We purchased the Medit i700. With the help of CAD-Ray and their amazing support team the transition to digital scanning was simple. Laura Geney walked us through the purchase and guided us during our training with the help of Andy Nova. Laura has bee...read moreWe purchased the Medit i700. With the help of CAD-Ray and their amazing support team the transition to digital scanning was simple. Laura Geney walked us through the purchase and guided us during our training with the help of Andy Nova. Laura has been there every step of the way checking in weekly answering all of our questions. We highly recommend CAD-Ray and look forward to doing business with them in the future.read less - 7/24/2022
All Clear
Great experience with CAD-Ray, specifically Damien, with purchasing and customer service with servicing a scanner that needed replacing under warranty. All around excellent service and I will definitely come back for future technology we'll eventuall...read moreGreat experience with CAD-Ray, specifically Damien, with purchasing and customer service with servicing a scanner that needed replacing under warranty. All around excellent service and I will definitely come back for future technology we'll eventually be adding to our practice.read less - 10/23/2024
Jim Ellis
I've only worked with this company for a short time but I have found them to be wonderful in every way. Call, emails, and texts are returned very quickly and the equipment that we have purchased works wonderfully. I would highly recommend. Dr Jim Ell...read moreI've only worked with this company for a short time but I have found them to be wonderful in every way. Call, emails, and texts are returned very quickly and the equipment that we have purchased works wonderfully. I would highly recommend. Dr Jim Ellisread less - 5/12/2020
Luciana Bretz-Pavie
Wayne Glassoff is the go-to guy here! The BEST!!! He is always on it, he helps figuring out exactly what you need, the best way possible. And fast! Great working with CAD-Ray, they have pretty much everything when it comes to digital dentistry. And t...read moreWayne Glassoff is the go-to guy here! The BEST!!! He is always on it, he helps figuring out exactly what you need, the best way possible. And fast! Great working with CAD-Ray, they have pretty much everything when it comes to digital dentistry. And they give you a damn good support too. Jessica Knott is awesome… training and support, just the BEST! Very satisfied customer here!read less - 2/05/2023
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
Inna Vinnikov
Frank was fantastic in helping me obtain my medit scanner. He answered all of my questions in detail. After the purchase of the scanner, he continued to follow up with me and presently remains a tremendous support with any concerns that may arise. Wa...read moreFrank was fantastic in helping me obtain my medit scanner. He answered all of my questions in detail. After the purchase of the scanner, he continued to follow up with me and presently remains a tremendous support with any concerns that may arise. Was a great experience overall from transitioning my practice into a digital world!read less - 1/25/2023
Gary Benson
Our orthodontic office is new to scanning and printing, but CAD-Ray, Laura, Medit, and SprintRay have made the whole transition a huge win. Our first scan and print was cleaner than any traditional impression/pour up we've ever produced. On our first...read moreOur orthodontic office is new to scanning and printing, but CAD-Ray, Laura, Medit, and SprintRay have made the whole transition a huge win. Our first scan and print was cleaner than any traditional impression/pour up we've ever produced. On our first full clinic day, we scanned 14 arches and managed to stay on schedule! We were waiting for this technology to be affordable, fast, accurate, and reliable, and we can now say we are there. Thanks for all your help and ongoing support.read less - 6/25/2021
will never buy any product they offer from any other company regardless of price. this team is the best and incredible. - 6/05/2022
Mark Sperling
Got a great deal in the medit i700 and the training was top notch. I had about 3 one hour sessions with Ryan at cadray and he was clear, concise and knowledgeable in both the software and hardware components of the computer/scanner and the detailed a...read moreGot a great deal in the medit i700 and the training was top notch. I had about 3 one hour sessions with Ryan at cadray and he was clear, concise and knowledgeable in both the software and hardware components of the computer/scanner and the detailed aspects of the dentistry itself. Got a direct line going forward and would recommend cad ray to anyoneread less - 8/17/2022
Mayoor Patel
Kaila is awesome with training and her customer service skills. Enjoy learning from her... Product (scanner) so far loving it. - 12/02/2021
Brian Jaques
