rotations

On most Monday and Wednesday afternoons, the D2 class is split into groups that then go through a variety of rotations.

Most recently, I had the BLS (Basic Life Support) rotation.  Basically, it was a class on CPR; and no CPR class is complete without plastic mannequins to practice on.  And obviously, and time there are dummies involved, a photo op will ensue.  Here are a few photos from our BLS rotation.  Don't you feel confident placing your life in our hands? :)

Another rotation I had recently was the CAD/CAM rotation.  CAD/CAM stands for computer-assisted design and computer-assisted milling.  Traditionally, when a patient needs a crown, the dentist will prepare the tooth, take an impression to send to the lab, and then place a temporary crown over the tooth.  Then, the lab will use the impression to make a model of the patient's mouth and fabricate the crown before sending it back to the dentist to be cemented in.  It takes 2 appointments that are spaced at least 2 weeks apart.  However, thanks to CAD/CAM, a permanent crown can be done in a single appointment. Obviously, this is more convenient for the patient.  The tooth is prepared for the crown and instead of an impression, the tooth is scanned into the computer.  This is what it the scan of the area looks like.

Then, you use the computer to design the shape of the tooth.  It is somewhat technical as you need to make sure you have proper contacts with the adjacent teeth, proper occlusion, good margins, proper material thickness, etc.  Once you are done, the tooth may look something like this.

Then you send it to the milling machine, which carves a block of porcelain into a crown.  There is a tiny window to watch it being milled, but since there is a lot of friction and lots of heat, there is a soapy cooling solution sloshing around that makes it difficult to see much.

Twenty minutes later, you get a crown out of the machine that looks like this.  At this stage, you can try is on the patient and make any necessary adjustments.

Finally, you glaze the crown and add all sorts of glazes and tints to make it look like a natural tooth (because the purple unfired porcelain just doesn't look right, obviously).  It is amazing all the different nuances that can be achieved.  You put the crown in a little oven for about another 20 minutes and fire it.    Finally, the crown is complete and once cooled, can be cemented into the patient's mouth.  And there you have it folks, a crown done in a single appointment on a single day.

Now the trick is being able to afford the $100,000 machine and learning how to use it...because it is not easy.