Download the 3D Occlusal Plane and Vertical Line
horizontal plane and Vertical line
Here’s a tutorial on how to use tinkercad in more depth
Download the 3D Occlusal Plane and Vertical Line
horizontal plane and Vertical line
Here’s a tutorial on how to use tinkercad in more depth
This webinar hosted by CAD-Ray is an information program detailing the specific screw called the Powerball for Full Arch Hybrid Restorations
The CAD-Ray team is happy to announce that CAD design software has experienced a breakthrough. One of the hurdles of using design software has always been that it was created with lab technicians in mind; the rationale being that technical staff would be using it more than clinicians. It is no wonder that many still send off their scans to labs to be designed “by the experts.”
With the boom in digital and CAD/CAM dentistry, many offices are finally making the leap to bringing some or all of that workflow in-house to be done chairside (as they should). While there are many solutions available to incorporate one or more aspects of the digital dentistry workflow into your practice, it’s safe to say that the innovative design of Clinux is a turning point for design software.
Clinux is the result of collaboration by a team of experts from the most reputable and recognizable brands in the dental industry, all previously involved with advanced technology and equipment. It is made by those who have seen the pain points of the best programs in the dental world. They came up with a plan to eliminate the confusing barriers to simple plug and play design. Clinux is made for dentists in mind, not lab technicians. Less time spent onboarding, less clicks to your finished designs, and clear, reasonable fees all result in the first dentist-friendly CAD design software. Best of all, storage is not required. It is the first CAD design software that operates in the cloud.
Clinux; it’s completely independent, and curiously intuitive. It’s reasonably (and transparently) priced and very accommodating to workflow integration. Combined with the power of Medit, it is easily the most portable and efficient digital solution you’ll find anywhere. As always, the CAD-Ray team, the leader at post-sale technology support will be in your corner with its White Glove service. We encourage you to check it out and see for yourself…
For advanced users of meditlink software, you can skip filling out the Rx form and go straight into scanning. But make sure to properly fill out the CAD Rx form so that all the necessary models are imported into the design software. If you don’t designate the opposing or the Pre-op / Wax-Up in the form, they will not be part of the design equation. Also, this video shows how to select multiple restorations at once.
This article features the new Meditlink 2.3 software which has some advanced functionality. One of the greatest achievements is he ability to tell the scanner to avoid imaging certain colors like green and blue. This greatly facilitates the imaging of full arches as you can let your gloves / fingers guide the camera and displace all the soft tissue that impedes image capturing. We also feature how easy it is to launch CAD software to design the restoration and mill it out of lithium disilicate material
Case set up: here we enter the patients name and a simple tab appears where we chose the material and restoration tab. Once you image, you can place an order to the lab or you can advance to the CAD tab:
After the Rx has been filled out, you can launch the Medit Scan and image the upper and lower arches. Please note how we tell the camera to avoid the color blue and it ignores the clinicians fingers during imaging. The upper jaw and lower jaw were captured, then the bite registration even before the preparation was finished. This allows the verification of proper reduction and space for the ceramic material
Lower Arch Scan
The lower arch is the most difficult area to scan as you frequently have to battle the tongue, saliva, and the lips. The optragate can be of great help but notice how we use the color filter to hide the blue gloves while we advance the camera. It is a great aid in facilitating the capture of the lower arch
Upper Arch Scan
The same principle is applied to the upper arch. Notice that the software does not care if you start with the upper or lower arch. Here, you can visualize how the blue glove was used to displace the cheek and capture the pre-op condition of the upper second molar. The rest of the arch was easily imaged. It is not necessary to capture full arch impressions and this was done just for demonstration purposes. For a single unit case, generally imaging distal from the canine is adequate.