After weeks of research I purchased the i700 through Nick at cad-ray. My office has never used a scanner before and despite the great pricing, this was still a major purchase for me. Nick was incredibly helpful guiding me through the process while an...read moreAfter weeks of research I purchased the i700 through Nick at cad-ray. My office has never used a scanner before and despite the great pricing, this was still a major purchase for me. Nick was incredibly helpful guiding me through the process while answering my many questions. The customer service was very responsive and my friends who have purchased medit scanner were correct that this is the way to go. 5 Stars!read less - 5/08/2021
jeremiah choi
Never had customer care like Cad-Ray, you can't go wrong purchasing through them. Trios is a great scanner. All the reps at Cad-Ray are very knowledgeable and helpful and will make sure you are up and running smoothly. Above and beyond customer serv...read moreNever had customer care like Cad-Ray, you can't go wrong purchasing through them. Trios is a great scanner. All the reps at Cad-Ray are very knowledgeable and helpful and will make sure you are up and running smoothly. Above and beyond customer service.read less - 8/27/2022
Absolutely the best customer service I have ever seen. I couldn't be happier with the service received. I won't be going anywhere else!! Thank you again. - 2/01/2022
blakesherrick-q6S
The Medit i700 is a game changer in speed and overall comfort for patients. I find it much smaller than other brands and have done almost 50 appliances/aligner cases the past 2 months with no fit issues from my lab. Love this scanner!
Dr. Sherric...read moreThe Medit i700 is a game changer in speed and overall comfort for patients. I find it much smaller than other brands and have done almost 50 appliances/aligner cases the past 2 months with no fit issues from my lab. Love this scanner!
Dr. Sherrick
Auburn Lakes Orthodonticsread less - 8/24/2021
We purchased Medit i-500 with CAD ray last December and customer support is great.One of best thing for our practice is having intra oral scanner ,works great . Laura was very patient with our learning curve. - 12/10/2021
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
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
Benjamin Polan
A while ago I became interested in an intra oral scanner for my office especially for dental sleep medicine and TMJ appliances. I searched online for Medit and found cad ray. Laura from Cad-ray quickly responded and set up a zoom meeting so she could...read moreA while ago I became interested in an intra oral scanner for my office especially for dental sleep medicine and TMJ appliances. I searched online for Medit and found cad ray. Laura from Cad-ray quickly responded and set up a zoom meeting so she could demo the unit. Great job at helping me understand. She set up the financing and I got my unit. A few glitches with my internet speed and getting IT to help with my upload and download speeds and I was ready to go. Every time I had a question I texted Laura and almost like she was waiting for my call she responds. We it turned out my unit wasn't just right so she immediately responded we will replace you unit. Laura has been a joy to work with and the customer service given will only encourage me to do business with cad-ray again.
Benjamin Polan DMD, D,ABDSMread less - 8/27/2021
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
Zachary Breen
I purchased the Medit i700 from CAD-Ray back in May and the purchasing process, setting-up and trouble shooting has been extremely easy and straight forward with CAD-Ray. The Medit i700 is one of the best, if not the best, scanner I have used in the ...read moreI purchased the Medit i700 from CAD-Ray back in May and the purchasing process, setting-up and trouble shooting has been extremely easy and straight forward with CAD-Ray. The Medit i700 is one of the best, if not the best, scanner I have used in the past 5 years of using intraoral scanners. Recently I ran into a software issues with my scanner and I am extremely impressed with CAD-Ray and Medit's timely manner in addressing my issue. Within minutes I was on the phone with them and they had my concerns addressed and solved. I previously recommended a few colleagues to CAD-Ray and I will continue to recommend with even greater enthusiasm. I am very pleased with their customer service and the Medit i700. Thank you CAD-Ray!read less - 9/30/2021
The i700 provides amazing ease of use and versatility for any digital restorative application. It’s been game changing for our practice. CAD-Ray’s amazing support and Medit’s constant improvement of the software are revolutionary. I’ve been taking di...read moreThe i700 provides amazing ease of use and versatility for any digital restorative application. It’s been game changing for our practice. CAD-Ray’s amazing support and Medit’s constant improvement of the software are revolutionary. I’ve been taking digital impressions for over 15 years with other systems and nothing comes close to the Medit.read less - 8/27/2021
