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 have had excellent , prompt , customer service and support from the entire team . Especially from Frank DeLuca as I move along the learning curve. His patients and expertise is much appreciated - 1/24/2023
Shefali Pilar
Our office has been using the Medit scanner for a few months now and are loving it! CAD-Ray was super easy to work with in purchasing the scanner and providing support as needed. Their Facebook forum with the updates and video tutorials are incredibl...read moreOur office has been using the Medit scanner for a few months now and are loving it! CAD-Ray was super easy to work with in purchasing the scanner and providing support as needed. Their Facebook forum with the updates and video tutorials are incredibly helpful.read less - 6/16/2020
Vivek Singh
I have had done business with these guys. I am impressed with their Amazing Customer service. John and Armen are great. I have and will order lots of stuff from them. Kudos to them!!!! - 6/19/2020
Jennifer Ebner
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
We are a new user of Medit i600. My rep Andy was very good with the training & very detailed & patient with the whole process. The online support is one of the best. Installation was also easy and straightforward. Our staff is really happy...read moreWe are a new user of Medit i600. My rep Andy was very good with the training & very detailed & patient with the whole process. The online support is one of the best. Installation was also easy and straightforward. Our staff is really happy with this new addition to our office. Thank youread less - 9/23/2022
only dental company that I have no complaints about - 11/03/2022
David Christensen
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
Truly Great Service. Glad I purchased my scanner here. - 8/03/2023
Greg Stepka
Highly Recommend working with Cad-Ray. Just purchased a MeditI700. So easy to work with. Training with Destaney was awesome. - 3/19/2024
Gunther Heyder
Fantastic Scanner. Has changed the way I practice dentistry. Opens up more time in my schedule and opens up new methods to allow for more consistent, satisfactory results. Customer service is fantastic. Feels like friends are on the other side of the...read moreFantastic Scanner. Has changed the way I practice dentistry. Opens up more time in my schedule and opens up new methods to allow for more consistent, satisfactory results. Customer service is fantastic. Feels like friends are on the other side of the phone. Good work CAD-Ray!read less - 12/08/2021
Jeffrey Martins
Service at CAD-Ray has been really great. About 6 months ago I purchased a Medit i700 scanner from them and have been really happy with it. Fortunately, I haven’t run into many problems, but if I need help they are so easy and friendly to work with. ...read moreService at CAD-Ray has been really great. About 6 months ago I purchased a Medit i700 scanner from them and have been really happy with it. Fortunately, I haven’t run into many problems, but if I need help they are so easy and friendly to work with. When my scanner did stop working, they quickly got me set up with a new one. If I have a computer question, they offer to log in and look at the computer with you. If you’re in the market for an intraoral scanner or any of their other products, I encourage you to talk with them to meet your goals. Thanks CAD-Ray!read less - 11/04/2022
George W
Frank DeLuca has been my rep for almost a year and has provided excellent, caring, professional service and with a great attitude. - 1/25/2023
Zachary Hickman
High quality scanner. Super fast. Have been happy with the support that Cad-Ray has offered. I really like the innovative technology that medit allows users to implement into their practice. - 10/13/2021
Great scanner at a good price...Excellent customer service . I never want to take a conventional impression again! Best upgrade to my office in years. - 11/16/2021
Jared H
