Tony Romanazzi's voice rises with excitement as he rotates an image of a tooth on a computer screen.
“God is good at making teeth,” he says, “but I can give him a run for his money.”
He is working with what he calls a “dental Etch-a-Sketch,” a computer-aided design and manufacturing tool that allows him to create a replacement tooth in minutes.
To the dentist with a busy practice in Glens Falls, N.Y., the technology is “the biggest paradigm shift in dentistry in more than 100 years.” And for an alumnus like Romanazzi '77, who enjoyed a range of studies at Union, it represents an exciting integration of anatomy, computer graphics, optics, robotics and other disciplines.
For patients, it is a dream come true. Typically, a crown means at least two visits to the dentist and a three-week wait while a lab manufactures a crude replica of the damaged tooth. It requires uncomfortable impressions, temporary crowns and a lot of retrofitting by the dentist. No wonder, Romanazzi observes, that dentists have become less than popular.
A visit with Romanazzi and the CEREC system takes about two hours. After preparing the tooth or the crown by removing decay or a defective filling, Romanazzi acquires a virtual image of the tooth (or the space it will take) with a small infrared 3D camera. Then he re-creates the restored tooth with the image data or from a library of model teeth.
Finally, he sends the virtual tooth to the milling machine, a microwave oven-sized box where high-speed diamond- coated drills shape the tooth from a ceramic block. After some polishing, the tooth fits as naturally as the one it replaces. Some patients remark that their CEREC teeth are the best ones they have.
The technology-called CEREC (Chairside Economical Ceramic Esthetic Restoration)-had its beginnings in the mid-80s. By 1995, Romanazzi visited his cousin in Italy-a dentist by the same name-who enthused over recent improvements in CEREC. Finally, in 2004, after some major software advances that impressed “a real 3-D guy like me,” Romanazzi climbed on board.
Most of Romanazzi's patients enjoy participating in the process, he says. They can watch the dentist design and build the virtual tooth. (One patient had Romanazzi monogram her initials on a molar.) Finally, they can watch the tooth take shape in the milling machine.
“I used to hate going to the dentist,” said longtime patient Ed Bartholomew '71, a counsel to New York State Senate Majority Leader Joe Bruno. “But knowing Tony was a Union guy made it easier.”
Bartholomew praises the technology but adds, “at the end of the day, the dentist is the operator. It's ironic, Tony's a dentist, but this also requires him to be something of an engineer.” Bartholomew, who served as mayor of Glens Falls for eight years, knows “Dr. Tony” as an enthusiastic community leader who also enjoys building and flying experimental aircraft. “He's not your typical dentist,” Bartholomew says.
Romanazzi knew he wanted to be a dentist at age 8, when he began to emulate a popular and outgoing dentist in his native Gloversville, N.Y. His father, a master tool and die maker, saw to it that his son had a thorough knowledge of tools and working with his hands.
While a full-time student at Union, he joined a dental lab, at first taking out the trash. But he eagerly took on the profession. By the beginning of his sophomore year, he had an unusual distinction for a Union student: certified dental technician.
At Union, he majored in biology and chemistry, with a good dose of engineering. The experience, he says, prepared him well. “Union pushed me harder, farther, faster and well beyond the best I could do,” he says. At Tufts, where he earned his D.M.D. degree in 1981, classes were “nothing more than one of Union's upper- level biology courses.”
He stays in touch with Union professors-George Butterstein, Twitty Styles, Will Roth and others. “I can pick up the phone anytime and it's like we just talked yesterday,” he says.
Romanazzi lives in Queensbury, N.Y., with his wife, Deborah. They have a son, Andrew, who will be entering college this fall; and a daughter, Julianna, in high school.