I am beyond impressed with Destaney and Cad-Ray! Despite accidentally throwing away my old scanner, which I was supposed to return, their team went above and beyond to advocate for me. Their exceptional support and understanding turned a stressful si...read moreI am beyond impressed with Destaney and Cad-Ray! Despite accidentally throwing away my old scanner, which I was supposed to return, their team went above and beyond to advocate for me. Their exceptional support and understanding turned a stressful situation into a seamless experience. Highly recommend!read less - 8/02/2024
dr sheth
It was very powerful and enlightening experience today to do 2 day sessions with Dr. Armen and Damien. I learned a lot, quite amazed by how much we can do with knowledge and Medit scanner. As usual great support by CAD-RAY always. I absolutely love M...read moreIt was very powerful and enlightening experience today to do 2 day sessions with Dr. Armen and Damien. I learned a lot, quite amazed by how much we can do with knowledge and Medit scanner. As usual great support by CAD-RAY always. I absolutely love Medit scanner.read less - 8/08/2021
Steven Hechtman
As important as the decision of which scanner to buy (I bought the Medit i500 - why is a separate review) is the decision of who to purchase it from. There is a Medit i500 distributor 5 miles from my office who agreed to lower their price to match C...read moreAs important as the decision of which scanner to buy (I bought the Medit i500 - why is a separate review) is the decision of who to purchase it from. There is a Medit i500 distributor 5 miles from my office who agreed to lower their price to match Cad-Ray. So why did I purchase it from Cad-Ray who is 2000 miles away from my office. Because I did my homework. Because the post purchase training and support offered by Cad-Ray was unmatched by any other dealer I spoke with. Their library of online training videos that came with the purchase is without equal. Bottom Line: I’m glad I purchased the Medit i500 and, with hindsight, I know I made the right choice to purchased it from Cad-Ray!read less - 5/12/2020
Artin Sakhaee
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
Michael White
Everyone I have dealt with during the process of buying my new N4 VHF mill (which by the way is fantastic) last year to buying a new iMedit 500 scanner. Having the open type system has been a God send. No more held hostage by the 2 main systems us ...read moreEveryone I have dealt with during the process of buying my new N4 VHF mill (which by the way is fantastic) last year to buying a new iMedit 500 scanner. Having the open type system has been a God send. No more held hostage by the 2 main systems us same day crown dentists have had to deal with for years. Cad-ray made the financing a snap and the post customer support is unbelievable. Thank you everyone at Cad-Rayread less - 5/12/2020
Ted Fang
Purchased a Trios 5 and the Sprint Ray Printer/Ecosystem from Cad-Ray at the end of 2022. Frank Deluca, my CAD-Ray rep, was instrumental in helping me see the value in purchasing both technologies to expand on my digital dental office. He came ac...read morePurchased a Trios 5 and the Sprint Ray Printer/Ecosystem from Cad-Ray at the end of 2022. Frank Deluca, my CAD-Ray rep, was instrumental in helping me see the value in purchasing both technologies to expand on my digital dental office. He came across as being very sincere and professional throughout the entire process. After the purchase, he even made himself available to go above and beyond what a normal dental rep would do. For instance, when I had my Sprint Ray Ecosystem installed, he set aside time on a Friday afternoon to walk me through the steps to print my first 3D study models. I would say he is one of the best dental reps that I have come across. Definitely received a 5 star experience and service from Frank. He is definitely and asset to CAD-Ray.read less - 1/25/2023
Andy M
It has been great to work with Laura and Heather. The purchase, financing, shipping, and training process has been smooth. The training was very comprehensive and not rushed at all. I love my Medit i-600 scanner, and I recommend CAD-RAY 100%! - 5/22/2024
Paul Crespo
Cad-Ray has been instrumental in implementing and supporting our experience with scanning. Having scanned previously with other services I can truly say that Cad-Ray takes their clients very seriously and will not leave you hanging. They set the ba...read moreCad-Ray has been instrumental in implementing and supporting our experience with scanning. Having scanned previously with other services I can truly say that Cad-Ray takes their clients very seriously and will not leave you hanging. They set the bar very high. Cad-Ray all the way!read less - 12/09/2021
Keith Bracy
My rep Nick at Cad-ray was very helpful in my purchase of the Medit i700. So far, I love the scanner and have no regrets about my purchase. The setup and support from the company have been seamless as well and the purchase process with financing!
