I'm a dentist in Maine and have been working remotely with CAD-RAY for about 5 years. They do all my implant planning and fabrication of surgical guides. I just send them a CBCT image and digital impressions and they take care of all the rest, it cou...read moreI'm a dentist in Maine and have been working remotely with CAD-RAY for about 5 years. They do all my implant planning and fabrication of surgical guides. I just send them a CBCT image and digital impressions and they take care of all the rest, it couldn't be smoother. I've only had good experiences with CAD-RAY, and am very grateful for this awesome service they offer.read less - 6/02/2019
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
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
Great people. Very helpful with anything you need. - 6/16/2020
I have owned this scanner for six months now. I have experience with other scanners including Trios and Carestream. The Medit scanner can stand with the big names. The scanned images are good. The ease of communication through the software with the l...read moreI have owned this scanner for six months now. I have experience with other scanners including Trios and Carestream. The Medit scanner can stand with the big names. The scanned images are good. The ease of communication through the software with the lab is probably my favorite part. Another thing I like is that the company is very open to improvements and listens to what its customers are wanting.
Cad Ray has a great team working alongside this product and continually updates all of the users on new features or new ways to use existing features. They are extremely responsive to questions and provide fast and competent support to the product that they sell.
I would recommend both the scanner and the company to anyone looking to get into the digital scanning world.read less - 10/09/2019
This was my intro into intraoral scanning and I did research for quite awhile. The i500 and the team at Cad Ray are top notch. The company has done such a great job putting this scanner in the ranks of the premier ones. With constant updates it gets...read moreThis was my intro into intraoral scanning and I did research for quite awhile. The i500 and the team at Cad Ray are top notch. The company has done such a great job putting this scanner in the ranks of the premier ones. With constant updates it gets better and better (though I’m still behind on updates). My crowns have never been better. They drop right in with no models. I didn’t believe it but I’m loving digital dentistry. I can’t wait to go to the class after COVID calms down!read less - 6/16/2020
Best place to buy a medit i500 from. Great support and an even better community. - 6/16/2020
Armen created series of these very helpful videos. They helped us tremendously in breaking into the new scanner we purchased. No matter you just got into digital dentistry or you are quite experienced with different fields of data acquiring or treatm...read moreArmen created series of these very helpful videos. They helped us tremendously in breaking into the new scanner we purchased. No matter you just got into digital dentistry or you are quite experienced with different fields of data acquiring or treatment planning, you will find those being tremendous help.read less - 5/24/2020
Finally going digital and Cad-Ray was the place to start. Got the Medit i500 and began scanning right away. Now I am doing digital dentures, making my own surgical stents, etc. The support available is the best. "Frank" is always available! :) - 10/09/2019
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
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.
On September 5, 2019 Medit will officially launch the 2.1 software that will allow dentists to mark their own margins before sending to the lab. Since most images captured from models are inherently large in file size, you can selectively focus on the area where the raw images are taken. You highlight the area and you process the data sets as shown in the first video.
Once the area is identified, you can utilize the margin marking tool. You have many aids to help with margins, including the ability to visualize the transition from one plane to another, along with colors in the models.
In this article, we demonstrate how to manage a crown replacement on a second upper premolar with the Medit i500, exocad, and the imes icore CORiTEC ONE milling machine. The pre-existing crown was over 2 decades old and the recession revealed a supra-gingival margin. Furthermore, there was no room to improve the anatomy or its outline form as it was in occlusion with the opposing dentition.
A powerful design technique is the copy of the pre-existing crown. Images of the pre-op are taken while the patient is numb and its contours are copied onto the final design of the restoration. This process usually takes a minute or so, after which we milled a size 12 emax block restoration.
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.
In CAD-Ray’s version of exocad, we have dramatically reduced the steps necessary to get a final proposal with copying a pre-op, mock up, or wax-up. We’ve configured the wizzard to walk you through the steps of defining your path of draw after margin placement, trimming away material you don’t want your proposal “to touch” and giving instant proposals.
There is one difference you need to be aware of in design modes; Anatomic Crown vs. Anatomic Wax up. When designing a crown, you can choose to include the pre-existing model in the equation. When you select “YES” to “Scan Pre-Op Model?” you tell the design software to incorporate that into the equation, but you will get a free form proposal and then you adapt it to the pre-op model. Alternatively you can choose Anantomic Wax Up and you will design an restoration in under a minute that is to your liking.
In this article, we feature an upper left lateral crown that needed to be replaced due to recurrent decay. While the patient was getting numb, we defined the job description in the Medit i500 software and imaged the pre-existing crown, the opposing and the bite. We digitally cropped out the tooth to be prepared and proceeded with crown removal. Once the margins were refined and the tissue was displaced, we imaged the preparation in HD mode and processed the case.