Purchasing my medit i700 from Cad-Ray was a great decision. I did my first training with Kaila and she was fantastic! Super knowledgeable, patient and truly helpful in making sure I was ready to hit the ground running with patient care. I put a call ...read morePurchasing my medit i700 from Cad-Ray was a great decision. I did my first training with Kaila and she was fantastic! Super knowledgeable, patient and truly helpful in making sure I was ready to hit the ground running with patient care. I put a call into cad-ray support in the middle of a case and sure enough Kaila was also the one to answer and handle the situation. She jumped right on my computer and had things fixed in a matter of a few minutes. Awesome support, great staff and overall super positive experience with Cad-ray thus far!read less - 5/06/2022
Mark Gaches
Excellent company to work with. Best customer service and technology available. Can't recommend enough! - 5/05/2021
Jose Morales
Service is extremely quick and on point. Highly recommended to join the Cad Ray facebook group! - 6/01/2022
Matt v
Matt Newman was excellent solving a cable problem.! Quick response and good follow up! - 9/11/2024
Johnny Vredenburg III
Before working with cad-ray, I was hesitant to dive into digital dentistry due to the complexity of it. Working with Laura at cad-ray made all of my concerns go away. She was there to help me with my Exocad software installation, even outside of norm...read moreBefore working with cad-ray, I was hesitant to dive into digital dentistry due to the complexity of it. Working with Laura at cad-ray made all of my concerns go away. She was there to help me with my Exocad software installation, even outside of normal business hours - really hard to come by! I also purchased a Medit i500 and getting that setup and working in my clinic was seamless. I could not have asked for better support while navigating digital dentistry. My next purchase will be a 3D printer, and i know exactly where i will buy it from! Highly recommend these guys.read less - 11/20/2020
Evan Bedell
Laura has always been so helpful with the medit when we needed assistance or resources. The training she provided the office was invaluable! She is quick to respond whenever we reach out. 13/10 - would recommend her to anyone looking to get a medit ...read moreLaura has always been so helpful with the medit when we needed assistance or resources. The training she provided the office was invaluable! She is quick to respond whenever we reach out. 13/10 - would recommend her to anyone looking to get a medit scanner.read less - 12/16/2021
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
Ponciano Melo
If your planning to buy dental oral scanner look for Jon. He will give you a great deal. He is very friendly and knowledgeable about the advantage of Medit I500. AGAIN, Don't forget to look for Jon for your next oral scanner. I highly recommend this ...read moreIf your planning to buy dental oral scanner look for Jon. He will give you a great deal. He is very friendly and knowledgeable about the advantage of Medit I500. AGAIN, Don't forget to look for Jon for your next oral scanner. I highly recommend this guy.read less - 1/09/2021
Suresh Goel
I have enjoyed using the Medit i500 scanner. Previously I had two 3Shape scanners, however, the yearly fees were adding up and there are no ongoing fees with the Medit. Quality is great, and support has also been solid. Overall very happy with thi...read moreI have enjoyed using the Medit i500 scanner. Previously I had two 3Shape scanners, however, the yearly fees were adding up and there are no ongoing fees with the Medit. Quality is great, and support has also been solid. Overall very happy with this purchase.read less - 2/16/2020
The customer service has been top notch, every single time. I have only good things to say about them. - 4/05/2022
Jeff Keh
I love my medit i-500. Cad-Ray has wonderful customer support, I can not imagine getting a scanner from anyone else. Armen and Frank are great! Thanks again. Will recommend cad-ray to all my friends. - 6/16/2020
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
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
Jennifer Goodale
Fantastic class. Amazing scanner.Cad Ray has been helpful not only with my purchase of the Medit i500, but every step of the way.Level 2 seminar with Armen and Damien was extremely informative, useful and practical! ⭐️⭐️⭐️⭐️⭐️ - 8/08/2021
Stuart Adam
Amazing team!
Andy was amazing with explaining everything needed to be successful with the medit i700 and encouraged me to give CADRAY a call if I have any questions in the future. I have some colleagues that have regarded CADRAY as the gold stand...read moreAmazing team!