I ...read moreMy rep Nick at Cad-ray was very helpful in my purchase of the Medit i700. So far, I love the scanner and have no regrets about my purchase. The setup and support from the company have been seamless as well and the purchase process with financing!
I was considering the new itero as well and happy I got the Medit instead! The lightweight scanner as well as no monthly ongoing fees was what ultimately won me over, as well as the robust software.read less - 7/21/2021
I've been using this for almost 2 months now and I just love it. At this price point, ROI is a no-brainer. The convenience factor is amazing. I only did the DIY online training and I'm pretty confident doing the scan. I've signed up for the actual ...read moreI've been using this for almost 2 months now and I just love it. At this price point, ROI is a no-brainer. The convenience factor is amazing. I only did the DIY online training and I'm pretty confident doing the scan. I've signed up for the actual course so looking forward to seeing it's greater potentials.read less - 10/14/2019
I cannot say enough about the support I have received from the beginning. I chose CadRay ultimately because of the support reviews...I can attest first hand...they are all right on...though I have been practicing for more than 35 years, this old dog...read moreI cannot say enough about the support I have received from the beginning. I chose CadRay ultimately because of the support reviews...I can attest first hand...they are all right on...though I have been practicing for more than 35 years, this old dog has been taught a lot of new tricks from the support staff at Cad Ray...Truly impressed with every interaction so far! Thanksread less - 5/11/2023
Rich Hirschinger
I had an issue that was due to the Medit settings. Damien logged on remotely to my laptop, and resolved the issue in a couple of minutes. Fantastic service. Thank you. - 8/27/2021
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
Every time I need support for my scanner, the Cad-Ray team is there to help. I recently had a question on how to manipulate a scan and export it back to Medit Scan. Damien logged in and helped me out. Problem solved in under five minutes. Awesome ser...read moreEvery time I need support for my scanner, the Cad-Ray team is there to help. I recently had a question on how to manipulate a scan and export it back to Medit Scan. Damien logged in and helped me out. Problem solved in under five minutes. Awesome service. Thanks Cad-Ray support team!read less - 3/04/2022
Dong Lim
I’ve been using Medit for close to 2 years. It’s a must for any practice. No evil monthly subscription and great support from CAD ray - 6/16/2020
Kyle Coffin
Bought a medit 6 months ago and customer service has been nothing short of amazing. Always very responsive and helpful. Great scanner, too! - 6/16/2020
Dixie Jernigan
The customer service we have received while working with Frank DeLuca is second to none! He is incredibly knowledgeable and enthusiastic, as well as always available to help with any issues. We are very pleased with CAD-RAY and relationship that they...read moreThe customer service we have received while working with Frank DeLuca is second to none! He is incredibly knowledgeable and enthusiastic, as well as always available to help with any issues. We are very pleased with CAD-RAY and relationship that they have with their clients.read less - 1/25/2023
Al Villalobos
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
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
Logan Riggs
I always rely on Frank to help with any questions or concerns regarding our printer. The best in tampa. - 1/25/2023
Thomas Lim
Just updating my post to show my cart setup. Hope it can help for someone :) - 10/12/2019
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
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
William Daily
Excellent support and price on our medit IOS! Bought a second one a year later. Can always count on Armen and Frank for help when we need it. - 6/16/2020
Island Dental Lab
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 - 6/23/2020
Lisa Greenstein
Exceptional customer service - 7/26/2023
Dino Mantis
I purchased the Medit700 a couple of months ago. I have the Cerec Primescan and what a difference!!! The Medit is easy to use and efficient!!! They have a great support system> Laura Geney is amazing. She is almost like being on call anytime I have a...read moreI purchased the Medit700 a couple of months ago. I have the Cerec Primescan and what a difference!!! The Medit is easy to use and efficient!!! They have a great support system> Laura Geney is amazing. She is almost like being on call anytime I have a question. If she is not available (which was only once) the person that helped me logged in and took care of my problem!! I highly recommend this scanner!!!read less - 12/30/2021
lizette aguero
Highly recommended. Ericka help me through all the process when we were having some trouble with our scanner. The help was super fast and secure. She answered all our questions and made sure our scanner were working perfectly. - 4/29/2025
here is a list of why the Medit Artificial Intelligent Implant Suprastructure Identification System is significantly more advantageous over all other cadcam systems.