Once the digital models were rendered, we launched the integrated CAD software that automatically imported the pre-op, the opposing, the prep model, and the bite. Their relationship is preserved in the CAD software and no modifications were necessary. You have two ways to copy the pre-op; one way is to program the CAD software so it replicates the pre-op perfectly while the other gives you a raw proposal that you can then choose to adapt to pre-existing situation.
Direct Import of Models into CAD Software for Design and Mill
Once the case is designed in the CAD software, you can then take it to any CAM and Milling Machine to produce a restoration. Here we milled an emax restoration with the CEREC MCXL and the imes icore CORiTEC ONE at the same time so we can compare the final results. The CEREC milling machine produced a restoration faster by about 90 seconds but the final results of the margins by the CORiTEC Machine was far superior. Also, the CAM software, Millbox in this situation, allows us to choose a third drill that is 0.6 mm in diameter. This increases milling time but results in less overmilling than the 1.2 mm burrs that milll the intaglio of the CEREC Machine.
Please, take a seat, you should not be standing while you watch this.
Artificial intelligence by Medit i500 now identifies the location of your scanbody but it also automatically launches all that proper information into CAD software for instant abutment designs. Make sure to watch both videos. Enjoy.
Few things in dentistry that can be as frustrating as seating a second molar restoration, whether you are doing same day dentistry or having a lab made prosthesis delivered. Here is a protocol we recommend that you follow to dramatically reduce surprises and post op adjustments. In this particular clinical case a zirconia crown debonded and we elected to fabricate an in-office emax restoration. The sequence is as follows:
While the patient is anesthetized and you are waiting for the onset of anesthesia, capture the opposing impression and the arch models. Trim away the prep digitally and then proceed to the buccal bite capture
Do NOT capture the bite until you verify clearance. In the sequences of videos that follow, watch how we use the Medit i500 to capture digital pictures of the clearance
Once we verify clearance, we image the bite. You have the option at this point to see how well your occlusal stamps match the digital stamps if you want to. A large deviation may mean the jaw settled or the patient moved during the bite capture. Note that unlike conventional dentistry, you capture the bite here BEFORE the prep is finalized
Once you achieve isolation you can finalize the prep and retract the tissue and capture the prep. We elected to capture the preparation in HD mode
The case is then immediately imported into the CAD software for design and fabrication
When we 3D scan the surface of an object, we plot geometric figures (usually triangles) on the surface of that object which is usually round or has some other geometric shape. A satellite beam hitting the surface of the earth is a good way to visualize the scanning process as the photo illustrates.
As you span across long distances, a meshwork of triangles are plotted together to accurately represent the topography of the object. You can start “veering off track” and forming models that are inaccurate representations of that object if you don’t properly form this framework. There are many variables that can introduce these errors including simple matters like speed of scanning.
Now, with this dental artificial intelligence program, the software can digitally plot and drop known shapes on top of attachments or devices we place in the mouth. Color mapping can let us know if we are staying accurate, on path, or introducing errors and deviations!
Now imagine if you have 6 objects sticking out of a flat plane that this AI program readily recognizes. Identifying these landmarks is the first step, but the bigger significance is that we can scan from object 1 > 2 > 3 > 4 > 6, and when we continuously to image backwards from object 6 to object 1, and our color coding remains the same, we are guaranteed scan accuracy.
People go to 2 extra years of schooling to do accurate work in complex cases, most of which will be replaced with software algorithms like this. This is a serious and significant advancement in dentistry, particularly in implant dentistry. Here’s a video that detail how we use it to restore dental implants.
In the following three videos we walk you through the steps of how the digital “scanbody drop” works to identify the location of an implant fixture. In the demonstration videos, we highlight this upcoming feature and how you an integrate the CAD software for implant designs and restorations. In the final video, we demonstrate how you can take the construction files to the milling machine of your choice and mill out the abutment and/or suprastructure.
In this case demonstration, we show how you can image in the Medit i500 and follow the most logical steps and sequences to produce a restoration. You capture the preparation, the opposing and bite and once the models are rendered, you can launch the CAD software of your choice. The lower right molar was endontically retreated and the porcelain fused to ceramic crown needed to be replaced as it was overcontoured and impinging on the soft tissue. After the crown was removed, the preparation was refined and impressions were taken. The remaining cotton / cavit / gutta percha was removed right before placement, a NX3 by Kerr was used, which is both build up material and a resin cement. The space between the intaglio of the crown and the pulp chamber was retrofilled at seating time and a final x-ray was taken to make sure there was no excess resin left behind.
