CAD-Ray provides the best support around. I started scanning with Medit i500 in 2018 and my dental practice immediately changed for the better.As a rookie, I had a lot of questions and I calledCAD-Ray a lot in the beginning. They were great!Jonathan...read moreCAD-Ray provides the best support around. I started scanning with Medit i500 in 2018 and my dental practice immediately changed for the better.As a rookie, I had a lot of questions and I calledCAD-Ray a lot in the beginning. They were great!Jonathan Acker helped me get set up. Frank Weinstein answered tons of questions. Laura Geney became an important source of information as I moved into scan bodies, AI library, and had hardware questions. I’ve attended classes in Dallas featuring Armen Mirzayan who is incredibly knowledgeable and will tell you the good, bad, and the ugly about digital workflow. The possibilities are endless with scanning technology. I also want to mention Nick Statly who has visited my Dallas office and is a wealth of information. I have to admit that I frequently view the CAD-Ray User Group Face Book page just to pick up a few pearls here and there.I highly recommend CAD-Ray because their support is by far the best in the IOS industry and because their people honestly care about the customer and are truly committed to your success.read less - 12/23/2021
DERYCK PHAM
STOP SEARCHING NOW!
Best bang for your buck scanner on the market. we have been using out medit for 8 months now. love our crowns, margins are fantastic. almost no adjustments needed at all. maybe one in ten crowns might have to adjust mesial or...read moreSTOP SEARCHING NOW!
Best bang for your buck scanner on the market. we have been using out medit for 8 months now. love our crowns, margins are fantastic. almost no adjustments needed at all. maybe one in ten crowns might have to adjust mesial or distal to get crown to drop in. occlusion is always spot on. patients love the technology and WOW factor -"SOOO COOOLLL." customer service is great also! dont waste your money on anythign else. our lab even comments on how easy it is to deal with medit and how good the scans are. they recommend it to their other doctors now as well.read less - 10/09/2019
Going with CAD-RAY and Laura is one of best investment I've made year 2020 ( I have MEDIT 500). Jumping into scanning is something that intimidated me since I am not a techie person and taking PVS impression is something second nature to me. Laur...read moreGoing with CAD-RAY and Laura is one of best investment I've made year 2020 ( I have MEDIT 500). Jumping into scanning is something that intimidated me since I am not a techie person and taking PVS impression is something second nature to me. Laura made everything a breeze, she is very accomodating and most importantly responds so fast, I never felt left out. Attending the level 1 course of Armen M. was awesome , learned the basics and it was taught in a way so easy to apply. Since my first scan, I never looked back, thinking to myself , I should have done this earlier. The crowns comes back with little to no adjustements which saves a lot of chair time. Cannot get better than this. Big shout out to CAD-RAY, Laura and Armenread less - 10/19/2021
I would like to let you know that Kaila Larson is excellent communicator, personable, professional and knowledgeableI have had the opportunity to talk to her 3 times and it has always been awesome.Regards,Dr Carlos santos - 4/08/2022
Mehryar Ebrahimi
Great costumer service. I needed a part for my i700 and they were able to ship overnight. No down time. - 5/06/2022
Shilpa Jobanputra
New user and absolutely love my Medit i500 scanner. Easy to use, fast, affordable and so quick for a first timer IOS user like myself. Customer service is fantastic, as are the sales people. It’s good to know you have strong knowledgeable people beh...read moreNew user and absolutely love my Medit i500 scanner. Easy to use, fast, affordable and so quick for a first timer IOS user like myself. Customer service is fantastic, as are the sales people. It’s good to know you have strong knowledgeable people behind the scenes ready to help at every turn. I would recommend this product highly. Happy in PAread less - 9/09/2020
Michelle Duong
Our office is new to using the Meditscan so far we love it. Our rep andy was so detailed and great with the training. Everything has been good so far and easy. Defenitely recommend. - 9/23/2022
After using the medit i500 scanner at an office as an employee, I purchased it from Cad-ray,com specifically because of their good reviews and their large, concise training library of videos. I've used CEREC as an instructor at a dental school and bo...read moreAfter using the medit i500 scanner at an office as an employee, I purchased it from Cad-ray,com specifically because of their good reviews and their large, concise training library of videos. I've used CEREC as an instructor at a dental school and bought a used Planscan, Planmill for my private office. Both were hard to learn and the fees and cost associated with training were a bitter pill to swallow after the costs to purchase. The ease of seating restoration was instant. The scanning learning curve is quick. I have easily added occlusal guard scanning, and implant scanning and will be trying a digital denture soon.