Checkingthe reduction and aquiiring the bite registration
We recommend that you capture the bite before you finish imaging the preparation. This gives you one last chance to verify that you have reduced enough to accommodate material thickness. You can see how we just take regular photos to document the lack of clearance and we continue to adjust the height of the preparation until we achieve the required space. We then activate the imaging process and capture the occlusal relationship between the upper jaw and the lower jaw
Image the preparation and place margin in native MeditScan Software that transfers to CAD Software
The preop condition is then transferred to the arch model and the tooth in question is cropped out. The rest of the arch is protected so no extra data is added unnecessarily to the equation. This protect feature is used for demonstration purposes and is subsequently removed. The prep in question is then highlighted and the local area is processed and the margins are placed. This margin line can be sent to the lab or it can be automatically carried to the design software
Launch CAD Software
The Meditlink software allow you to launch a variety of CAD programs that include 3shape, exocad, cerec, etc… Here we launch exocad which automatically imports and aligns the models and marks the margins. The restoration is then designed to completion.
Design of restoration
The CAD software allows you or the lab to alter the marked margins if necessary. The restoration is aligned in the arch for and the contacts are adapted to the adjacents and the oppising
You can take the designed restoration to ANY milling machine or printer
Milling of Lithium Disilicate with Imes Icore Coritec One
The final restoration design can be exported as an stl and taken to a variety of mills or printers. Here we designed it millbox and milled with the coritec One. The material used was Amber Mill and it was crystalized and seated
Final X-ray was taken to verify the fit and to make sure no excess resin was left behind
The following pictures depict the sequence of burs we recommend that you use to finish a preparation quickly. While patient is getting numb, take a quick look at the clearance you will need to reach proper material thickness. Once the quadrant is isolated with isolite and optragate, take an occlusal router bur and create a trough to gain the proper depth. Follow that with a flat disk, and you can quickly reduce the occlusal height.
A shoulder bur of .8 mm thickness can help you reduce the interproximal areas as well as the buccal and lingual margin lines. Before finishing the prep, place hemostatic agent like expasyl in the sulcus and place retraction cord. while it is setting, check your reduction. If you need more space, now is the time to reduce some more.
Once you have adequate clearance, retraction, and hemostatis, you can readily image and find your margins in the CAD software
Thanks to Justin Shafer who created a script for us that allows you to export an stl file to a specific directory, where you create a subfolder for each program you want to run. Once the file lands in a subfolder the program is launched and the models are important.
Justin did this at no cost. The more you donate to his work, the more programs he can add to the installer. Some programs like Rayware allow you to import multiple files into one program whereas others launch a single program for each file, like BlueSkyBio. Contact the software designers to easily add commands line to accommodate your needs
Click to download the installer file and donate to Justin through paypal
One of the big limitations of CEREC (a registered trademark of denstply sirona) with tibases and implant crowns is that it is limited to very few implant lines and the antirotational notch can just ruin your day as it needs to go into a specific location. You also have to deal with making sure the tibase is seated all the way and the scanbody is properly indexed. The one benefit is that you are dealing with just crown and bridge and you do not need to know implant position or timing at all when doing the design.
In this case, we demonstrate how we utilize the Medit i500 to capture a Tibase from Blueskybio, Biomax NP Conical Connection. Once the tibase is seated, we simply start scanning and then use the artificial intelligent implant suprastructure identification system to identify the location of the tibase. This in essence allows you to capture your margins OUTSIDE the mouth and you don’t have to bother with imaging the tibase, which is highly reflective in the patient’s mouth.
Once processed, you can then modify the tissue digitally and gain access to the tibase margins. You can print the model if you want and manufacture the restoration. In this particular case, we took the design to the CEREC mcxl inlab cam, nested it, and milled it out to demonstrate how we can image with one device from one manufacturer and fabricate a restoration by another company’s manufacturing machine. But the single greatest benefit is that you can place the sprue wherever you want.
IMPORTANT NOTE: The Tibase that you use MUST be wider than the drill milling the intaglio and the sprue must be thick enough to handle the milling process.
Once you understand how the digital workflow goes, you can image with one device, design in another, and then either print or manufacture with yet another device. Here we mill a sectional stent with the cerec that was designed in Blueskybio plan, although printing makes more sense because it is less wear and tear on your drills
PRODUCTS USED IN THIS CASE:
Marking margins on your model can occur in the native imaging software or the CAD software.
