Presentation

CEREC
THE VISION OF DIGITAL RESTORATIONS
by
Werner H. Mörmann

 The 1980 Problems

in
Operative Dentistry

1) Toxicity of Amalgam
2) Inadequacy of Composite

The 1980 Menu of posterior restorations

 Kompositinlays 1980-82
Composite - Inlays
1980 - 1982

New Quality
NEUE QUALITÄT
Time Consuming Manufacture
AUFWENDIGE HERSTELLUNG
- Homogenous,
Homogen, tightly sealed
weniger Abrasion
Inlays rand-dicht
- Search for
Suche nach fast
schneller
resistenterem Material
production
Herstellung &

- Adhesive Bonding - Enamel-like material

Mörmann WH, Ameye C, Lutz F: Mörmann WH & Lutz F (1982).
Mörmann WH:
Komposit-Inlays: Marginale Adaptation, Composite inlays: marginal adaptation,
Kompositinlay: Forschungsmodell mit
Randdichtigkeit, Porosität und okklusaler Verschleiss. seal and occlusal abrasion. J Dent Res 61:
Praxispotential?
Dtsch Zahnärztl Z 37: 438-441 (1982) 571, Abst 57.
Quintessenz 33: 1891-1900 (1982)

 5m

Information Technology Marble

Block

1977 Apple II home computer

Sculpting Restorations by Computer
Vision of Generating
1980 CEREC process patent
1981 IBM PC
1984 Apple Macintosh
1985 Windows, Microsoft
1985 CEREC 1 first clinical application
‚David‘ by MICHELANGELO 1501 -1504

 1862 First fired porcelain inlays (feldspathic ceramic)

1889
Qualtrough AJE, Wilson NHF, Smith GA. Operative Dentistry 1990; 15: 61-70

Jacket-crown, Charles Henry Land

1982 First machining experiments with dental ceramics
• Machining with
constant load
Feldspathic ceramic • Diamond coated
discs (VITA) wheel &
handpiece &
• water spray
Feldspathic ceramic can be machined
fast
fine surface quality
fine edge detail
without macroscopic damage

CERamic REConstruction “CEREC“ Patents: Europe, Japan, USA

1980 Process
EP 0 054 785 B1
1983 Brand name CEREC
1984 Material-block
EP 0 160 797 B1

1984 CEREC-CAD/CAM Unit

EP 0 182 098 B1
1985 Brains Inc., Zurich

1986 Intraoral 3D-Camera

EP 0 160 797 B1

1971-2000 Other CAD/CAM Pioneers

1971/73 Altschuler B. Dental laser holography CAD/CAM - Early Projects Japan
1975 Swinson WE. Dental fitting process - Uchiyama et al., Hokkaido 1991
1983 Anderson M. Procera titanium crown - Tsutsumi - Maeda, Kyoto 1991
- Sohmura et al. 1992
1971/85 Duret F. ,French System‘ - Miyasaki et al. 1995
1980/85 Mörmann&Brandestini ,Cerec‘ System
1987 Rekow D. ,Minnesota System‘

Peter Schärer‘s group Celay CAD/CAM & COPY IDS 1995

- DCS - System CH/D 1991

1990/91 Wohlwend A Empress-System - Celay CH 1992
1992 Eidenbenz S Celay copy mill - DCS - Precident CH/D 1994
- Ceramatic S 1995
2000 Filser, Gauckler, P. Schärer DCM/Cercon - Microdenta D 1995
DCM - Cercon - Procera S 1995
CEREC Scanning

Intraoral 3D Scanning
the gist of the matter
1. Scan How
2. Design did
3. Manufacture we do
it?
of Chairside CAD/CAM
9

CEREC 1 first “optical impression“ on the bench

May 4, 1983
CEREC 1 Camera

Functional 8-1985

CCD SENSOR 14x14 mm

Pixel size 55 µm
Inlay-Software COS 1.0 Dr. Alain Ferru 1983
Pascal (Prof. N.Wirth ETHZ 1972 Lehrsprache; Apple MacOS; Motorola 68‘000 CPU)
1984/85 Auxiliary materials
Ready-made blocks Scan powder applicators Scan liquid Scan Powder
VITA Mark I