The purchase was easy, the product came quickly and the set-up videos guided me through very necessary adjustments to my Laptop I never knew I needed. Learning the new features with each FREE update is a treat. The DIY option was an extra bonus as the $2000 rebate came without having to ask for it. Cad-ray has delivered more than I expected with the purchase of the fantastic Mediti500 scanner.
I've included my cart set up. purchased from Amazon for $68. Its stable, has room for the necessities. I've taken it home and back to the office half a dozen times and it transports the scanner safely. It also keeps the cords from being run over. I haven't taken the included 2 day course but look forward too it after Social Distancing mandates are lifted.read less - 4/25/2020
Cad-Ray's customer service has been amazing since day one! From getting a quote to setting everything up and doing my first scan. Everyone has been super helpful! Heather Gramley has been awesome, it's like having a tech in my back pocket! They offer...read moreCad-Ray's customer service has been amazing since day one! From getting a quote to setting everything up and doing my first scan. Everyone has been super helpful! Heather Gramley has been awesome, it's like having a tech in my back pocket! They offer tons of training videos and offer one on one training. I would 10/10 recommend them for all of your scanning needs!read less - 11/21/2022
W Timothy Brooks
Excellent fast color scanner. A great improvement over my old proprietary scanner. Easy to learn software and great free technical support. - 6/18/2020
I purchased my medit in April of 2019 from Cad-Ray. The support offered is second to none, and the training videos are some of the best out there. Add to that a great support team that is fast to answer questions and issues, its hard to beat Cad-Ray. - 6/19/2020
Lora Wonderly
Thank you Frank DeLuca for being so accessible and making everything right again! Customer service is above and beyond. We also love our Medit Scanner - we would be lost without it! - 1/25/2023
Anita Madhav
Absolutely love Laura. She was my initial contact and is an amazing resource for any questions even months later. Would highly recommend buying from Cad Ray especially Laura! - 6/28/2022
Erica Zolnierczyk
Purchased the Medit right before the COVID shut down, which gave us time to train on it by watching all the awesome videos CAD-Ray provides. If I couldn’t figure something out, our questions were answered quickly. Now we’re back and using it like cra...read morePurchased the Medit right before the COVID shut down, which gave us time to train on it by watching all the awesome videos CAD-Ray provides. If I couldn’t figure something out, our questions were answered quickly. Now we’re back and using it like crazy. It’s quick, my assistant picked it up quickly and my cases have been coming back perfect. Super happy with the Medit!read less - 6/16/2020
Armen Mirzayan
Are you happy with the support and training you have received with our team at CAD-Ray.com?
Our business grows much like yours, with referrals and recommendations. We would greatly appreciate a quick review / testimonial
NOTE: ...read moreAre you happy with the support and training you have received with our team at CAD-Ray.com?
Our business grows much like yours, with referrals and recommendations. We would greatly appreciate a quick review / testimonial
NOTE: All testimonials are submitted by verified owners.read less - 5/08/2021
Awesome! Great support. If you are planning on getting a scanner, make sure you have Cad-Ray on your side ! - 4/20/2022
Todd Haskin
The medit is one of the best scanners on the market with the best price. Cad ray's support and training is phenomenal and they are very quick to respond. We work with Laura. Highly recommend. - 12/16/2021
Kirk Arritt (fldnstrm)
Whatever digital workflow addition you want to add to your dental practice look no further than Cad-Ray. Top notch support and training. - 1/29/2023
Dr. Terry Zervos, DDS,PA.
