Digital Technology Lets Dentists Make a Crown While a Patient Waits; The one-day crown systems are sold by Sirona Dental Systems

September 2, 2013, 4:44 p.m. ET

Are One-Day Crowns Worth the No Wait?

Digital Technology Lets Dentists Make a Crown While a Patient Waits



The E4D system includes machines for digital impressions and milling.

The Ache: Getting a crown for a weak or damaged tooth can be a big pain—and not just in the tooth. The process usually requires at least two dentist visits and a one-to-three-week wait for the crown to be made.

The Claim: Dentists say, with digital technology, they can make a crown in the office while a patient waits. The process takes only an hour or two.

The Verdict: One-day crown technology is convenient and produces durable ceramic crowns, dentists say. But there are “aesthetic limitations” to the one-day crown procedure making it a less appealing option for front teeth, says Jacinthe M. Paquette, a Newport Beach, Calif., prosthodontist.

A crown is a cap made to cover a damaged tooth. To prepare for the crown, dentists drill to remove the decayed portion and shape the tooth for the crown. Depending on the dentist and location, a traditional crown can cost $800 to $2,000 or more, and take at least two visits and a wait in between while a lab makes the crown.The one-day crown systems are sold bySirona Dental Systems Inc.SIRO -1.83% of Long Island City, N.Y., and D4D Technologies LLC of Richardson, Texas, which does business as E4D Technologies. The machines are now available in about 10% to 15% of U.S. dentists’ offices, the companies say.

The systems, which cost dentists about $100,000 to $130,000, include a computer that takes digital images of the damaged tooth, software to design the crown and a milling machine, the companies say.

Dentists say they don’t charge more for a one-day crown than a traditional crown partly because the machine saves on lab costs. D4D and Sirona both say their crowns are generally covered by dental insurance that covers traditional crowns.

The process starts with the dentist using a wand with a camera on the end that uses reflected light to create a three-dimensional picture of the tooth and adjacent teeth. The software suggests a design for the crown, which the dentist can tweak. A mouse click sends the design to the milling machine, which sculpts the tooth from a small block of ceramic.

Several studies show restorations made using the computer-assisted systems fit well and have good longevity, but more research is needed, particularly comparing lab-made crowns to those made in dentists’ offices, scientists say.

And if cosmetic appearance is paramount—particularly on the front teeth—a patient may prefer going the traditional route because “the artistry is just a little better,” says Steven D. Spitz, a Brookline, Mass., dentist who bought an E4D machine in 2011.

Teeth aren’t a single color, dentists say, but yellowish at the gumline with gradually changing color until they become nearly translucent. In the one-day process, dentists can simulate this effect by painting on colors with tiny brushes.

But in the lab, a technician called a ceramist can achieve an even better result by layering different colors of ceramic.

Lab-made crowns may be better for people who clench their teeth, dentists say. Clenching puts a patient at higher risk of breakage, they say, so they might prefer a gold crown—the strongest kind—which can’t currently be made with the small mills in dentists’ offices.

About bambooinnovator
Kee Koon Boon (“KB”) is the co-founder and director of HERO Investment Management which provides specialized fund management and investment advisory services to the ARCHEA Asia HERO Innovators Fund (, the only Asian SMID-cap tech-focused fund in the industry. KB is an internationally featured investor rooted in the principles of value investing for over a decade as a fund manager and analyst in the Asian capital markets who started his career at a boutique hedge fund in Singapore where he was with the firm since 2002 and was also part of the core investment committee in significantly outperforming the index in the 10-year-plus-old flagship Asian fund. He was also the portfolio manager for Asia-Pacific equities at Korea’s largest mutual fund company. Prior to setting up the H.E.R.O. Innovators Fund, KB was the Chief Investment Officer & CEO of a Singapore Registered Fund Management Company (RFMC) where he is responsible for listed Asian equity investments. KB had taught accounting at the Singapore Management University (SMU) as a faculty member and also pioneered the 15-week course on Accounting Fraud in Asia as an official module at SMU. KB remains grateful and honored to be invited by Singapore’s financial regulator Monetary Authority of Singapore (MAS) to present to their top management team about implementing a world’s first fact-based forward-looking fraud detection framework to bring about benefits for the capital markets in Singapore and for the public and investment community. KB also served the community in sharing his insights in writing articles about value investing and corporate governance in the media that include Business Times, Straits Times, Jakarta Post, Manual of Ideas, Investopedia, TedXWallStreet. He had also presented in top investment, banking and finance conferences in America, Italy, Sydney, Cape Town, HK, China. He has trained CEOs, entrepreneurs, CFOs, management executives in business strategy & business model innovation in Singapore, HK and China.

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