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ePaper created 2015-03-06, 14:42:46 | version 1.33.01
I 53 opinion _ ecological advantages of CAD/CAM I CAD/CAM 1_2015 of your dental office to environmental mercury. It also means that dental practices needn’t worry about using an amalgam separator. Currently,theAmericanDentalAssociation(ADA) does not have national regulations in place for amalgam separators, so many dental practices and laboratoriesaren’tcompelledtousethem.Although designing and milling all-ceramic materials still re- quires energy and results in some waste materials, can they really compare with the toxic by products of metal-based restorations? _Crunching the numbers: CAD/CAM math In-office CAD/CAM systems provide more than just a clear conscience about saving the environ- ment. There are real, tangible benefits and savings that can easily be estimated to demonstrate the immense value of this digital technology. Because same-day in-office CAD/CAM dentistry reduces the number of appointments from two (or possiblymore,iftherestorationdoesnotfit)toone, it stands to reason that every dentist who incor- porates these procedures would positively impact the environment by reducing the number of auto- mobile trips patients make to the practice. This would result in a 50 per cent reduction in gasoline and oil product use. Withacarboncontentof2,421grams,onegallon of gasoline produces approximately 19.4 pounds per gallon of carbon dioxide emissions. This is cal- culated by multiplying the carbon content (2,241) by the amount of carbon that remains unoxidized (0.99)bytheratioofthemolecularweightofCO2 (44) to the molecular weight of carbon (12). Using the state of California as an example, where approximately 10 per cent of the 100 million laboratory dental restorations are completed in the United States every year, we can calculate an approximate savings. If four gallons of gasoline are used for a round trip to the dentist, a restoration needing two appointments to complete would re- quire eight gallons of gasoline. But if these dental practices adopted same-day in-office CAD/CAM dentistry, that number could be cut in half, saving fourgallonsofgasolineperrestoration.Fourgallons of gasoline multiplied by 10 million restorations would equal a savings of 40 million gallons of gasoline for restorative procedures in the state of Californiaalone.This,inturn,wouldequalareduction of carbon dioxide emissions by 776 million pounds per gallon each year (assuming the previously cal- culated 19.4 pounds per gallon measurement). IfweextrapolatetotheUnitedStatesasawhole, we can calculate that this would equal 400 million gallons of gasoline saved and 7,760 million pounds per gallon of carbon dioxide emissions eliminated, per year. This would all be due solely to a reduction in patient automobile trips to and from the dentist for restorative procedures. While same-day dental procedures may not save the world, their potential impact, even estimated, is undeniable. _Conclusion In-office CAD/CAM systems’ advantages are limitless. In addition to the clear financial and prac- ticalbenefitstheybring,theirpositiveimpactonthe environment makes the decision to upgrade even better. They remove toxic, wasteful and disposable materials and practices from the equation, replac- ing them with greener practices that have a tan- gible influence. While the clinical advantages of CAD/CAM systems and same-day dentistry con- tinue to be rightfully celebrated, their ecological advantages should not be overlooked._ Editorial note: This article was published in CAD/CAM C.E.MagazineNo.01/2014. _References 1. Della Bona A, Kelly JR. The clinical success of all-ceramic restorations. J Am Dent Assoc. 2008; 139:8S-13S. 2. Sjogren G, Molin M, van Dijken JW. A 10-year prospective evaluation of CAD/CAM-manufac- tured (CEREC) ceramic inlays cemented with a chemically cured or dual-cured resin composite. Int J Prosthodont. 2004;17(2):241–246. Dr Joel Strom is a former president of the California State Dental Board and former course director of“Ethics in the Practice of Dentistry” at USC School of Dentistry. He graduated from UOP School of Dentistry in 1979 and completed an NIH post-doctoral fellowship at Columbia University in 1983.He has owned an E4D milling machine and camera for five years and practices general dentistry in Beverly Hills and provides consultation and litigation support in the dental health area,including corporate clients, governmental agencies and individual dentists. CAD/CAM_about the author CAD0115_50-53_Strom 02.03.15 13:18 Seite 4 CAD0115_50-53_Strom 02.03.1513:18 Seite 4