When advising patients on dental restorations, practitioners must choose between modern CAD/CAM solutions like CEREC and traditional laboratory-crafted porcelain restorations. This comprehensive comparison aims to support dentists in making evidence-based recommendations that best serve clinical outcomes and patient satisfaction.
Clinical Assessment of Available Options
CEREC Restorations
Material Composition
- Fabricated from solid ceramic blocks (typically lithium disilicate or zirconia)
- Computer-milled from a single block of material
- Monolithic construction provides structural advantages in select clinical scenarios
Technology & Fabrication Process
- Utilises CAD/CAM technology for single-appointment delivery
- Digital scanning eliminates conventional impression materials
- Software-designed restorations based on real-time digital measurements
- In-surgery milling unit produces the restoration during consultation
Practice Efficiency
- Same-day completion (typically 2-3 hours total chair time)
- Eliminates the need for temporary provisionals and follow-up appointments
- Reduces patient recall requirements and streamlines scheduling
Clinical Indications
- Appropriate for routine to moderate restorative cases
- Particularly efficient for posterior restorations where functional requirements predominate
- Valuable option for emergency situations requiring immediate intervention
Traditional Porcelain Restorations
Material Composition
- Multiple formulations are available, including feldspathic porcelain, lithium disilicate, and layered ceramics
- Utilises multi-layered construction to replicate natural dentition properties
- Materials can be selectively combined to optimise both strength and aesthetics
Craftsmanship & Fabrication Process
- Produced by specialised dental technicians and master ceramists
- Created through systematic layering techniques with individualised characterisation
- Each restoration is custom designed to patient-specific requirements
Clinical Protocol
- Standard two-appointment approach with 1-2 week laboratory phase
- The temporisation period allows for patient assessment of aesthetics and function
- Interdisciplinary communication facilitates refinement and customisation
Clinical Indications
- Exceptional results in aesthetically critical cases (anterior restorations, high smile line patients)
- Ideal for complex restorative cases requiring precise shade integration
- Recommended for patients with elevated aesthetic expectations or complex occlusal schemes
Critical Evaluation Criteria
Aesthetic Parameters
CEREC Restorations
- Satisfactory aesthetics for standard clinical presentations
- Inherent limitations in colour gradation and translucency
- Potential uniformity or monochromatic appearance
- Challenges in achieving precise match with adjacent natural dentition
Traditional Porcelain Restorations
- Superior optical characteristics mimicking natural teeth
- Multi-dimensional layering creates authentic depth and translucency
- Customised characterisation techniques available
- Precise shade-matching capabilities with adjacent dentition
- Enhanced surface texture and light reflectivity properties
Marginal Integrity & Fit
CEREC Restorations
- Digital precision offers consistent, reproducible results
- May necessitate additional chairside adjustments
- Marginal accuracy contingent on scan quality and design parameters
- Generally acceptable fit but limitations in complex preparations
Traditional Porcelain Restorations
- Expert technicians achieve exceptional marginal adaptation
- A laboratory-controlled environment allows meticulous refinement
- Superior emergence profile and axial contours
- Enhanced management of complex occlusal schemes
Clinical Longevity
CEREC Restorations
- Demonstrated durability in appropriate clinical applications
- Monolithic design mitigates the risk of veneer fracture
- Literature supports 90%+ survival rates at 10 years in suitable cases
- Potential for accelerated wear of opposing dentition without proper finishing protocol
Traditional Porcelain Restorations
- Established long-term clinical performance with proper maintenance
- Material selection can be tailored to specific occlusal considerations
- Superior performance in high-load scenarios when properly designed
- Extensive clinical documentation supporting long-term success
Practice Economics
CEREC Restorations
- Generally comparable fee structure to traditional options ($800-$3,000)
- Substantial initial capital investment for practice equipment
- Single-appointment protocol may improve practice productivity
- Reduced laboratory costs offset by technology investment and maintenance
Traditional Porcelain Restorations
- Fee structure varies based on materials and laboratory expertise ($800-$3,000+)
- Reflects technical expertise and time investment of laboratory partners
- Premium restorations command appropriate fees for superior aesthetics
- Represents sound long-term value proposition for practice and patient
The RWD Dental Image Partnership Approach
At RWD Dental Image, we support practitioners in offering both CEREC restorations and traditional porcelain restorations while maintaining our commitment to exceptional quality. Our recommendations are founded on decades of clinical collaboration and thousands of successful restorations:
Clinical Scenarios Favouring CEREC Restorations
- Patients presenting with legitimate time constraints requiring immediate delivery
- Posterior restorations where functional considerations outweigh aesthetic demands
- Emergency presentations requiring prompt intervention
- Cases where digital workflow offers specific advantages for the practitioner
Clinical Rationale for Traditional Porcelain
For practitioners committed to delivering the highest standard of restorative care, we believe laboratory-crafted porcelain restorations represent the gold standard for several evidence-based reasons:
- Superior Aesthetic Outcomes: Our master ceramists create restorations with natural optical properties and individualised characterisation that exceed the capabilities of milled alternatives.
- Enhanced Customisation: Traditional fabrication enables precise control over morphology, shade gradients, and anatomical detail to complement each patient’s unique dentition.
- Documented Longevity: The meticulous craftsmanship and material selection contribute measurably to restoration durability and long-term success rates.
- Optimised Marginal Integrity: Our laboratory protocols ensure excellent marginal adaptation, minimising recurrent caries risk and enhancing clinical longevity.
- Practice Differentiation: Offering premium laboratory-crafted restorations enhances practice reputation and patient satisfaction, supporting referral-based growth.
Clinical Decision Framework
When discussing restoration options with patients, we suggest considering these evaluation criteria:
- Restoration location and aesthetic zone considerations
- Patient’s functional and aesthetic expectations
- Practice scheduling and efficiency requirements
- Financial considerations and long-term value assessment
- Practitioner’s clinical experience and technical preferences
While CEREC technology offers significant workflow advantages and acceptable outcomes for many indications, our collaborative experience consistently demonstrates that practitioners seeking to deliver exceptional aesthetic results and long-term patient satisfaction achieve optimal outcomes with expertly crafted traditional porcelain restorations.
RWD Dental Image remains committed to supporting practitioners in providing restorations that exceed functional requirements and aesthetic expectations, creating results that integrate seamlessly with natural dentition and demonstrate exceptional clinical longevity.