Andy was amazing with explaining everything needed to be successful with the medit i700 and encouraged me to give CADRAY a call if I have any questions in the future. I have some colleagues that have regarded CADRAY as the gold standard for service and I can now say that I completely agree. Thank you!read less - 12/27/2021
Amazing support. Great product. Thoroughly happy with all that this organization offers and provides to our team. Looking forward to doing more business with them in the future. - 12/13/2021
Jordan Bower
Frank helped me out when 3dbiocad could not help me with my trios issue. Thank you cad-ray. - 9/15/2024
Lawrence Falender
W are an Oral Surgery practice. We started treating TMD patients with the Urbanek TMJ device and decided to switch from impressions to a scanner. We have no past experience with using a scanner. Ryan was very nurturing and patient. Though we are no...read moreW are an Oral Surgery practice. We started treating TMD patients with the Urbanek TMJ device and decided to switch from impressions to a scanner. We have no past experience with using a scanner. Ryan was very nurturing and patient. Though we are not ready to make the switch, we are well on our way. Looking forward to our next session.read less - 11/21/2022
Christopher Chin
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
I just purchased the CAD-Ray unit at Chicago Mid Winter meeting. We have used it for single crowns so far and have been very pleased. Nick was my sales contact and he has helped a great deal with some of our 'learning curve " issues. I looked at a nu...read moreI just purchased the CAD-Ray unit at Chicago Mid Winter meeting. We have used it for single crowns so far and have been very pleased. Nick was my sales contact and he has helped a great deal with some of our 'learning curve " issues. I looked at a number of scanners and felt CAD-Ray was the best-two of the labs I use also feel it is the best scanner.read less - 5/12/2020
vy pham
I have been a customer of CAD-Ray for about a year now. We have purchased multiple items from Laura, including exocad software, a milling machine, and the Imetric4d. I can’t express enough how happy we are that we made those purchases through them. T...read moreI have been a customer of CAD-Ray for about a year now. We have purchased multiple items from Laura, including exocad software, a milling machine, and the Imetric4d. I can’t express enough how happy we are that we made those purchases through them. The customer service and the fast responses, (especially Laura) has been top notch! At the beginning, just like anything else in dentistry, we needed support and reassurance of the items acquired and all I have to say is a big thank you for an amazing customer service and support!!!! And did I mention that they offer really good financial options? Again, thank you! Looking forward for the next purchase. - The Inspired Dental team in Las Vegas:)read less - 8/31/2021
John Pobanz
We had an outstanding experience purchasing two Medit scanners. The delivery was timely . The onboarding clean. Laura was dazzling with her acumen and quick solutions . We highly recommend the investment in Cad Ray .Pobanz Orthodontics , Ogden Utah :...read moreWe had an outstanding experience purchasing two Medit scanners. The delivery was timely . The onboarding clean. Laura was dazzling with her acumen and quick solutions . We highly recommend the investment in Cad Ray .Pobanz Orthodontics , Ogden Utah :)read less - 12/10/2021
Asi Cohen
Armen Mirzayan's knowledge base sets CAD-RAY.COM apart from all other digital dental-equipment dealers. Not content with linking manufacturer support content, Armen's team provide instant feedback to any equipment queries, in-depth video tutorials, a...read moreArmen Mirzayan's knowledge base sets CAD-RAY.COM apart from all other digital dental-equipment dealers. Not content with linking manufacturer support content, Armen's team provide instant feedback to any equipment queries, in-depth video tutorials, and regular product testing, streamlining, and pushing the boundaries of their products - be it software, hardware, or connectivity between various brands. I highly recommend this team if you want to fully utilise your equipment and have the backup needed going forward!read less - 11/05/2019
Nicely done Cad-Ray- Thanks for helping me get back to work! The new i700 is our tech fav! - 3/03/2022
Kenneth Gould
A most helpful, detailed, easy to follow, personal primer via Zoom on integrating the i700 scanner into our practice. Well done! Thank you Kaila! - 5/03/2022
Scott Terry
Six Stars! On a scale of one to five, I give CAD-Ray six stars. They really are that good. If you are purchasing an intra-oral scanner, I would recommend buying the Medit I-700. It is a dream machine. But, if you want incredible service every time, y...read moreSix Stars! On a scale of one to five, I give CAD-Ray six stars. They really are that good. If you are purchasing an intra-oral scanner, I would recommend buying the Medit I-700. It is a dream machine. But, if you want incredible service every time, you should buy your scanner from Cad-Ray. They have come through with flying colors each time I have contacted them. Their sales team great and their service is amazing. They have volumes of educational videos available, as well. I have worked with Jonathan, Damien, Frank, Armen and Laura. In a time where we are seeing the opposite, CAD-Ray will totally blow you away with the entire experience. I totally appreciate them and their value.read less - 11/01/2021
