After years of development the newest Cad Cam systems are so much better than what was available just a few years ago I believe it is now reasonable for the typical dentist to consider.
CAD-CAM stands for Computer Aided Design and Computer Aided Manufacture. The system uses a high tech device to take an digital impression of a prepared tooth. The computer then designs a restoration and mills it out in a special chamber. The result is a one step lab type restoration with no impression, no temporary and no second appointment.
Past criticism of the early Cerec Cad Cam units has centered on poor marginal fit, the inability to do full coverage, lack of esthetics, limited materials and it took too much time. The new systems address all of these issues. The marginal fit is now the same as traditional lab restorations. The user can now do both full and partial coverage but can not do bridges (yet). The esthetics is better because the materials have improved and now include materials that are the equivalent of pressed porcelain like Empress and composite polymers like Belleglass. And new Windows based software streamlines the process so that a single restoration can be designed in three to five minutes.
Despite all these advantages most dentists are still afraid of the cost. A single system is over $100,000. That seems like a huge investment, however it is really easy to justify based on both lab savings and time saved with no second appointment. It will be a stretch for offices that still do a lot of amalgams. For dentists who are already doing a lot of indirect posterior onlays and crowns it is a natural fit.
If you have been considering a Cad Cam system take a good look at the E4D for dentists which will be available from Sullivan Schein later this year.