Today I had to order new tips and Laura was EXTREMELY helpful, Cad-Ray has all the products you need for digital dentistry and they do Education, if you buy Medit scanner from them they include 12 CE training course. Cant just buy a Lamborghini you h...read moreToday I had to order new tips and Laura was EXTREMELY helpful, Cad-Ray has all the products you need for digital dentistry and they do Education, if you buy Medit scanner from them they include 12 CE training course. Cant just buy a Lamborghini you have to learn how to drive it!read less - 7/02/2020
Levy Do
I'm a repeat customer because Cad-Ray's customer service is fast, efficient, and no nonsense. The classes offered for training for particularly for the Medit is awesome and it comes included which is phenomenal. All the classes that I've gotten to at...read moreI'm a repeat customer because Cad-Ray's customer service is fast, efficient, and no nonsense. The classes offered for training for particularly for the Medit is awesome and it comes included which is phenomenal. All the classes that I've gotten to attend so far has been well organized and I left learning very practical things. Remote support team solves my problem right then and there. Recently I had an issue, and instead of me talking to a sales rep who doesn't know what to do, Kaila remoted in and got it fixed just like that. Thank you and great job guys!read less - 4/19/2022
Chad Gardner, DDS
Can not find a single negative thing to say about my transactions with CAD-Ray. Great people, absolutely unbelievable customer service, and the best products.They stand behind the products they sell as strongly as the manufacturers do. - 4/27/2022
Matt Stratman
only dental company that I have no complaints about - 11/03/2022
Lauri Ann
I am about the worst person when it comes to technology. I decided to get a scanner and chose the Medit due to all the positive comments users had. I haven't used it much-the pandemic started right as I received it, however, the customer service has ...read moreI am about the worst person when it comes to technology. I decided to get a scanner and chose the Medit due to all the positive comments users had. I haven't used it much-the pandemic started right as I received it, however, the customer service has truly been amazing! I had an online training and a rep checked in with me several times to see if I needed help. I am going to do another online training soon as a refresher. I wouldn't hesitate to recommend this company and scanner to anyone!read less - 6/16/2020
Mostafa Koperly
I love my medit scanner. I purchase many dental equipments each year and by far it’s the best thing I got for the bucks I spent ( beating my 6 digits equipments ).
We have omnicam and I hated it, multiple crushes, expensive monthly service fee, hor...read moreI love my medit scanner. I purchase many dental equipments each year and by far it’s the best thing I got for the bucks I spent ( beating my 6 digits equipments ).
We have omnicam and I hated it, multiple crushes, expensive monthly service fee, horrible support, etc. I was so frustrated and had to look for an alternative. Many mentioned itero to me and I was about to purchase it and suck another monthly fee until I came by Armen’s video about medit on one of the Facebook group in 2018. I was surprised with the image and the speed and started digging more and contacted Frank to explain the scanner more. Ended purchasing it late 2018 and I’m a happy user Since after. The support is excellent, Frank is there when you need any help plus the Facebook community is there to answer anything. Recently, I attended Armen’s course to learn how to mill from the medit and I got shocked by the AI and the options that the software has. This machine is a beast and you won’t regret it getting it from Armen and Frank. They go beyond and not like other salesman or equipments where you are left behind after they sale you and finish their training. We are in 2020 and I still get the same support as I bought it in 2018.read less - 1/09/2020