Visualizing your margin accomplishes 2 things.
In this video we use Exocad design software to quickly mark the perfect margin. We use the computer to manipulate models for best viewing purposes.
In Digital Dentistry, once you acquire your models accurately, the CAD software doesn’t care where and how you capture them. Once you are done with the design, the cam and the milling machine have no clue what scanner you used.
here we take an intra-oral scan with the medit i500 and design in exocad and send it to 2 different milling machines. One is the CEREC MCXL and the other is the imes icore coritec one.
we even milled the bridge with the z4 milling machine by vhf just to show the concept works
Please Note: This page is from dentalcadcamshop.com: 13.03.2020
When it comes to single visit dentistry (procedures in under 90 minutes), CEREC is tough to beat. From the integrated camera, CAD software and mill, CEREC is the most streamlined technology to serve patients in one visit.
Nevertheless, increasingly doctors are expanding their range of indications with CAD/CAM technologies and sometimes we simply want to combine CEREC with other equipment and software manufacturers. But wait, isn’t CEREC a closed system? Yes and no. While nobody would accuse CEREC of being a completely open system, it is possible to export .STL files of CEREC scans which gives us some flexibility to bring CEREC scans into other programs.
But today we are not focusing on exporting CEREC scans, but rather:
1) How can we bring scans from other cameras into CEREC?
Example: I own a 3rd Party Camera and I want to import those scans into CEREC for making crowns, etc.
2) How can we use CEREC to mill CAD objects made from 3rd Party Software?
Example: I own a 3rd Party CAD Software and want to import those into CEREC for milling.
But wait, I thought no 3rd Party files (scans or CAD designs) may be imported into CEREC. How, then, can we unlock the system? The missing piece to the puzzle is the inLab Software! With inLab Software, the CEREC system can be opened up for all kinds of interesting workflows. Here are two workflows CEREC owners constantly ask us about:
1) I own a 3rd Party Camera – How do I mill from my MC XL?
2) I own a 3rd Party CAD Software (e.g. exocad) and I want to mill (e.g. crowns) designed with 3rd Party software and mill them with my MC XL
Please note carefully the Requirements listed above!
– If you want to import a Scan .STL… You will need the inLab SW Interfaces Module, inLab CAD Software (18.0 and above) andthe inLab CAM Software (18.0 and above).
– If you want to import CAD .STL designs for milling… You only need inLab CAM Software (18.0 and above).
– In case you never owned any inLab Software before, or your copy of inLab Software is below 4.X, you will additionally need to order the License Stick (SKU: 6364785) and install the License Stick on the PC or workstation on which you are using the inLab Software (CAD or CAM). Please note this is NOT the same License Stick as you have on your CEREC AC unit!
– In no case can the inLab Software mill on the CEREC MC!
Still have questions? No problem, we are here with answers: Contact us
Good luck everyone and Happy Milling!
Import Scan .STL
Shop inLab SW Interface Module
Import CAD .STL
We scanned with the medit i500, designed with exocad and milled with coritec. after try-in, we scanned the restoration in the bluephase and then merged it with the design in exocad to see how well our material, or design, and our margins measured up against the proposal. we also documented the fit clinically and with radiographs. you can download the 3d models of the case and compared them yourself
Every distal extension case I have to accomplish the following:
this video shows the clinical steps. to see what the lab does with your case, click in the link to see the subsequent steps. you can also choose to design and mill it, which is what I did
When you have preops that you are trying to stitch to preps in medit, and this could also include relating scanbodies to arches as well, you need enough data that is redundant in both catalog boxes
if you watch this video carefully, you can see how i over trimmed the mesial part of the equation and even though the camera is active, it is not acquiring images. you can see the red box.
once i move the camera to the distal molar, the acquisition starts because the molar has more data points than the premolar and the software / camera recognized the area and started to acquire images.
understanding this will unlock a lot of complicated cases and make the easier for you
DOWNLOAD CASE FILE
We are very pleased with millbox and the imes icore coritec one for a chairside milling solution. We’ve been testing it for a long time and its CAM (millbox) is very intuitive and the results are always predictable. It can mill titanium abutments, emax, and zirconia blocks.
