Category: Computer Aided Design (CAD) Software

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First Molar Crown Margins by Medit i500 and exocad

This is a first molar crown that was replaced with an in-office milled eMax restoration.  The adjacent second molar had recurrent decay under the existing class 2 restoration.  That was removed and replaced and pre-existing crown was also removed.

The preparation was refined and the recurrent decay was removed. Once hemostasis was achieved and the tissue was retracted the area was scanned with the medit i500.  The crown was designed to full contour and milled chairside.  After it was chrystalized, it was bonded into place with Nx3 resin cement.  The excess was removed and an immediate post-op bitewing was taken to verify that no excess cement was left behind.

Pre-Op

This video shows the design of a crown after the impression was taken where vivid colors of the retraction cord, the sulcus, the preparation, and the details of the adjacent tooth can be visualized.

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Immediate Post-Op

Download the case files in OBJ Format

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CAD-Ray Design Software powered by exocad

There are so many incredible and robust features to exocad and it is precisely why there are over 35,000 users around the world. There are many distributors to the software, including us, at CAD-Ray.com

We focus mostly on our clients who are generally dentists, and our main goal is to streamline your workflow and make this easy and not intimidating. During our two day hands-on course for new medit i500 owners, we install the software and design four cases in exocad.

Here are some of the top highlights for you to understand. The software is installed and self contained within a folder that you can place anywhere on a computer’s directory. What’s great about this is that your software operates completely independent of the windows operating system. So whenever there is an automatic windoes update, it does not mess with your configurations or settings and you don’t have to deal with firewalls and other technical terms we don’t even comprehend.

Another benefit to this is that you can place this folder on the cloud like dropbox and then you can go to ANY machine- at home, in another operatory, at another office and launch the program there, instead of carrying a laptop around. Since the data can only be accessed by a real license / dongle, there are no concerns about HIPAA violations as it is encrypted and only accessible by the active license.  Moreover, one machine can be running Windows 7 and another could be runnng Windows 10, and you wouldn’t know the difference or have to worry about configurations

Also, multiple doctors in multiple locations could be working off the same program on the cloud, as long as they have an active dongle. This really allows for a lot of flexibility in a practice or a group setting.

You can see the basic elements in the folder, which are broken down into a case data storage folder, the CADApp and the DentalDB folders. We’ll explain what these other two folders do below.

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As a distributor, we can custom make our own private label version of exocad. Since we are focused on chairside dentistry, or on dentists, generally, we strip the software down to the essentials. Namely, we’ve programmed it for inlays, onlays, crowns, and veneers. We also include bridges that can fit in 40mm blocks. You can choose to add on other modules like implant planning, implant designs, dentures, etc.. if you choose to.
It is important for you to understand that we provide a fully functional version of this software, and if you want to add more features as your confidence grows, all you have to do is swap out these files called WorkParamsDB.xml

Watch the video that shows you how we have multiple versions of the file. We provide you with many versions of this file that you always have access to and they are all configured differently. In seconds, you can change the look and the feel of the software to your liking, and turn on multiple modules that we hide from the version that we provide. Please note that we only provide support and tutorials for the what we call the Dentist Version of exocad, as opposed to the lab version. If you grow to the point where you want to add the other components, it is very to transition, just recognize that we don’t support the heavy duty version. We certainly can refer you to the right people to learn how to use those extended functions.

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One more thing for you to get excited about is the WorkParamConfigTool.exe
Now, if you are scared of the mouse and can’t press the “Any Key” button on keyboard, stop reading any further.

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In this file, you can add, edit, remove material profiles, parameters and configurations to your delight. Let’s just leave it at that for now

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Korolation with Medit i500

One of the greatest advantages of digital impressions is the ability to copy a pre-existing condition.  This has a lot of benefits, one of which is that the patient will not notice a difference in the new restoration vs. the old one.  For this to happen with the medit i500, you need an extra image catalog box.  Rumor is that this will be available in the near future.  Since we only have the upper and lower jaws, and the buccal bite to imagine into (and scanbody catalog boxes), what you can simply do is treat the case as if they are two separate patients.

Create a new patient, and scan the preop condition and save the case.  Once processed, you can export the case file in OBJ, PLY, or STL format.

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You can then launch a second case, where you take the opposing, the prepared arch, and the buccal bite images. You can download the Korolation OBJ case files and design along. Just remember, in exocad, the upper and lower arches from “patient #2″ will automatically articulate with each other, but you will have to manual import the preop scan and merge the prepped model and the pre-op models.

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Once you import in the pre-op condition, you can manually relate the models to each other by identifying common landmarks between the two models. After you perform alignment, you can then click on “Best fit matching”. The color scheme in exocad is a great guide in letting you know how well you have articulated the models together.

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The more blue you see in the Korolated models, the more reliable your stitch is and you can be assured of greater accuracy in your final restoration.

 
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Full Mouth Reconstruction with Medit i500

To see this case presented in webinar fashion click on the image and enter the members area for much greater detail and information

Pre-existing restorations that warranted replacement with an increase in vertical dimension.

Pre-existing restorations that warranted replacement with an increase in vertical dimension. The upper and lower arch were captured with the medit I500 and articulated together with enough clearance to accommodate new restorations and to restore the patient to an ideal tooth position.

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This video shows how the vertical dimension was captured with cotton rolls blocking out the tongue and the dark oro-pharynx, which usually spell trouble for an IOS

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The digital models were then imported into a third party software where a library of tooth morphologies are available for the clinician to choose from.

Once the appropriate library is chosen, the digital wax ups are performed. In the subsequent photos you can see the transparent overlay of the wax-ups to the original position of the existing dentition

 

Once the case is designed to the ideal vertical dimension then multiple shells can be fabricated for treatment. The wax up model can be uniformly reduced by .5mmm’s circumferentially and a temporary shell can be designed. Once the teeth are prepared, these shells can be relined and seated onto the preps.

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PREP AND TEMPS

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How was this done? Watch this video of how the case was imaged over a 4 hour time span in multiple segments

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FIRST VERTICAL DIMENSION
The initial vertical dimension was greater than desired and the tooth shape was too bulky in appearance.

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ADJUSTED TEMPORARIES AND NEW VERTICAL DIMENSION
Over the course of a few appointments, the vertical dimension was reduced and the temporaries were adjusted to the patient’s desires. The new upper and lower arch were captured with the Medit i500 and the jaws were related to each other.

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This was then imported into exocad where the prepped arches from a few weeks prior were force matched to the new bite

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After the upper jaw was related to the temps, the same was done with the lower arch. Great care was taken to make sure the arches were properly related to each other throughout the process

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CASE DESIGNS

The case was designed by CADENT BESSA, and the models were printed by Burbank Dental Lab with Carbon Printers. There restorations were milled and cut back and layered by Burbank Dental Lab

IMAGES OF PRINTED MODELS

 

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IMMEDIATE POST-OP PHOTOS AND VIDEO WITH IPHONE CAMERA

 

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ONE WEEK POST-OP RADIOGRAPHS / CEMENT CHECK

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