Achieving Biomimetic Goals With Digital Dentistry

As a result of this shift in mentality, Nejad's career path changed early on. Instead of starting out as an associate after dental school, he opened his own practice immediately. "I realized that was the only way that I could do this type of dentistry," he says. "Since then, my whole career has been about making my own opportunities. Rarely will you have things handed to you. When you see something that you know you want, you need to figure out how to acquire it and not make excuses. I put my mind to it, committed to finding a way, and figured it out over the past 10 years." During that time, Nejad has become a leader in the biomimetic dentistry movement. He opened the Nejad Institute to teach other dentists the same philosophies and principles. Although he now practices in Beverly Hills, California, Nejad emphasizes that his first practice was in a blue-collar neighborhood. "My fees were lower, but so was my overhead," he says. "With the correct approach to running the business and to treating patients, it is very feasible for almost any dentist to run a successful practice by focusing on inlays, onlays, composite restorations, and the overall principles of biomimetic dentistry."

For Nejad, digital dentistry has been a significant part of that approach, providing both efficiency and precision. He has utilized intraoral scanning and 3D printing for diagnostic purposes for several years. Recently, he had been considering adding a mill to his in-office laboratory when he was introduced to Amann Girrbach's new Ceramill^® DRS system at a tradeshow. "I wanted an open system with a small footprint and high quality," he says. The Ceramill DRS system includes the Ceramill^® Map DRS intraoral scanner, the Ceramill^® Mind DRS software, the Ceramill^® Motion DRS mill, and access to the AG.Live portal for data storage and transfer. "The system offers the versatility to utilize scans from anywhere, and the anatomy that it can mill is incredible because it has such a fine bur," Nejad says. "It produces posterior restorations that actually may be better than what my master ceramist can make by hand, which saves him time so that he can focus primarily on anterior restorations. It has been amazing."

Although milling can be an excellent option to improve efficiency in many practices, Nejad resisted adding a mill previously because he did not believe that the anatomy of milled restorations could meet the quality benchmark that he had set. "I want my posterior restorations to look as amazing as the porcelain veneers that we provide, and with most milling machines, that is not possible," he says. "However, the results that we are achieving with the Ceramill Motion DRS are incredible. We can mill restorations in 7 to 30 minutes, depending on the material used and the level of detail required. There is an HD mode that provides anatomy that I truly believe cannot be matched with pressing. I am blown away that you can actually get this level of detail with milling and then just staining and glazing."

In keeping with his biomimetic principles, Nejad primarily mills lithium disilicate, but he has experimented with feldspathic porcelain blocks. "When a case includes, for example, eight veneers and two crowns, using a different material for the crowns ruins the whole case, in my opinion, because it does not look the same," he says. "We are trying to find which materials we can work with that will be the same on the surface. You cannot take a feldspathic ceramic and put it on any restoration that you want; it needs compatible firing temperatures. Some zirconia blocks allow us to layer the same ceramic that we use for feldspathic porcelain, and some feldspathic blocks make that possible as well, so we are looking at those. For routine posterior restorations, however, we are still using lithium disilicate."

The Ceramill Map DRS intraoral scanner has performed comparably to Nejad's other scanners. "It is super small, super quick, and really easy for assistants to use," he says. "It is designed for restorative dentistry, and the software makes the process so streamlined. If you know you are doing a restoration, that is the smoothest process, but I also love that you have other options as well due to the open nature of the system." Nejad adds that the accuracy of the system was part of what initially sold him on milling. "We were concerned that a scanned model would be less precise than a stone model," he says, "but it has been the opposite. When I try a milled restoration on a printed model or in the mouth, it fits even better than a pressed restoration from a stone model. This is not like going from bad to good; it is like going from excellent to incredible. The restorations that I have produced with this system so far have had some of the best margins that I have ever seen."

In addition, Nejad has found the Ceramill Motion DRS mill to be relatively easy to maintain. "It does not require very frequent water and filter changes," he says. "Amann Girrbach provided an excellent 1-day, in-office training session, and since then, we have not had any major need for support."

Cost efficiency is especially critical for the approach that Nejad teaches because so many resources must be devoted to achieving high quality; therefore, the price point of the Ceramill DRS system—approximately $50,000 less than some competitors—is an important factor. "The fact that the price point is not difficult to justify at all will open doors for a lot of people," he says. "Between the cost, the open access to certain other closed ecosystems for in-office CAD/CAM, and the anatomy and detail that I believe are unmatched by any other system, this presents a huge opportunity for so many dentists to improve their practices."

Key Points

The Ceramill DRS Connection Kit with Ceramill Map DRS and AG.Live provides the basis for interdisciplinary cooperation.

The Ceramill DRS Production Kit with Ceramill Mind DRS, Ceramill Motion DRS, and AG.Live facilitates the fabrication of single-tooth restorations and up to 3-unit bridges directly in the practice.

With high precision and open access at an attractive price point, the Ceramill DRS system presents an excellent opportunity for dentists to begin producing in-office restorations.

FOR MORE INFORMATION, CONTACT: AMANN GIRRBACH • AMANNGIRRBACH.US/CERAMILL-DRS • 800-851-3719