It s technically a crown and bridge case and the implant location or timing does not matter
You can find margins outside the mouth! See the first video to appreciate the significance of this
You don’t have to deal with retraction or hemostatis at all
You don’t have to worry about sprue position. Many other systems force the placement of the sprue to a specific location often making the case more difficult to manage than necessary
you are not limited to just a few implant lines
you don’t have to worry about location of anti rotational notch
you can digitally alter the prep and get a virtual reduction coping in cad
Use any restorative block you want. There is no need to order special blocks with pre-fabricated access channels and keep a large inventory of many colors. Your regular block inventory will suffice. Just make sure the top of the tibase is wider than the diameter of the drill used to mill out the intaglio. Also, the CAM and the milling machine determine the exact product and different settings maybe utilized to give you relief off the walls. Some will even remove the antirotational notch because the adaptation is so tight, the restoration will not rotate due to the tall walls of the tibase
You can check the fit outside the mouth on the same tibase or a one you keep chairside for every case to let you know that if you are not seating, it is clearly a contact or contour issue as opposed to an intaglio issue.
One of the greatest advantages of digital impressions and oral appliances is how there is very little post op adjustments to be made when you capture the vertical dimension correctly. Here, we deliver a Panthera OSA device with just an exam kit.
This article features the new Meditlink 2.3 software which has some advanced functionality. One of the greatest achievements is he ability to tell the scanner to avoid imaging certain colors like green and blue. This greatly facilitates the imaging of full arches as you can let your gloves / fingers guide the camera and displace all the soft tissue that impedes image capturing. We also feature how easy it is to launch CAD software to design the restoration and mill it out of lithium disilicate material
Case set up: here we enter the patients name and a simple tab appears where we chose the material and restoration tab. Once you image, you can place an order to the lab or you can advance to the CAD tab:
After the Rx has been filled out, you can launch the Medit Scan and image the upper and lower arches. Please note how we tell the camera to avoid the color blue and it ignores the clinicians fingers during imaging. The upper jaw and lower jaw were captured, then the bite registration even before the preparation was finished. This allows the verification of proper reduction and space for the ceramic material
Lower Arch Scan
The lower arch is the most difficult area to scan as you frequently have to battle the tongue, saliva, and the lips. The optragate can be of great help but notice how we use the color filter to hide the blue gloves while we advance the camera. It is a great aid in facilitating the capture of the lower arch
The same principle is applied to the upper arch. Notice that the software does not care if you start with the upper or lower arch. Here, you can visualize how the blue glove was used to displace the cheek and capture the pre-op condition of the upper second molar. The rest of the arch was easily imaged. It is not necessary to capture full arch impressions and this was done just for demonstration purposes. For a single unit case, generally imaging distal from the canine is adequate.
Checkingthe reduction and aquiiring the bite registration
We recommend that you capture the bite before you finish imaging the preparation. This gives you one last chance to verify that you have reduced enough to accommodate material thickness. You can see how we just take regular photos to document the lack of clearance and we continue to adjust the height of the preparation until we achieve the required space. We then activate the imaging process and capture the occlusal relationship between the upper jaw and the lower jaw
Image the preparation and place margin in native MeditScan Software that transfers to CAD Software
The preop condition is then transferred to the arch model and the tooth in question is cropped out. The rest of the arch is protected so no extra data is added unnecessarily to the equation. This protect feature is used for demonstration purposes and is subsequently removed. The prep in question is then highlighted and the local area is processed and the margins are placed. This margin line can be sent to the lab or it can be automatically carried to the design software
The Meditlink software allow you to launch a variety of CAD programs that include 3shape, exocad, cerec, etc… Here we launch exocad which automatically imports and aligns the models and marks the margins. The restoration is then designed to completion.