The support is even better then the camera itself. I used many other scanners and this is by far the best one. Recommended to many people. Looking to purchase a second one for my practice. The use and results are amazing. No adjustments to the p...read moreThe support is even better then the camera itself. I used many other scanners and this is by far the best one. Recommended to many people. Looking to purchase a second one for my practice. The use and results are amazing. No adjustments to the prosthetics at all.read less - 7/15/2020
Robin Thoman
Instant support, nice people at Cad-Ray but LOTS of trouble getting CIT 12m same-as-cash approval as offered. CIT fumbled around for 7d in finding credit report. Eventually fed up with inactivity or support after lifting Equifax credit freeze and d...read moreInstant support, nice people at Cad-Ray but LOTS of trouble getting CIT 12m same-as-cash approval as offered. CIT fumbled around for 7d in finding credit report. Eventually fed up with inactivity or support after lifting Equifax credit freeze and directed to Experian quagmire of automated phone calling tree.read less - 1/09/2021
Keon Ahghar
Fantastic support and customer service! This is an awesome company. They aren't big box and actually know how to use, trouble shoot and ball out with the products they sell. They only will sell and endorse a good product. They are selective. Whatever...read moreFantastic support and customer service! This is an awesome company. They aren't big box and actually know how to use, trouble shoot and ball out with the products they sell. They only will sell and endorse a good product. They are selective. Whatever they sell they back. And they have your back too. Their support, service and training is industry leading. Also Laura from CadRay is a beast. She's wizardread less - 4/23/2022
Gwen Giannina
CAD-Ray is an amazing company. I purchased my scanner 3 years ago. Any small issue immediately resolved by calling them for help. I originally scanned with Cerec. The ROI doesn't even compare. The Medit was by far the best technology purchase of my ...read moreCAD-Ray is an amazing company. I purchased my scanner 3 years ago. Any small issue immediately resolved by calling them for help. I originally scanned with Cerec. The ROI doesn't even compare. The Medit was by far the best technology purchase of my 20 plus years in dentistry. I will upgrade at some point and will buy again from CAD-RAY!read less - 2/04/2022
Arielle Forbes
Just got my Medit IOS delivered last week and the service from Jon was great! I had a ton of questions before placing the order and he happily answered. This is the type of customer support many dental suppliers are missing. Great company to work wit...read moreJust got my Medit IOS delivered last week and the service from Jon was great! I had a ton of questions before placing the order and he happily answered. This is the type of customer support many dental suppliers are missing. Great company to work with.read less - 6/19/2020
Milton Ruiz
Best customer service I have ever experienced from any company I have worked with! They alway answer the phone and are ready to help with whatever question you may have. Love that I do not have to press 500 buttons to get to a live person. Bought my...read moreBest customer service I have ever experienced from any company I have worked with! They alway answer the phone and are ready to help with whatever question you may have. Love that I do not have to press 500 buttons to get to a live person. Bought my Medit from them and could not be happier with decision!read less - 12/20/2022
Jennifer Hastings
Andy was wonderful with setting everything up and explaining everything. The Medit i700 has been great thus far, easy set up! The only "issue" is that it can be occasionally glitchy. - 1/11/2022
I purchased the Medit i500 from Cad-Ray December 2018. I couldn’t be happier with the scanner. The improvements Medit has made over the last 10 months are nothing short of astounding! I can’t imaging what they’ll come up with next.
As for Cad-Ray...read moreI purchased the Medit i500 from Cad-Ray December 2018. I couldn’t be happier with the scanner. The improvements Medit has made over the last 10 months are nothing short of astounding! I can’t imaging what they’ll come up with next.
As for Cad-Ray, their support has been second to none. Never have I experienced the kind of attention and help from any other company. Wether it’s with help installing, computer hardware issues or technical help they respond IMMEDIATELY!