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
Yoav Taub
I purchased my Medit from Cad-Ray just prior to Covid and they have been fantastic in getting me the proper training on the machine, both through there 2 day class as well as the many video's they post on the website. I recently purchased some acce...read moreI purchased my Medit from Cad-Ray just prior to Covid and they have been fantastic in getting me the proper training on the machine, both through there 2 day class as well as the many video's they post on the website. I recently purchased some accessories for a different office and they accidently sent it somewhere else. After a quick email they had my stuff at my door within 24 hrs and they threw in a box of tips which I was not expecting (around $300). It is a pleasure to deal with them!read less - 7/19/2021
Samuel Koth DDS
These guys are great. Always quick to answers questions and trouble shoot. Only a text away...they are spot on. Would purchase from them again in a heart beat......and will soon! We are getting close to adding a second Medit i500 to the office. Every...read moreThese guys are great. Always quick to answers questions and trouble shoot. Only a text away...they are spot on. Would purchase from them again in a heart beat......and will soon! We are getting close to adding a second Medit i500 to the office. Everyone whats to use the one we have!read less - 6/19/2020
Jonathan Mason
I bought a Medit 3 years ago and have had amazing success with both the scanner and the support from Cad-Ray. My scanner recently broke and They were on the phone with my assistant trying to fix the problem, and when it was unfixable, they overnight...read moreI bought a Medit 3 years ago and have had amazing success with both the scanner and the support from Cad-Ray. My scanner recently broke and They were on the phone with my assistant trying to fix the problem, and when it was unfixable, they overnighted a new scanner and helped us set it up. Medit is now available through many dealers, but I would only buy next one from Cad-Ray.read less - 11/03/2022
Alec Keon
I was on the fence on getting a scanner for years and finally pulled the trigger. CAD-Ray's support and knowledge has made this one of the best investments in my practice to date. When I spoke with Damien on the phone about my options he literally sa...read moreI was on the fence on getting a scanner for years and finally pulled the trigger. CAD-Ray's support and knowledge has made this one of the best investments in my practice to date. When I spoke with Damien on the phone about my options he literally saved me thousands after figuring out what my exact needs were. I went with the Medit i600, MSI laptop and 3D dental systems cart. The final product looks and feels as premium as it gets.read less - 2/21/2024
Roy Elturk
Outstanding customer service! Laura helped me purchase my first Trios scanner and she took the time to go over all the specs, models, and details with me. Their on going tech support is what sets this company a part from others. - 3/05/2024
Oleg Eisenstein
Great products and services. Highly recommended - 6/16/2020
There are may advanced ways that you can articulate the maxilla with the mandible if you happen to have models that are not accompanied by a bite registration or the arches were scanned intra-orally in separate folders as files
Generally, when you scan intra-oral and complete the case with both arches and the buccal bite, the models maintain their relationship to each other when exported to CAD software. But if you do not include the buccal bite scan, or if you scan the arches in separate files or cases, there is no way for a software to know how they are supposed to align with each other.
This simple video tutorial shows beginners how they can hand articulate the arches together with digital software. There are two steps you should take to make this an easier process to visualize, once you become comfortable with the moving models around as a system or as independent units. Crop the model at its base so that you can see through it and then turn on the feature “show distances” in exocad that will give you a color map and help you with alignment.
Obviously a bite alignment scan will come in hand, whether you use a desktop scan or an intraoral buccal bites scan
Once in a while, our users get themselves in a bind and you have to rely on manual alignment of jaws to each other. Sometimes, it feels like you are doing gymnastics to get the process to work. The sequence of how you import the models and how you set up the case is important in exocad.