The CAD software allows you or the lab to alter the marked margins if necessary. The restoration is aligned in the arch for and the contacts are adapted to the adjacents and the oppising
Milling of Lithium Disilicate with Imes Icore Coritec One
The final restoration design can be exported as an stl and taken to a variety of mills or printers. Here we designed it millbox and milled with the coritec One. The material used was Amber Mill and it was crystalized and seated
The following pictures depict the sequence of burs we recommend that you use to finish a preparation quickly. While patient is getting numb, take a quick look at the clearance you will need to reach proper material thickness. Once the quadrant is isolated with isolite and optragate, take an occlusal router bur and create a trough to gain the proper depth. Follow that with a flat disk, and you can quickly reduce the occlusal height.
A shoulder bur of .8 mm thickness can help you reduce the interproximal areas as well as the buccal and lingual margin lines. Before finishing the prep, place hemostatic agent like expasyl in the sulcus and place retraction cord. while it is setting, check your reduction. If you need more space, now is the time to reduce some more.
Once you have adequate clearance, retraction, and hemostatis, you can readily image and find your margins in the CAD software
A Medit i500 scan was taken and merged with a CT scan and the distance to bone was measured (5.5 mm’s) giving enough space for soft tissue contouring with a diode laser. The 3D X-ray must be captured with cotton rolls placed in the vestibule so that you can differentiate between the gingiva and the lip. Ideally you should not close the base of the digital model by the intra-oral scanner as it can make the merge of the data sets more difficult than it needs to be.
I am not one to place much faith in published articles from academicians. I usually draw my information from trusted colleagues and also a very reliable source, Mr. Andrew Sedler, from Advanced Technology Centers in Burbank California. He is in charge of manufacturing thousands of full arch restorations for clinicians and many other labs that outsource their manufacturing.
One of the things I always get a kick out of is whenever they do purchase technology or implement a process, they always have to do it with redundancy. What that means is that their machines can never go down for whatever reason, so they always purchase printers and mills by multiple sets. Interestingly, I was witness to them incorporating printers into the lab about 6-7 years ago and now they have a large wing dedicated to printing with over 20 machines for many different purposes.
I trust his judgement and always follow his recommendation and tested methods. When he says “do not bypass verification jigs, no matter what scanner was used”, I don’t even question it. He sees all the cases many entities can’t manage and he can manufacture any screw, prosthetic, abutment, etc… with their high end milling machines. In fact, it was on his word alone we decided to distribute the ICam4d by imetric.
I thought it would be a good idea to revisit full arch implant restorations with him and see what the state of the industry is like today and what he would recommend for the end users and patients. A very good perspective for a clinician to keep is how a simple mistake or misunderstanding can wipe away all the profit margins for a lab and even for the clinician. A simple example is if you have to correct an angulation issue on an abutment which can dramatically impact the costs of the lab work.
Here is the Q/A session:
“Hi Andrew, I am writing an article on full arches and would appreciate some info”
what % of the full arches that docs order from you are zirconia on tibases only at implant sites?
what % are on titanium bars?
what % are hybrids with acrylic?
what % are MUA vs Implant level?
what is the most prescribed full arch prosthesis now compared to 5 -10 years ago?
what % are soft tissue level vs bone level / mua level?
what would you do for yourself?
which one has the most failure rate?
how often does zirc framework break?
how much damage do you think people do to zirconia frameworks while trying to mill it to sharp corners of tibases?
Answers:
MUA vs IMPLANT LEVEL : over 90% of upper arches will have MUA and 60 to 70 % of the lower arches will have MUA
BONE LEVEL vs TISSUE: majority of implants (90% and up) bone level that requires MUA .