Armen is also a huge reason why I chose Cad-Ray. No one selling a product has helped me more evolve my scanning technique. He’s quick to respond to questions and issues I feel his service is a huge reason why to buy from CAD-RAY.read less - 10/09/2019
These guys are great. My favorite part about them is they set you up for success with your products. A lot of dental companies will be happy to sell you big ticket tech item but don't have much to set you up for success. I bought the Medit i500 and t...read moreThese guys are great. My favorite part about them is they set you up for success with your products. A lot of dental companies will be happy to sell you big ticket tech item but don't have much to set you up for success. I bought the Medit i500 and they have tons of videos on how to get it working and working well for you in your office. If you need a much of hand holding they have that our if you are like me and like the do it yourself videos they have that. I am sure you can buy these products all over but it is there service that sets them apart. If to are looking to buy some dental tech use these guys!read less - 6/05/2020
David Weber
Much like dentistry is not a commodity, CAD-RAY's service is not a commodity. What CAD-RAY does so well is not just sell pieces of technology affordably and smoothly, but provides service, training, and insight so these tools can be used meaningfully...read moreMuch like dentistry is not a commodity, CAD-RAY's service is not a commodity. What CAD-RAY does so well is not just sell pieces of technology affordably and smoothly, but provides service, training, and insight so these tools can be used meaningfully and profitably.read less - 12/12/2022
larry bybee
We have been using an intra-oral scanner (not a medit) in our practice for 4 years and it was decided that we needed to purchase another scanner due to practice growth. After a thorough review we decided on the Medit i700. Due to the great team at Me...read moreWe have been using an intra-oral scanner (not a medit) in our practice for 4 years and it was decided that we needed to purchase another scanner due to practice growth. After a thorough review we decided on the Medit i700. Due to the great team at Medit I have learned more about scanning 1 week than i received from the other company in 4 years. i700 great price, great scanner and amazing customer service.read less - 12/23/2021
Carter Mitchell
Pretty much echoing what everyone else has said. Frank DeLuca and the whole team at CAD-RAY are fantastic. The best customer service and support in dentistry, hands down, not even a close second. We are thrilled with our Medit scanner and will certai...read morePretty much echoing what everyone else has said. Frank DeLuca and the whole team at CAD-RAY are fantastic. The best customer service and support in dentistry, hands down, not even a close second. We are thrilled with our Medit scanner and will certainly be choosing CAD-RAY for any future purchases.read less - 12/30/2021
Dr. Howard Lassin
Great 1st lesson with Ryan on the Mediti700. We are ready to scan:) - 12/30/2022
Maureen Copeland
Our office has been really happy with the i700 scanner so far. It was really easy to set up and use after watching only, 1-2 of the videos Cad-ray has on the website. Training with Andy was a breeze! Looking forward to taking level 2 training soon. - 1/20/2022
Great service and scanner support! Company delivers well above my expectations! Love my medit scanner. - 1/29/2023
Francis Shin
Amazing customer service. Wayne Glassoff helped me with purchase decision, taking the time to find out my needs, and then my order was delivered quickly! Easily the best "dental" purchase experience that I have ever had. - 9/07/2022
Jacob Masters
Best dental equipment company I have ever worked with! Great response and super helpful for any issues even years later. - 8/03/2023
Samir Rana
Ive had the medit since 2018. One of the best decisions in dentistry ive made. I met some of the great trend setters in digital dentistry(armen, jonathan ab and others through social media platforms). Medit Has changed The way i practice, live and ...read moreIve had the medit since 2018. One of the best decisions in dentistry ive made. I met some of the great trend setters in digital dentistry(armen, jonathan ab and others through social media platforms). Medit Has changed The way i practice, live and think! Happy not to have a monthly fee as i did for years. Support is always a message or call away. Would be glad
To further share my experience with you if u need.read less - 6/16/2020
Nancy Hartrick
I am absolutely in love with my MEDIT i700, as is my entire staff. The Medit i700 is reliable, fast, easy to use and the software is incredibly intuitive. I couldn't be happier with the team at CAD-Ray. They are true professionals, and very hands and...read moreI am absolutely in love with my MEDIT i700, as is my entire staff. The Medit i700 is reliable, fast, easy to use and the software is incredibly intuitive. I couldn't be happier with the team at CAD-Ray. They are true professionals, and very hands and responsive in terms of their support and training. Thank you to the entire team.read less - 8/24/2021
Needed help with scanner updates and Frank is the man! Once he was done the scanner was operating in hyper-drive!!thanks frankoffice of Glenmont Dental - 2/15/2022
Bracy Haynie
I have had the wonderful experience of working with Ryan at Cad-Ray for the last several weeks and he has been very professional and informative on how to properly use the Medit I700 scanner with regard to the software. I would highly recommend using...read moreI have had the wonderful experience of working with Ryan at Cad-Ray for the last several weeks and he has been very professional and informative on how to properly use the Medit I700 scanner with regard to the software. I would highly recommend using Cad-Ray and contacting Ryan for any of your Medit needs.read less - 1/27/2023
Mitchell Rubinstein
I purchased my medit i500 scanner about a year ago from CAD Ray, and I have been extremely happy with both the scanner and the service / support.
