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CROWNING achievement -New procedure at local dental office restores crowns, veneers in one visit

April 20, 2010

Gina Geiser is constantly on the go, juggling her children’s school schedules and extracurricular activities with little time left for herself.

And lack of time prevented her from scheduling an appointment despite recurring dental problems. The Berwick woman has experienced problems over the past four years, after suffering from a locked jaw. Any dental work has the potential to be troublesome, since she can’t open her mouth wide or keep it open for a long amount of time. Her teeth and gums are also sensitive to ongoing work.

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“My tooth had a root canal,” she explained. “The tooth became chipped and the surface was worn down over time. I knew it needed to be fixed, but I kept letting it go and then I was afraid that tooth would break.”

So when her dentist, Dr. James DeFinnis of Back Mountain Dental in Trucksville, told Geiser, 31, that she would need a crown to replace a tooth that was worn down by TMJ, she was apprehensive.

But when he told her that the work could be completed in a single dental appointment in less than two hours, Geiser felt a lot better.

Saving time is the main benefit behind the new dental technology that restores crowns and veneers in only one office visit.

The process, called CEREC, restores crowns and veneers in about two hours. But while it has been available since 1987, with more than 15,000,000 restorations done nationwide, only one dentist offers the procedure locally.

DeFinnis said the new Blue Cam CEREC machine, which he acquired last fall, can make dental crowns and replace fillings chair-side.

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“The new technology has taken dentistry to a whole new level,” he said. “In the past year, our office saw a change in the way patients scheduled their appointments. Patients had to leave work early to get their crowns done. Then, they had to schedule another appointment to get fitted and a temporary crown while their crown was being made in an out-of-town laboratory. We needed to extend our hours to serve our patient population. CEREC helps alleviate that with only one appointment necessary. A lot of our patients are happy that they don’t have to return for a second visit.”

Geiser had a traditional crown replacement several years ago and cringed at the thought of the hassle and discomfort of getting fitted for an impression and wearing a temporary crown until a new permanent crown could be placed in her mouth. On top of all that was the inconvenience of several 45-minute commutes from Berwick to Trucksville.

But after one visit, Geiser has a new “tooth.”

“I was really pleasantly surprised that everything went so smoothly,” she said. The woman wore a bite lock so that her mouth could remain open during the process.

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CEREC is a dental restoration product that allows a practitioner to produce an indirect ceramic dental restoration using a variety of computer-assisted technologies, including 3D photography and CAD/CAM, explained DeFinnis. CEREC is an acronym for Chairside Economical Restoration of Esthetic Ceramics.

With CEREC, teeth can be restored in a single sitting with the patient, rather than the multiple sittings required with earlier techniques. Additionally, with the latest software and hardware updates, crowns, veneers, onlays and inlays can be prepared, using different types of ceramic material.

The major draw to the dentist is that CEREC conserves the natural tooth structure of the patient, saving as much healthy tooth tissue as possible, DeFinnis said, which literally “banks” that part of the tooth in the event more dental work needs to be done. “Old silver fillings break down and cause the natural tooth structure to crack,” he said.

CEREC is chemically bonded to the tooth. The result is a natural look and feel with enamel-like materials that are long-lasting and tooth-colored, the dentist explained.

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Years ago, dentists could only use amalgam, gold and other metals to fix decayed and damaged teeth. “Before, crown work took all of the tooth’s natural structure,” he said. “With CEREC, the work is very specific to that patient. It is tailored to what a patient needs. It’s like a piece of a jigsaw puzzle in how it fits into the mouth.”

The procedure is simple and the patient can watch along as the technician does the work, as Geiser did, or they can work on their laptop computer. “It was interesting to see how the computer forms the new tooth,” she said.

“Time really flies by as we’re doing it,” said DeFinnis.