The following videos illustrate how you can image a scanbody intra-orally and then design it in cad software. Here we used exocad to identify the biomax RP implant and designed both the custom titanium abutment and the suprastructure, both of which were milled with the CORiTEC ONE
There are so many implant and component libraries in cad/cam dentistry which can lead to a lot of confusion. What we highly recommend is that you visually compare the part numbers that you will be using with the part numbers displayed on the millbox software. One letter or number difference and the mistakes will have a profound impact on the bottom line of a dental practice
In this case presentation, we utilize the medit i500 to image the pre-existing crown and to fabricate a restoration that is a replica of the pre-existing condition. The patient was advised that the recurrent decay was in close proximity to the canal space and that endodontic treatment may be a possibility. The CBCT showed no evidence of any peri-apical radiolucency and the premolar tested vital prior to treatment
Case set up involved imaging the pre-existing condition in the pre-op catalog box. Excess information was cropped to reduce file size. The data was then copied to the maxillary arch catalog box and the area to prepared was edited out in preparation for final optical impressions.
Immediate Post Op
The remaining decay and previous build up material was removed just prior to bonding the restoration with NX3 dual cure resin cement so the dentin was exposed for the least amount of time possible.
In this case presentation, we feature a crown that needs to be replaced due to open margins and recurrent decay.
With the Medit i500, after the patient is anesthetized and the area is isolated, the pre-existing crown is imaged in the pre-op catalog box. The area to be prepared is cropped out in anticipation of the imaging the modified preparation.
Once the crown is removed, expasyl is packed into the sulcus with a Number 2 cord. With the pre-op bitewings X-ray it was readily apparent that the tissue should be positively displaced in order to capture the margins. It took two layers of cord to achieve hemostasis for imaging with the Medit i500.
While placing the margin in the native imaging software, it was noted that some tissue was obscuring the margin on the lingual side. The area was isolated both clinically and in the software. It was cropped out and filled in with ‘good data’ after proper protection of the adjacent teeth and margins so that we did not obscure their geometry.
Once the margins are identified and the case is processed it is automatically imported into exocad for design and then sent to the Imes Icore CORiTEC Once for manufacturing. The emax restoration was tried in and then delivered after crystalization.
Immediate Post-Op X-Ray taken to verify seat and no excess resin cement
Click Image to Download the OBJ Files And design Along
In this particular case, we are restoring a lower left molar with a full coverage crown. The pre-existing condition has multiple fracture lines and the patient currently wears a retainer. The pre-op optical impression is taken while the patient is reaching anesthesia. Once enough reduction has been achieved, the preparation is captured and an immediate proposal is rendered that replicates the pre-op condition perfectly.
Note how the settings for the start of the adhesive gap influence the cement line that you see on the post-op bitewing after immediate delivery, even though it was milled with the CEREC MCXL.
A new feature coming to Medit i500 is the automatic detection of scanbodies while you are imaging. In this clinical case, two implants are placed in the lower left quadrant in a fully guided fashion. Spacing limitations and proximity to vital anatomy did not allow for proper parallelism. This can create all kinds of headaches with analog dentistry where the trays can inadvertently lock in the mouth of distort upon poor up.
With the digital approach, you can scan the gingiva, the arch with easy access to adjacent contacts, and then the scanbodies themselves. What is great is that you do not disturb the primary stability you just achieved by placing physical forces on freshly placed implants.
Once the images are captured and the scanbodies are identified, we launch exocad and the data is not only automatically imported into the Computer Aided Design Software, it also plots the fixtures in the correct position and identifies their location and timing so you can proceed with the design of the custom abutment and / or tibase restoration.