Armen and Frank consider your purchase to be the beginning of your relationship with them, not...read moreI purchased my medit i500 scanner about a year ago from CAD Ray, and I have been extremely happy with both the scanner and the service / support.
Armen and Frank consider your purchase to be the beginning of your relationship with them, not the end. They do their best to make sure you learn everything you need to know in order to get the best possible results .
They answer calls and messages promptly, and it never takes me very long to get my questions answered.
I am VERY glad I bought from them, and not from one of the "big box" Dental Mega retailers.read less - 10/09/2019
CAD-Ray's online resources and customer support has made my Medit scanner implementation possible without the need for any hands on training. They are full of resources and have expert knowledge. - 7/01/2021
Hieu Pham
Been super happy with service from this company. Very responsive, really passionate about their work. - 7/16/2020
AJ Ganir
Cadray has great support and service! They are very responsive to questions. Love the new medit scanner! - 5/06/2021
Jared Gustafson
We started our journey with CAD-Ray 3 years ago them helping us find a digital scanner that fits our practice needs and have relied on them for our 3D printing needs. They are an excellent company and I highly recommend them for their knowledge and s...read moreWe started our journey with CAD-Ray 3 years ago them helping us find a digital scanner that fits our practice needs and have relied on them for our 3D printing needs. They are an excellent company and I highly recommend them for their knowledge and service they provide. I would buy and dental tech needs from them!read less - 9/07/2022
A repetitive theme that is a common issue with all intra-oral scanners is the inadvertant capture of data that does not belong to the model you are building. The software and camera are smart enough to ignore the tongue and the lip, but if they show up repeatedly in an area you are scanning, they ultimately get incorporated in the equation.
In this image, you can see how the tongue is capture on the occlusal surface of the second molar. The trouble is that the ios does not recognize the difference between soft tissue and hard tissue (yet) and once it is part of the model and you go back to the area you want to scan, the software is actually looking for that (now) displaced data. Since it is not present, the camera cannot initiate the capture of new data and the user gets frustrated with the red box instead of the green box.
Retract the lips and the tongue and you can easily capture an arch in 60 seconds.
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.
It i sometimes confusing to some doctors when looking at bitewings shot at specific angles that make the margin look like it has filled in with resin, or the the margin is “raised” with composite material. When looking at a sloping margin, where you have a deep chamfer or finish line, instead of a shoulder margin, when you take a bitewing immediate post-op X-ray, the flow of the margin line is superimposed on itself due to the two dimensional image.
Clinically, if you look at the margin design, you will appreciate the anatomy of the prep and how that can lead to this effect.
This is a lesson in chairside efficiency for all CAD/CAM users. Traditionally, you would be forced to prep two teeth and impress them both at same time, but with digital dentistry, you can break the case up and do it in segments, as if they are two separate patients involved.
In this particular case, the restorations were designed, milled, and seated in a single appointment. To speed things along, only the second premolar was addressed; it was prepared, imaged, designed and milled. While milling, the second molar was prepared.
After the tryin, they were chrystalized and seated at the same time. Leveraging preparation time with mill time of multiple units can greatly increase efficiency at chairside. See the following videos to pick up on all the details of the case.
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.
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.
