Nothing Is New

I remember reading somewhere that an original thought is, by definition, impossible because our cognitive insights are always derived from external experiences. Obviously the argument was expressed much more elegantly by the author, and it made sense at the time. Our common intuition, however, seems to suggest otherwise, and we enjoy taking ownership of our intellectual creations.

During my time in graduate studies, CAD/CAM dentistry was something of an odd subject. On paper, it was always teetering on the brink of showing great potential, only to be mercilessly condemned by the clinical community. The power of digital technology was seemingly restricted to the virtual world, and had trouble finding satisfactory and practical real-life applications.

The consensus at the time was that dental CAD/CAM was simply not ready in terms of accuracy and aesthetics.

It appeared to be a logical conclusion. But was it? It was very strange to me that “machines” wasn’t synonymous with “accuracy”. After all, aren’t most things that require high precision nowadays made by machines? Was dental CAD/CAM different, or was I just blinded by an engineer’s propensity to trust digital technology more?

Thus began my pursuit to discover the source of this accuracy problem, and the more I look, the more it became clear that the vast majority of inaccuracies can be attributed to errors in human operation. Soon I was convinced that if a CAD/CAM restoration doesn’t fit, it’s the operator’s fault. This wasn’t a popular subject in literature at the time, and so I wrote my dissertation and that was that.

A couple of days ago I came across a journal article from Nature that outlined in detail the state of CAD/CAM dentistry, and how dentists need to adjust their preparation techniques to accommodate the new digital workflow. The problem? It was an article written in 2008, many years before I completed my research.

After all this time, people are still complaining how this technology is simply “not ready” for mainstream use. One of the most common questions I get as a lecturer is “why are CAD/CAM crowns either too loose or too tight, and rarely a good fit?”

So why did these recommendations fall on deaf ears?