DICOR Machinable
Glass Ceramic

Ceramics etch gel Enamel etch gel Light curing

Micro-mechanical interlocking of enamel & ceramic
13

13
1985-87 First chairside CAD/CAM unit
in action

14

1986, August 26
R&D and Licence Agreement Brains AG - Siemens AG

1997 Siemens Sirona

2016 Sirona Dentsply Sirona

 Teaching CAD/CAM

Students Scientists

Practitioners Faculty

Manufacturers / Market 16

16
 1988 CAD/CAM - Tutorial
1
Finishing &
7 2
polishing Preparation rules
Powdering

6 3
Handling of
Contouring the camera

5 4
Restoration design
Adhesive bonding & machining
17
 1988, June First international CEREC course

1989
Course attendee Dr. Pluim, the Netherlands

Mörmann WH, Brandestini M, Lutz F, Barbakow F: Chairside computer-aided direct ceramic inlays. 18
18
Quintessence Int 20: 329-339 (1989)
4
7

 CEREC-1 Inlays after 25 years

Courtesy: Dr. Tobias Otto; Aarau, Switzerland. E-mail:praxis.otto@bluewin.ch

H.S. *1938, male, age 51, wishes replacement of amalgams

1 CEREC-1
Hydro-drive
Software
COS 1.0

2 VITA Mark I
3
June 1989 July 1989 July 2014
Lower right 3 Lower left
CEREC-1 inlays
inlays 3 inlays after 19

2 hours 45 min 2 hours 45 min 25 years of service

1991 Symposium Schwärzler R; Bronwasser PJ; Lüthy H;

Switzerland
Barbakow F; Cerutti A; Italy
Switzerland Conforti GP;
Switzerland Switzerland
Magne P;
Switzerland
Otto T;
Switzerland
Peters A;
Germany

Lambrechts Bergmann Baumann M; Italy

Walther W; Geiger F; Switzerland Germany Magnusson Roznowski
Essig ME; USA D; Sweden M; Germany
P; Belgium M Sweden
Germany Leobold JM; France Saliger G;
Wilder AD; Nash RW; USA Besek M; Federlin M; Martin N; Germany
Lutz F; Grossman USA Reiss B; Germany Switzerland Germany United Kingdom Überschär
Beuttell JM; Siervo R&S; Italy Biniek KW; Meyer B;
Switzerland D; USA USA Carlsen S; Denmark Germany Switzerland
M; Germany
Nathanson Haller B; Zuellig-
Singer R;
D; USA Germany Switzerland
Féher, A;
Pallesen U; Heners M; Switzerland Fett,
Denmark Germany Heners M Lutz F HP; Switzerland
Nathanson D Mörmann W
Gougoulakis
Roulet JF; Hofmann N; B. Reiss,
Pallesen U
Kelly JR Bergmann M
A; Switzerland
Germany Germany Hahn R;
Germany
Sörensen JA; Isenberg B; Hickel R;
Germany
USA USA Holz, V;
Switzerland
Stachniss V; Kelly JR; Hürzeler M;
Switzerland
Germany USA Jedynakiewic
Stoll R; Klaiber B; z NM; United
Kingdom
Germany Germany Kunzelmann
Thordrup M; Krejci I; KH; Germany
„Adhesive Loeffel O;
„Adhesive
Denmark Switzerland Dentistry“
20 Switzerland
Dentistry“
Roulet JF Lambrechts P; B
1974 Loesche GM;
1974 Germany 4

1992 Department of Computer Restorations

Vita Mk II Enamel
Ceramic

10-year in vivo wear facet 200x

Mö
Andi 1 Björn
Daniel Andi 2
Anja
Team
2005
CEREC-1 CEREC-2 CEREC-3
1992-94 1994-2000 2000-2006
480 bonded esthetic ceramic (Vita Mark II) CAD/CAM inlays in 70 patients after 10 years: 93% survival

1996 10-Year Anniversary Symposium - the CEREC crown

208 Mark II Crowns, Survival rates up to 7 years
100

80

Cumulative Survival [%]

60
2005*
40 Classical 94.6 %
preparation : Molars
n. s. P > 0.05
Reduced 92.1 % (Log Rank)
50 Articles, 663 pages 20 preparation: Molars

