can be milled, though many front tooth cases are handled better by a laboratory technician who layers ceramic by hand for color. The material is a ceramic block, usually lithium disilicate or zirconia, chosen for the position and the force on that tooth. See same-day crowns.

What happens during the appointment?

The visit runs in five steps. The tooth is numbed and prepared, with decay or the old filling removed. A digital scan records the prepared tooth, the opposing teeth and the bite.

We then design the restoration on screen, adjusting contours and contacts, and you can look at it. The block is milled. Finally it is stained, glazed in a small furnace and bonded onto the tooth, and the bite is checked with you biting and grinding on marking paper. Plan on roughly two hours in the chair, most of it spent waiting comfortably.

How long does the milling take?

Milling takes 15 to 30 minutes depending on the shape and the material. Zirconia needs a sintering step in a furnace afterward, which adds time. Lithium disilicate is crystallized and glazed together, usually in about twenty minutes.

You can stay in the chair, wait in reception or step out. Street parking is free, there are free spaces behind the building, and the parking structure charges. Suite 450 is reached by elevator. The Laguna Woods Village resident bus stops at the plaza, which suits people who would rather not come back for a second appointment.

What still goes to a dental laboratory?

Some cases belong in a laboratory, and saying so honestly matters. Front teeth where color must blend with natural neighbors often need hand layered ceramic. Full arch cases and long bridges need laboratory control over the fit across the span.

Implant restorations with custom abutments, complex bite reconstructions, dentures and partials all go out. So do cases where we want a technician to build the shape in wax first and test it in your mouth. We send the digital file electronically, so you still avoid the putty tray. Learn about implant restorations.

What same-visit dentistry will not do

It will not shorten the appointment. It removes the second appointment, and you trade that for about two hours in the chair at once. People who cannot sit that long are served better by two shorter visits with a temporary crown, and we are happy to do it that way.

It will not save a tooth that lacks enough structure. A tooth broken below the gum may need crown lengthening first, or a root canal and a post. We check that before we start, because a crown on a weak foundation fails within a few years whoever makes it.

What does a CAD/CAM restoration cost?

A milled crown is quoted in writing, itemized, after an examination, and the estimate lists the crown as one line whether it is finished here or at a laboratory. We tell you before the visit which route your tooth is taking and why.

We are in network with most major PPO plans and Delta Dental HMO, and crowns are usually covered at a percentage after any waiting period. Third party financing is available and the practice is not the creditor, through CareCredit, Cherry, Sunbit and Happen Bank (formerly LendingClub). See financing.

Questions people ask about cAD/CAM Same-Visit Dentistry

Is a milled crown as strong as a lab crown?

For single teeth, yes. Milled lithium disilicate and zirconia are the same materials a laboratory uses, pressed or milled from industrially made blocks with consistent properties. Ten year survival figures for single milled crowns match conventional ones in published studies. The difference is where the shaping happens, not what the ceramic is.

How long does a same-visit crown last?

Most single crowns last ten to fifteen years, and many go longer. What decides it is not the ceramic. It is the amount of healthy tooth underneath, whether you grind, how clean the margin stays and whether decay starts at the edge. We make a night guard for grinders and check margins at every maintenance visit.

Can everything be done in one visit?

No, and we tell you at the planning stage. Front teeth needing close color matching, long bridges, implant work with custom abutments, dentures and full mouth reconstructions all go to a laboratory. Those cases still start with a digital scan, so you avoid the putty tray, but the restoration is delivered at a second appointment.

Will the color match my other teeth?

For back teeth, almost always. The block is chosen from a shade guide against your neighboring teeth, then stained and glazed before bonding. Front teeth are the harder case, because natural enamel has depth and translucency that a single shade block reproduces only so far. For visible front teeth we often recommend a laboratory made restoration.

Do I still get numb?

Yes, for the preparation and the bonding. Local anesthetic is given at the start and usually lasts through the whole appointment, so you feel pressure and water but not pain. If it wears off during the wait, we add more before bonding. Nitrous oxide and oral sedation are available if sitting for two hours concerns you.

This page is general information, not a diagnosis. What is right for you can only be decided after an examination.