Here, we utilize exocad. Once we click on the CAD software button, the software is launched and the models are imported automatically.
Once the case is designed, meditlink walks you through the next step which is to nest the restoration and to mill it with whatever milling machine you choose to utilize. Here, we used the CEREC MCXL, the Z4 from VHF, and the imes icore CORiTEC one.
When you start a case in exocad or in Meditlink, you have to define a project or define the job by entering a prescription. A dentalproject file is created that has all the pertinent data, like the type of restoration, the shade, the material, parameter settings,etc..
After the case is designed a dental cad project file is formed, along with the stl file of the restoration, accompanied by the construction information. Once the construction file is formed, the case can be import it into CAM software like cerec inlab. It carries a lot of information like the margin line.
Some CAM software can process simple redirections without the need for any other pertinent information from the construction file, while others require it. Some are so specific that a simple typo or wrong character will lead to mis-production.
In the case of cerec inlab, it’s best to have the construction file accompany the stl of the restorations, although there are numerous work-arounds in case you don’t. Once processed, the restoration is taken to the Mcxl milling machine.
Why are we so focused on teaching this concept ? Because it is critical for milling metal abutment where you have to keep track of an object that is cylindrical and symmetric in shape. The code in these files will dictate the indexing of the connections and how these abutments are milled.
In this video we showcase the set up page of the Medit i500 Lab Version for software version 2.1, where you define the job description, enter parameters, designate the opposing and proceed to the next step where you launch the imaging software.
Captured Impressions While Patient Was Reaching Anesthesia
While the patient was reaching anesthesia, the opposing arch was captured along with the preparation model. The area to be prepared was cropped out and once enough reduction was achieved the bite was captured. We highly recommend that you verify reduction and adequate clearance before you capture the final preparation. This way, you have one last ditched effort to verified you will have adequate thickness to your restorative material.
The new Medit i500 software will feature the ability to mark margins in the imaging step before you import the case into a CAD software or send it to the lab. In this article we showcase a case where a 12 year old implant crown needed replacement. The pre-op images were captured, along with the opposing and the bite.
After the area was anesthetized and the crown was removed, expasyl was used to achieve hemostasis and tissue retraction. The margins of the abutment were imaged. Note how we used a feature in the Medit scanner to change the scan light from blue to white, which allows you to pick up red (blood and tissue) that is normally difficult to capture.
Once the margins were captured, we activated the margination tool. You highlight the area you want to address and the meshwork is calculated and processed locally, where you can then designate your margins that are exported to CAD software along with the jaw model, the opposing, the pre-op and the bite.
Alternatively, the traditional way would be to not place the margins in the native Medit software and to place it in the CAD software itself. As you can see both options are very viable and you do not lose any resolution of the scanned data between the imaging program or the design software.
There are multiple ways one can capture the bite for a patient. In this clinical case, we focus on the easiest way to capture two bites (one in maximum intercuspation and the other in an opened vertical dimension and in protrusive for a sleep apnea oral appliance).
The Medit iScan software allows you to capture two bites. Most people treat them as “Left Bite” and “Right Bite”, but the software doesn’t care if you follow this guideline. You can capture full arch bites in maximum intercuspation in one catalog box and then capture a full arch bite in the open / protrusive position in the second bite.
The next step is to clone or duplicate the case, where you set the first desired bite and process the case manually in maximum intercuspation and then in the second cloned case, you manually set the bite to the different occlusal scheme. As our users advance in their experience and knowledge level, they clone the same case multiple times so that they don’t have to re-image the upper and lower jaws multiple times and just capture different bites in all the different case files.
Our super advanced users image multiple bites in any folder they want, process it, and use that digital model to related the jaws together to any position they want in a CAD software like exocad.
The Medit i500 intra-oral scanner has two different software programs to operate, one is of which is geared towards clinical dentistry and the other is geared towards laboratories. Our advanced users are encouraged to use the lab version as it has a lot more functionality. One of them is to directly link to exocad software.
In this particular preview we show you the interface where you can launch the iScan program and define the work order and set all the parameters for your restorations.
Once all the settings are chosen, you launch the Medit scanner and image the case. Here, we defined the custom abutment for the crown and the opposing, which activated the catalog box for the antagonist, the arch, the scanbody, and the buccal bite. All respective images were captured.
The models were then processed and exocad was launched for the design of the custom abutment and crown.
Once the implant type is identified then you can design the abutment and crown with great control, where you can contour the underbelly of the abutment to help provide tissue support.
The design and the construction file is taken to the milling machine. Here, we used the CORiTEC ONE to mill the titanium abutment and then the Lithium Disilicate crown. You can see the great internal adaptation when the crown and the abutment are flipped around completely and the abutment does not fall out.