Success strategy for CEREC in the dental practice: one-day dentistry with VITABLOCS is popular with patients

Dr. Tsao had already tried a number of things in order to feel content with his field of dentistry. Initially, he wanted to specialize in implantology. There was also a time when he focused on orthodontics. But at the time, that was still completely analog. In 2005, his supervisor purchased a CEREC 3 unit. This was a pivotal encounter, even though the first attempts were challenging: “I still found it quite difficult to get used to the digital workflow. The software wasn’t exactly user-friendly, and the range of indications was still very limited. We thought that one-visit dentistry simply didn’t work.”

So it was back to traditional dentistry, at least to begin with. And instead of scanning and designing on virtual models, they returned to putting trays with impression material in patient mouths and waxing restorations on master models. As a result, Dr. Tsao’s search for fulfillment in dentistry continued.

Eventually in 2013, Dr. Tsao established his own clinic in Taiwan’s capital city Taipei, a very competitive market. With five treatment chairs, the practice was small to begin with. It was clear that they had to offer something different to stand out. He asked himself, “How can we survive with so much competition?” This was the question that led him back to digital dentistry. His vision was to be the person who would solve the functional and esthetic problems of patients using this technology. In the meantime, the biogeneric database was generating good design suggestions so that the esthetic restorations that could be fabricated, only had to be finalized. Dr. Tsao still remembers well the first patient who he treated in his practice with a posterior crown using the digital workflow: “We completed treatment within an hour. The patient was very happy and genuinely surprised at how fast it went. And because the patient was happy and satisfied, we were too! That’s when we knew that we were on the right track.”

And then there was a moment that changed everything. One day, a social media influencer came to Dr Tsao’s practice for treatment. The deal was quickly made that the crown restoration would be free of charge if the treatment result was showcased appropriately on her social media channels. No sooner was the fast and esthetic treatment result posted with a link to Dr. Tsao’s practice than there was a veritable rush of patients. They all wanted exactly the same treatment as the social media influencer, with one-visit dentistry. “Wow! That really inspired me. Now I knew that this treatment concept worked and that using it generated positive attention”, recalls Dr. Tsao, of this crucial encounter. The doubt that he initially felt, as to whether there were really enough patients for this type of treatment was suddenly gone. “Looking back, it was worth persevering with the idea and the conviction that this worked,”, says Dr. Tsao, of his journey to success. 

It was clear that the treatment already worked superbly in the posterior region. Here, the primary focus was on function. The biggest challenge was then to reproduce the correct tooth shade with absolute precision in the visible esthetic zone, particularly in the anterior region. “What’s the point of perfect morphology and texture if the shade isn’t right? The patient would reject the restoration. What’s more, Taiwanese tend to have more of a yellow basic tooth shade,” says Dr. Tsao, regarding the next big hurdle that had to be tackled. He adds: “This was really the biggest challenge for us!” The blocks on the market were often only available in three different translucency levels. They were often more white or gray. So, they couldn’t really be used to reproduce Taiwanese tooth shades. A shade gradient wasn’t integrated either. “What we needed for anterior teeth was a block with the correct shade in three different intensities,” says Dr. Tsao, when describing the required materials.

He kept thinking about the problem and began looking for a solution. Then, one day at a trade show, he made a discovery that offered him what he had been looking for: VITABLOCS TriLuxe! Since his dental technician was not with him, he was reluctant to try the block on site. VITA’s dental technicians immediately jumped in to assist, working collaboratively with Dr. Tsao to be part of the solution he was seeking for anterior restorations in his practice. VITABLOCS TriLuxe is a polychromatic block that represents the final restoration result. Finally, treatment in the anterior region became easier and more predictable. “I can still clearly remember the first patient I treated with VITABLOCS TriLuxe, with the assistance of VITA. It was a 28-year-old woman. She wanted 20 upper and lower restorations in a single session, and I said yes. The dental technicians were anything but happy and told me that I’d promised too much,” recalls Dr. Tsao, of the first time he used VITABLOCS TriLuxe in his practice. In the end, they managed to tackle this difficult challenge together, even though it took until well past midnight. From that moment on, Dr. Tsao realized how important effective teamwork is among dentists and dental technicians. Today, this is still the cornerstone of his success and is something he takes pride in.

Soon a new VITA innovation was added: Thanks to its integrated three-dimensional layer structure, VITABLOCS RealLife offered a variety of translucency levels and decreasing shade intensity towards the incisal area, even for bright shades. “This block saved so many of our anterior cases. That’s why we’ve nicknamed it the Single King. It’s the right material to choose for anterior single tooth restorations,” says Dr. Tsao, who still remains delighted about VITABLOCS RealLife to this day. Now anterior single-tooth restorations could also be provided quickly and successfully with one-visit dentistry.

And Dr. Tsao would not be Dr. Tsao if he didn’t continue to try to further improve the digital workflow. “We continued to adapt tooth shade determination, virtual design and the furnace temperature even further. We keep learning new things when designing surfaces, so that now we only need five minutes,” he says when describing the developments that made the restorations even more robust and more natural looking.

“Today, we can provide patients with a restoration within two to three hours. VITABLOCS has made our digital workflow efficient and reliable. We only need five additional minutes to add the surface texture and staining because the restoration already has the right basic shade effect. In fact, just simple polishing is also enough,” says Dr. Tsao, describing the current situation. This is where he differs from many dental practices that use other CAD/CAM materials, and can only achieve a final result that may match after time-consuming staining. He also sees the shade fidelity with VITA Shade Guides for visual shade determination as a fundamental advantage for correct shade reproduction.

An increasing number of patients wanted treatment using one-visit dentistry with the result that the practice soon had to be expanded from five treatment chairs to 22. In other words, the patients themselves had brought about a significant milestone, thanks to the incredible demand they had generated. Dentists, dental technicians, VITABLOCS and CEREC had become a successful and well-received unit. After almost nine years, the success rate of VITABLOCS at his clinic is 97 %.

“Without one-visit dentistry, I probably wouldn’t be a dentist anymore. I like dentistry in combination with this technology,” says Dr. Tsao, summarizing his career path. His advice: “Dentists must change their analog approach and no longer just send impressions to the laboratory. They must collaborate closely with dental technicians if they want to be successful with CAD/CAM. And every new workflow has a learning curve. This is particularly true for the esthetic anterior region. Trying it just once is not enough. You need to put your heart into it and keep questioning yourself.”