[videopress RkqfM9CJ permalink=”false” hd=”true”]
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.
[videopress U5aJCxQ3]
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.
Happy Hump Day! We might be in your area! It’s going to be a crazy month! Here’s the 411! WE ARE SHOWING THE WORLD HOW MUCH WE LOVE DIGITAL DENTISTRY! C2 will be traveling to Utah this weekend for a show on Saturday….
North Carolina & South Carolina Sunday & Monday!
Send us a PM if would like a demo! #mediti500 #c2style #welovedigitaldentistry
Grady Dix Armen Mirzayan Frank Weinstein Carol BarberLamb
This a very common question we get at CAD-Ray.com and it reflects on how little dentists understand about digital impressions and CAD/CAM in general.
It reminds me of a dental conference I want to, fresh out of school, placing orders for our start-up practice. As we went to the X-Ray equipment section, one of the first things the representative said to us was that their machines are “Digital Ready”! We all had good laugh explaining to the rep that the machine had nothing to do with digital X-Rays, the sensors did!
We feel the same way with digital impressions and CAD/CAM platforms when people talk about integration and making sure one “product talks to the another ” and how it all needs to be developed by the same single manufacturer. It’s loaded with a lot of inaccuracies and misrepresentations.
The reality is that every system has its flaws and can have just as much trouble talking to a machine manufactured by the same company! As dentists, we are much smarter with our decision processes now, but it is still a buyer-be-ware landscape.
Here are some basics you should appreciate before committing to a high ticket item. It’s imperative to understand that imaging has little to no impact on milling. These are completely independent processes- let us explain:
You can image (take an intra-oral scan) with system A. Then you can take the data from system A and take it to CAD software of system B. A lot can go wrong here at this step alone. Simple examples include;
The patient name doesn’t come along with the data.
Incorrect data may come across with incorrect information- you can have the occlusal relationship look perfect in system A but when it goes to CAD, the bite can be off.
You mark your margins in A, but they are distorted in cad software. So you have to make sure this works.
Keep in mind that this can even happen if you stay within a “System A” or “complete system”. Luckily a lot of this is ironed out already with legacy and legitimate products and competent practitioners. Now comes the design step. You have a few choices; exocad and 3shape being the leaders. If exocad does the margin placement and the final restoration from start to finish, a lot of errors are eliminated.
After the design process, comes the nesting and manufacturing. At this step, the milling machine has NO idea what iOS you have used. It’s just data for a restoration that it needs to process. Ar this most vulnerable step, we need to make sure the CAM software for a particular machine can interpret the design software that did the nesting. A lot happens here;
Then comes the consideration for your milling needs.
You can mill soft ceramics for 15,000$
For a little more, you can wet mill emax
Cross the 30k barrier with and you can cut zirconia (we do NOT recommend in office zirconia- dumbest thing you can do)
Closer to 40k and you can do in house metal custom abutments.
Over 40k you can mill roundhouse bridges and you are as much a labtech as a dentist.
The trickiest part of all this is the last step. Making sure the mill has the right cam to talk to design software. This can be a nightmare if you don’t do your homework.
So, with the Medit iOS you can mill to any machine. You can even take it to cerec inlab software and Jump through a lot of hoops to mill with CEREC chair side milling machine. Not worth the headache!
The CEREC chairside mill remains the fastest carver of emax restorations, but it can come at a cost – you need to bulk out the margins so they don’t break off at mill.
It was a long struggle to find margins with the Omnicam and after 4 years it was sold. The margin definition and resolution never reached an acceptable level. After seeing margins from high resolution scans by the Medit and defining them in exocad, it completely validated that we shouldn’t settle for anything less than the highest standard. This is an scan performed on a upper second molar with tough access, replacing a failing crown.
This article demonstrate how a case be set up while the patient is being anesthetized. While waiting for it to take effect, your team can scan the opposing arch, the arch to be prepared, and even the buccal bite. You can see how that is set up in first video. Notice how we crop out the tooth to be prepared so that the software doesn’t get confused between the preop and prep stages.