Here we have 3 models; one of the upper, one for the lower, and one for the bite. Don’t ask how we ended up here:) The “direction of travel” is important to keep in mind, and as you can see in this video that is sped up, how the case was managed. if you bring in the upper and lower models in together, and then the bite, as soon as you align the bite to one jaw, you end up dislodging it when you tack it to the opposing jaw.
Reversing the sequence of import helps. We first bring in the upper jaw and the bite alignment and stitch those together. Then we bring the lower jaw into the equation and then merge that to the whole complex. Once that is done, the arches now know their relationships to each other and when you save each arch individually and import them into other programs, they will know exactly how to line up.
At the end of this video demonstration you can see how we re-import the two models in stl format just to verify that they do align properly
Don’t be mislead; it is much easier to scan the upper edentulous jaw than the lower, as you don’t have to deal with the tongue or saliva. With the Medit i500 we have a feature called the model display mode, where you can see how the meshwork is being formed by turning red areas to green. When scanning, you can image at the rate of “red colors turning green” so you can produce global accuracy across the arch without distortion or double images forming like you see with all intra oral scanners when they try and scan edentulous ridges on a flat plane
In this particular case, we demonstrate an emax restoration fabricated with the Z4 milling machine by VHF. In the first video, you can see how the case was set up initially within the software. You will notice how we image the preop, image the opposing and can even image the bite out of sequence, all while the patient is being anesthetized.
Once the preparation is captured, we place the margins and design a crown in exocad. The emax is milled, tried in, and them placed in the oven for crystallization. It is then delivered to the patient. Note how the decay at the contacts of the adjacent teeth was drilled out and restored, while the crown was milling / crystalizing. An immediate post op x-ray was taken to make sure there was no resin left behin
The Z4 Milling Machine can drill emax, zirconia and metal abutments. You can use a scanbody, identify the location of the fixture, design the abutment and mill our either ceramic or metal as the abutment.
Metal abutments in the posterior molar areas, tibases in canine and premolar regions, and angled abutments in incisor area is the general consensus for restoration of choice
One of the greatest advantages of the Z4 is that it can start milling while it is doing the calculation for milling. Furthermore, you can load multiple designs in preparation of continuous milling. In the picture attached, the CAM software is shown which operates in the background. Most users don’t usually see this interface.
Here you can see how there are 5 drills for the machine. The top tier, consisting of 3 drills, labeled G240, G100, and G060 are all labeled as R. The G120-T and G060-T are used only for a screw access holes
The following case demonstrates how a symptomatic cracked tooth was treated with an emax restoration that was fabricated / seated during the same appointment as it was prepared. The patient had a heavy gag reflex and the preparation and access were difficult. The medit i500 was utilized and the restoration was designed with CAD-Ray’s design software, powered by exocad, and then milled with the Z4 milling machine by VHF
In this pre-op of video, trans-illumination was utilized to highlight the lack of light propagation at the crack line. Moreover, the patient was percussion sensitive on the lingual cusps for over 5 days where he initially developed symptoms
The Medit i500 software was launched while the patient was anesthetized. The appropriate job definition was defined where we identified that a pre-op scan would be taken. We also identified the spacer parameters and the marked the opposing dentition. All of these items define the image catalog that will be launched when we capture the optical impression (there will be a preparation model, a pre-op model, the opposing, and minimally one bite registration)
While anesthetic was taking affect, salt on the tongue was used to suppress the gag reflex, and the opposing arch was imaged. Then the lower arch was scanned and the bite was captured. The software then was set to the mandibular arch where the tooth in question was cropped out of the equation.