The most failure rate in order is (all of these in respect to the material limitations ):
the traditional acrylic hybrid
composite hybrid next
zirconia monolithic
and the least breakage will be zirconia hybrid supported by metal frame
Zirconia failure is around 4 to 5 % (adding the internal lab remakes – i would say another 3 to 4 %)
The damage caused by adjusting the zirconia could be very considerable, especially around the access hole since those areas are thinner than the full teeth . For myself i would restore zirconia over metal frame if my choice is hybrid, while removable bar overdenture will be a more predictable and more hygienic choice .
Shining3d has a projector and a single camera that takes photos of the surfaces it is scanning. at first, you may think this is a shortcoming, but in many ways, it dramatically reduces errors a new user can introduce.
in the early days of cerec, all you needed to do was capture the margins and the area above the height of contours of the adjacent teeth. This made the try-in and the contacts really easy as the design software just dropped straight a straight wall down to make contacts to. same concept here!
also, after you image and place margins, A SINGLE CLICK takes you to design software where you can finish the case and mill it right away.
it’s here! well technically it is crossing the atlantic. the icam4d’s are on their way.
separate from that, after i think a year long search, we have decided to carry the dess line of abutments because it is the one of the only lines that i can confidently say is well thought out and verified from start to finish. so you will be able to get a MUA to pretty much any implant line. some like bicons, if you choose to go that route will still have to be custom made and we can help you with that. But the vast majority of the implant lines and connections will be covered by this approach. Keith Goldstein is a tremendous resource and has agreed to provide us with a some important files and libraries. here is the significance of all this:
if you want a fixture level impression vs MUA in those rare situations, you can still place a MUA and image that. The dess library can easily convert that information to the location of the fixture. you just need to make sure that you make note of the exact mua and collar height you used. the timing won’t matter as these are RP non-indexed abutments. that solves the number 1 request you folks make when looking at this.
we will have all the libraries of the abutment from the margin and up available to you so you can pop them into the medit scan and easily identify the MUA in the mouth.
for the process to work in the traditional way, you would have had to place the mua’s, place the scnflags, image with icam. take off scanflags, place cylinders, scan with ios. then take off cylinders and then place healing caps. NOW, you can place the MUA’s, place scanflags, image with icam. export the stl and import it into medit. take off scan flags, BYPASS the cylinders, and just start scanning MUA’s in the mouth. With the AI feature, you will readily identify the multi unit abutments no matter how bloody the field is and if parts of the margins are buried under tissue. Of course, in the situation where the implant is super deep and the mua can’t stick its neck out, you will still have the option of popping the cylinders on. you will know which route to go as soon as you seat the MUA after surgery or uncovery
Thanks to Justin Shafer who created a script for us that allows you to export an stl file to a specific directory, where you create a subfolder for each program you want to run. Once the file lands in a subfolder the program is launched and the models are important.
Justin did this at no cost. The more you donate to his work, the more programs he can add to the installer. Some programs like Rayware allow you to import multiple files into one program whereas others launch a single program for each file, like BlueSkyBio. Contact the software designers to easily add commands line to accommodate your needs
This molar’s suggested mill times with the MCXL are for either Size 12 or 14 blocks:
Sprue on distal in normal speed mode is 14:05 minutes, fast speed at 7:54
Sprue on buccal in normal speed is 13:48 minutes, fast speed at 7:46
This molar would only fit in a size 14 block of Amber Mill in Imes Icore Coritec
Sprue on distal in normal speed mode is 14:15 minutes, sprue on buccal in normal speed is 14:42 and speed crown is proosed at 13:23
For our advanced users who mill in house or what to speed up their digital impressions we advocate taking advantage of digital dentistry’s unique features that allow you to take impressions over a period of time and segments, building larger models over different sequences and time. In this particular case we have two molars in the lower left quadrant that warranted replacement. The traditional method would be to prep both, isolate both, retract both, and take your final impression, but we will approach this as if there are two separate patients involved
Case Presentation on how to manage two crowns with a single milling machine
For the second molar, we will take advantage of the anesthesia time and capture the first bite, the opposing, the pre-existing situation and then crop out the preparation area digitally. Once the tooth is prepared, we will check for proper reduction. We will then take the second bite to verify the vertical dimension has not changed.