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Once the tooth is prepared, the premolar is imaged back into the arch form in high resolution mode. This mode comes in handy for picking up the enamel that is exposed at the cavosurface margins. Some intra-oral imaging systems struggle with picking up the detail in these situations.
You can see how clearly discernible the margins are in this preview. Feel free to download the case data at the end of the article. Please note that areas that are not critical for the restoration design were essentially ignore as they play no significant role in the desired outcome.
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.
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
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.
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.
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
When planning for guided surgery in edentulous patients, it is important to have the final vertical dimension and tooth position determined. Ideally, a denture duplicate should be used with proper radiographic markers.
The traditional way was to embed radio-opaque material in the denture dupe, CT scan the patient with the denture dupes, and then CT scan the denture dupes themselves. Alternatively, you can scan the denture duplicates with a digital impression system. Here we used flowable composite and spread them through the wax set up and take a 3D X-ray of the patient. We then use those landmarks to merge the data sets between the digitize denture and the markers on the CT Scan
Once the dentures are digitized and merged with the CT data, the cases is analyzed to make sure there are no gaps in between the intaglio of the denture and the soft tissue of the palate and the lower / mandibular ridge
An important concept to keep in mind for these edentulous cases is that you actually need 2 models for each arch. One model is used for tooth positioning and implant design, and the other model is used for stent design. Essentially, you design the stent on the ridge, not the denture dupe
One of the biggest hassles in most software is to plan a guided surgery case when the tooth is still present in the arch. Some software will force you to part-take in pylon course handling, gymnastics maneuvers, musical chairs, and multiple imports and exports. The issue revolves around the placement of the sleeve / ring in the design step. Usually you are forced to manipulate the data in 3rd party software and then bring it back with the tooth virtually extracted.
This article is about how you can scan the arches and export the STL, OBJ, or PLY data from the Medit i500 scanner. You can then clone the same case and alter it- namely, you can crop out the tooth that will be extracted in the future. This video shows you how the virtual extraction is performed.
The multiple data sets are then imported in BlueSkyBio software where there are no limits to the number of models you can bring in. In the following video, you can see how the complete upper arch, the virtually extracted lateral arch model, and the opposing are brought in an merged with the CT Data.
The implant is planned for fully guided procedure and a surgical stent is manufactured on the model that has the virtual extraction. You cannot design a stent correctly with the tooth present in the equation. Open architecture and speedy results are the name of the game now with CAD/CAM dentistry. As you can see, these steps are super fast and easy with the open licensed Medit Scanner
This article documents how to capture upper and lower scans for an oral appliance to treat obstructive sleep apnea. The patient was recently diagnosed with mild sleep apnea with a Home Study Test which revealed quite a lot about his sleeping habits and patterns.
The patient decided to pursue treatment with an oral appliance in lieu of CPAP therapy. Upper and lower impressions were taken, and the occlusal relationship was captured in protrusive and with the vertical dimension set a a tolerable distance. Cotton rolls were used to block out the movement of the tongue which usually interferes with capturing the bite.
Once the bite is captured, we recommend that you move back to the maxilla and mandible catalog box and take additional images to complete and remaining voids in the model. At the end of the article, you can download in multiple formats to see the meshwork and the data that is rendered from the Medit i500 scanner.
Once the patient adapts to the appliance, a titration study will be conducted to measure the effectiveness of the oral appliance
This is a case imaged for an occlusal guard, wehre the upper arch took only 43 seconds to capture. Afterwads, the lower arch is captured, and then ultimately we move to the dual buccal bite. To get enough clearance, we just have the patient bite down on two cotton rolls and hold that position.
One thing to keep in mind is that when you move from one image catalog to another, some processing is done. What we recommend you do is to actually go back to your upper and lower models and fill in any missing data or correct any artifact you may have captured inadvertently. You can see in the footage how the second molars are corrected and filled in with good information.
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