First, the cavity preparation is photographed and stored as a three-dimensional digital model. Proprietary software is then used to approximate the restoration shape using biogeneric comparisons to surrounding teeth. The practitioner refines that model using 3D CAD software. When the model is complete, a milling machine carves the actual restoration out of a ceramic block using diamond head cutters under computer control. When complete, the restoration is bonded to the tooth using a resin.

A patient must still get anesthesia. After the procedure, a patient can immediately resume normal brushing, flossing and eating.

Geiser said she didn’t experience any problems. Any initial discomfort and sensitivity was attributed to her existing dental condition, she said.

A week later, the Berwick woman says she’s eating normally and has no sensitivity. DeFinnis also made Geiser a new bite guard, which she wears at night to prevent grinding her teeth in her sleep.

DeFinnis and the three dental assistants at his office received training in the equipment and procedure in Scotsdale, Ariz., where they studied under Dr. Frank Spears, one of the country’s leading educators in aesthetic and restorative dentistry. DeFinnis is part of Spears faculty study club and also attends courses around the country.

“This is more comfortable to our patients because there is less stress for dental visits, which is good for those dental-phobes,” DeFinnis said. “And some of our patients have a gag reflex, so it’s great because the dentist isn’t as much in the mouth with this procedure as the old way.”

The procedure is applicable for patients of all ages, depending upon the severity of the tooth decay, DeFinnis said. A silver filling can be removed and replaced as necessary. “It lasts as long as a traditional crown or even longer,” he said. “These are the longest-lasting restorations on the market.”

About 95 percent of all the crown and filling work is now done by CEREC. However, if a cavity falls below the gum line, DeFinnis said the old filling replacement work would most likely be done.

Most major insurance plans will cover CEREC, with the cost of the procedure the same as the traditional crown replacement, which is under $1,000, according to DeFinnis.

“This has really changed the face of dentistry and 10 years from now, it will change it even more,” said the Back Mountain dentist. “While CEREC was around since the late 1980s, it is more user-friendly.”

Geiser agrees. “Just the time savings alone is worth it,” she said.

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Top 40 under 40

March 3, 2009

Dr. James C. DeFinnis
Company: Back Mountain Dental
Title: Dentist

Dr. James C. DeFinnis is one of Northeastern Pennsylvania's most respected practitioners of general and cosmetic dentistry. His private practice at Back Mountain Dental in Trucksville offers a full range of dentistry with an emphasis on cosmetic and restorative dentistry.

A graduate of Temple University School of Dentistry, Bucknell University and Berwick Senior High School, he is the third member of his family to join the dental profession. His father, Dr. John DeFinnis, and brother, Dr. Thomas DeFinnis, practice in Berwick and Philadelphia, respectively.

James is a member of the American Dental Association (ADA), Academy of General Dentistry, American Academy of Cosmetic Dentistry (AACD) and Pennsylvania Dental Association.

He continues to educate himself in the latest dental techniques and has attended classes at the prestigious Las Vegas Institute for advanced dental education and attended courses by Dr. Frank Spears, one of the country's leading educators in esthetic and restorative dentistry. He also attends courses throughout the country to enhance the services he provides to residents who live in the Wilkes-Barre, Scranton areas.

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What do you do in your spare time?
Spend time with my friends and family (wife Jodee and two daughters, Isabella and Nadia).

What is something most people don't know about you?
I enjoy extreme sports like drag racing a snowmobile on grass and surfing.

Who has been the most influential to you professionally?
My father, who also is a dentist, showed me how to run a successful group dental practice.

What is your favorite type of music?
Rock

When you were a child, what did you want to be when you grew up?
A professional skier

Who is a celebrity that people say you look like or remind them of?
I wish I could say someone like Brad Pitt but the girls at my office jokingly say Hermey from Rudolph the Red-nosed Reindeer.

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What was your first job?
Sales in a ski shop

If you could switch places with one person for a day, who would it be and why?
Richard Branson, owner of Virgin Mobile. He seems to have balanced his business success while having fun doing it.