Baseline Follow-up
Endo 87.1 %
preparation : Molars

0 0 10 20 30 40 50 60 70 80 90 Months

*
Bindl A, Richter B, Mörmann WH. Survival of computer-aided design/manufacturing crowns bonded to preparations
macroretention geometry. Int J Prosthodont 2005;18:219-224
22
22 with reduced

University of Zurich Dental School

1997
CAD/CAM
introduced
into the
curriculum Video 2004
Jakob Müller

Undergraduate CAD/CAM Education 4thyear students 32 hours

23

 CEREC hardware development

Integrated Systems (CAD/CIM) Split Systems (CAD&CAM)
MC XL
CEREC 1 BRAINS CEREC 1 SIEMENS CEREC 2 SIEMENS CEREC 3 SIRONA CEREC AC
inLab
inLab &Laserscanner
inEOS

1985/87 1992 1994 2000 2007 2009

VITA Mark I VITA Mark I/II VITA Mark II VITA Mark II ZIRCONIA & others BLUECAM

Furrer O, Mörmann WH. Effizienz und Kantenqualität beim computer-technischen Formschleifen von Ke-ramikinlays. Schweiz MonatsschrZahnmed 1993; 103:851-59.
Schug, J., Pfeiffer, J., Sener, B. und Mörmann, W.H.:Schleifpräzision und Passgenauigkeit von Cerec-2-CAD/CIM-Inlays. Schweiz Monatsschr Zahnmed 105: 913-919 (1995
24
Thoma K: Schleifeffizienz und Kantenqualität bei Cerec 3 Inlays, Onlays und KronenMed Diss Zürich 2001Leiter: Prof. Dr. W.H. Mörmann
24
Schrage, B.U.: Untersuchung der Effizienz des computergestützten Formschleifens von Inlays und Kronen aus ästhetischen Werkstoffen und deren Festigkeit. Med Diss 2008. Leitung W. Mörmann.

1985 2009
Introduction of the BlueCAM
CEREC-1 RedCAM 1985 (840 nm) Blue = short wave length ≈ 450 nm Higher
precision

Angle Scans - Multiple Scanning & Matching

Active image 15x21mm
Active image 14 x 14 mm; pixel 55 x 55 µm
pixel 25x25µm

1994 2012 Omnicam

Powder-free, video-mode, color
CEREC-2 RedCAM 1994

Active image 14 x 17 mm; pixel 50 x 50 µm 25

2017
Chairside Scanner
A Multitude of Hardware Offers
Computer Aided Machining Units

Laboratory Scanner

26

26
 January 2019
Primescan Confocal-Measuring Technology The vertical variation of the
focusposition provides the
hight-information required
for the 3D-measurement
20 mm foccussed depth range Object
Focal lens
lens

Focal plane
Focal plane
Surface
Surface

Vertical Focussed
Focussed
Vertical
Movement
Movement

January 2021 Full Arch Scanning with Primescan

Instruction for students by PD Dr. Andreas Ender

 May 4, 1983 January 2019

Grey scale image High
definition
image

PRIMESCAN
Confocal
scanning

Clinical scan
courtesy PD Dr.
CEREC 1 active triangulation Andreas Bindl

 New Vision of Digital Dentistry

Workflows - Fast & Easy & Precise

- Full Mouth Documentation Scans 3-5 min
- Clinical Diagnosis & Oral Health Monitoring
- Intra- & Extracoronal Restorations: Inlays, Veneers, Crowns
- Implantology: Multiple Unit & Reconstruction & Surgical Guide
- Full Mouth Rehabilitation: Planning & Reconstruction
- Complete Denture Prosthetics: Planning & Reconstruction
- Periodontology: Planning & Healing Documentation
- Orthodontics: Planning & Therapy Aligner Splints
- Maxillo-Facial Surgery: Planning & Therapy Templates
- Clinical scans courtesy PD Dr. Andreas Bindl

January 2020
CEREC Primemill

- Milling (Zirconia, PMMA, All-purpose (e.g. Tessera))

- Grinding (fast & fine, extra fine)

31

32
Pioneering times are over!!!
It‘s time now
to put your hands on
fascinating
Digital Dental
Medicine Historical Dental CAD/CAM showcase.
University of Zurich Dental School,
Switzerland, ZZM, Floor A.
Established: September 2015
33

 End of Presentation

CEREC
THE VISION OF DIGITAL RESTORATIONS
A brief historical review
by
Werner H. Mörmann