A great benefit to this approach is that you can analyze if you have taken the bite registration correctly before you even image the preparation. Sine the medit i500 can capture color, you can can the patient bite down on articulating paper and pick up the color renderings while imaging. You can then compare the digital occlusal stamps to the ones left behind by articulating paper. This is a great way to gauge if you or the patient has introduced errors in the capturing the correct occlusal relationship between the upper arch and the lower arch
Since the patient was very sensitive while taking impressions of the tongue, the model of the preparation was built in multiple segments and steps. With the medit i500, the initial part of the preparation was imaged, certain areas were cropped out, then the tip of the camera was used to displace the tongue so the lingual margins could be captured. The image itself was capture in the local HD mode. The attached video demonstrates how areas were protected with the software so that we did not inadvertently introduce errors to areas that already had accurate data captured
Once the image was captured, it was processed and directly launched into CAD software. the pre-existing condition was replicated in the design of the crown and minor adjustments were made to its morphology while taking the opposing dentition into consideration
Once the restoration was designed it was automatically transmitted to the milling machine for fabrication. After it was milled, the restoration was checked for fit and contacts while in its blue stage and then crystalized in an oven. Once cooled it was seated with resin cement.
The Meditlink software has a Work File List that is maintained after you have finished your design. It hold the arches, the occlusion, the restoration stil file and the dentalCAD file that you can relaunch to either continue with a previous design or launch a whole new design
There are many ways to capture the upper and lower jaw digitally and mount them correctly in a protrusive and open bite for obstructive sleep apnea devices. In this videos, we feature how to digitize conventional impressions with the Medit i500 and mount them with a model creator so that that you order printed models and/or oral appliances.
Desktop scanners accomplish this much more readily, but it is a snap with intra-oral scanners. The key is to know how to pick up hidden and deep areas, which you can often correct by trimming away excess flash of impression material with a scalpel
One of the greatest challenges in oral appliances for obstructive sleep apnea therapy is to capture the bite in the protrusive and open position in such a fashion so that you reduce or eliminate any adjustments after delivery
One of the greatest benefits to capturing the arches digitally and relating to each other before production is that you eliminate most of these adjustments. Proper scans and proper prints of model for appliance manufacturing make delivery appointments just a few minutes long. We hardly ever open the exam kit anymore
A very important principle to keep in mind with intra-oral scanners is how that data is printed. There are too many reasons to list what can constitute a mis-print. One method to verify accuracy of your printed models is to scan them and take that digital model and merge them with your intra-oral scan model. You pick some common data points and manually align them.
Once that is performed, you can do “best fit matching” and the more green and blue you see in the color profile, the more accurately your meshwork or data points match each other. Once you do that you can take your slice tool and look at the contours of the data and see how well they relate to each other. In this case, we scanned the upper printed model and then merged it with the intra-oral scan used to fabricate the device. There was not a single adjustment made to the appliance for occlusion or for fit
The following case is a 4 unit splinted bridge where the upper central incisors where root canal treated. The laterals remained vital after trauma to the upper maxilla fracture a pre-existing bridge. In this single appointment procedure, the case was set up by imaging the pre-existing temporaries, the opposing and the bite.
After the preparation were made, the tissue was retracted and hemostasis was achieved. The preps were imaged in HD mode with the Medit i500 intra-oral scanner. The restorations were designed in exocad and the final prosthesis was milled with the Z4 VHF Milling Machine. A size 40 block was used to mill the splinted units of eMax.
The fixed bridge was seated with NX3 resin cement and the excess was removed. Cord, packed in the sulcus, allowed for easy identification of the margins in the design step and aided in cement clean up. The patient will return for post op photos once the tissue has healed. The following video depict the steps the milling machine goes through as it carves out the four unit bridge, starting with the 2.4 mm drill, then the 1 mm drill, and the 0.6 diameter drill. Milling time was under 40 minutes
Look at that contact area! A dentist’s and lab tech’s dream, but you still get some crowns that are way too tight and you adjust like crazy until it seats and if you were too aggressive, you likely blew right through the contact. Here is what is happening:
When you image what is happening is that you are imaging below the height of contours of the adjacent teeth / contacts. A designer just sees a big contact area with lots of colors and s/he is happy, not realizing that they actually made contact with material BELOW the height of contour of the adjacent teeth. This is a VERY common error. It will sound strange, but if you are an advanced user, consider NOT taking scans below the HOC and let the software drop a straight wall down to the gumline and your seat issues will disappear! You can also recognize this issue and communicate it to the lab so they can address it
This a case that was done in a single appointment, where the second molar was restored with a class 2 composite restoration and the first molar was replaced using the copy mode in exocad. An initial scan was taken copying capturing the outline form of the pre-existing restoration, the crown was then removed, the tissue was retracted and the preparation was modified
After the decay was removed the Medit i500 was used to capture the prep and the restoration was designed in our CAD software. The eMax restoration was milled and crystallized and then delivered with NX3 resin cement
This restoration was milled in the regular mode without using the 060 drill. This speeds up milling but does not provide for detailed anatomy, which you can accentuate with a handpiece. It is your decision to select fine mode, regular, or fast mode.
Since July, we have imaged and milled many restorations with at least 4 different milling machines, including lab fabricated restorations. The margins and fit have been impeccable even with my terrible preps :). I love seeing the post op bitewings and the adaptation of the restorations. One thing I love having control over is the spacer settings; both the amount of space and also the distance I want the gap to end from my margins.
The following case is a lower first molar with the distobuccal cusp fractured and recurrent decay underneath the pre-existing composite restoration, warranting full cuspal coverage. The case was managed with the CAD-Ray workflow, where the medit software is launched and all the imaging is done in that platform.
Directly from meditlink, exocad software is launched and the margins are placed. Once the restoration designed, it nested in the block and sent off to the milling machine. The total time from final design to end of mill was about 18 minutes, and the last 4 or so minutes, the milling machine refined the sprue size and location. One can easily stop the milling process and remove the sprue manually.
Once the restoration was assessed for fit and proper contours, it was chrystalized and then bonded in with Kerr NX3 material. A final post op bitewing was taken to assess if any excess cement was left behind.
This video is sped up at some points, but from the time the design was finished and it was sent to production, it tool less than 90 seconds for the milling machine to start milling. It took a total of 9 minutes and 20 seconds from the time the first water is sprayed to the time the water stops.
The Meditlink software allows you to log in as a clinician or a laboratory. There are quite a few benefits to logging in as a lab, one of them is to have control over the whole process from imaging to design to fabrication
Here, we demonstrate how the case is set up in the job definition. We have linked the exocad CS CADapp as the design software of choice. You have many other options including manually exporting the models.
Once you define the job, you can directly launch the Medit scanner and start imaging. Once you are finished with imaging, you can start marking margins and complete the design of the restoration in the CAD software.
Once designed completely, you have a number of ways to submit it tofabrication. One big advantage here is how you can start milling as soon the calculations start, with the VHF Z4 milling machine. As opposed to milling machines that must have the calculation completed before they start milling, which oftentimes puts the procedure outside the realm of single visit dentistry
Imaging highly reflective surfaces can be challenging. In this particular situation, every tooth had either a pfm or a gold crown restoration. The video playback feature of the medit software allows you to see exactly how these areas are managed and captured. in the live preview box in the lower right corner, you can see the purple silhouette which shows areas that cannot be seen. Just angle the camera and moving its focal length and angulation allows all the areas to be captured. Not retraction besides a mirror was used. No isolation, air, or suction was used. Both arches were captured for an obstructive sleep apnea device with the Medit i500
We had the pleasure of demonstrating the Medit i500 to a doctor today who happened to have a crown prep on the schedule. He had used an intra-oral scanner previously so it did not take much effort for him to use the device.
We first started by capturing the pre-existing condition. Then we captured the opposing arch. Both were captured in just a minute. We then captured the bite and put the camera aside. After the preparation was made, hemostasis was achieved and the doctor only had to impress the prepped tooth at this step, making the procedure very quick and easy.
A new feature in the meditlink software allows us to play back the video of how the arches were captured. You can get a very good sense of how things can work for you if you are looking to integrate into intra-oral into your practice. Contact us for a demo with an agent!
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