While the second molar is being designed and milled in the first case, we will launch a second window by cloning the first case. All the data remains the same and this time we crop out the first molar digitally and protect the rest of the arch. Once the first molar is isolated, it is digitally captured and then designed and milled.
image first molar while second molar is being milled
To manage the contact between the two crowns, there are many advanced applications. Here is a simple explanation of how we use the prep model from case 1 as the pre-op model for case two. Since the second molar in case 1 made contact with the distal wall of the first molar, when we design the crown for the first molar in case 2, all we have to do is make sure the distal wall is flush to the pre-op. This guarantees us a contact between the two. There are lots of shortcuts to this puzzle once you get the basics of digital impressions under your belt.
One of the big limitations of CEREC (a registered trademark of denstply sirona) with tibases and implant crowns is that it is limited to very few implant lines and the antirotational notch can just ruin your day as it needs to go into a specific location. You also have to deal with making sure the tibase is seated all the way and the scanbody is properly indexed. The one benefit is that you are dealing with just crown and bridge and you do not need to know implant position or timing at all when doing the design.
In this case, we demonstrate how we utilize the Medit i500 to capture a Tibase from Blueskybio, Biomax NP Conical Connection. Once the tibase is seated, we simply start scanning and then use the artificial intelligent implant suprastructure identification system to identify the location of the tibase. This in essence allows you to capture your margins OUTSIDE the mouth and you don’t have to bother with imaging the tibase, which is highly reflective in the patient’s mouth.
Once processed, you can then modify the tissue digitally and gain access to the tibase margins. You can print the model if you want and manufacture the restoration. In this particular case, we took the design to the CEREC mcxl inlab cam, nested it, and milled it out to demonstrate how we can image with one device from one manufacturer and fabricate a restoration by another company’s manufacturing machine. But the single greatest benefit is that you can place the sprue wherever you want.
IMPORTANT NOTE: The Tibase that you use MUST be wider than the drill milling the intaglio and the sprue must be thick enough to handle the milling process.
Once you understand how the digital workflow goes, you can image with one device, design in another, and then either print or manufacture with yet another device. Here we mill a sectional stent with the cerec that was designed in Blueskybio plan, although printing makes more sense because it is less wear and tear on your drills
For our coritec users: new users often mislabel restorations in the Rx form that leads to a lot of trouble. like calling a crown and onlay or vice versa. this can lead to all kinds of trouble
first sign of trouble is if the two purple lines don’t define the borders of the the restoration. sometimes it is missing, other times it is off the restoration. so always double check this step and usually the missed nomenclature is what causes the trouble.
the next problem people have is that the default setting for the sprue design is poor. it makes the sprue thicker at the mandrel than the restoration. this creates a crevice that the drill can’t get to. this leads to quick drill breakage as it tries to drill into that space (red circle). it is easy to set change these settings so the drill “flows” with the design of the sprue and you get a lot of use out of it. it’s annoying to do this manually so a subsequent video shows you how to change this by default.
another problem is the offset. the last video shows the distance from the restoration to the mandrel as 2mm. the drill is 2.5 in diameter. if you set it at 2, the calculation doesn’t allow enough space for the drill that also breaks it off. set it at 2.7 or 3 and it will last you a long time.
two subsequent videos will show you how to create your own blocks and change their orientation, so you can fit a taller design into a smaller size block
Last Thursday, we announced RayWare 2.5 – the software update that makes your SprintRay 3D printer new again. Watch the announcement here to learn about Pixel Toning, Parallel Slicing, Ludicrous Speed, and much more. Full-Length Video: https://youtu.be/Cix1DNNQdYY Download RayWare: https://sprintray.com/software/ Request a Dental Model Sample: https://store.sprintray.com/samples
If you place enough implants, you may find yourself in need of a prosthetic part that just isn’t manufactured by anyone. For example, you may have a hybrid case on Bicons and for some reason you wanted to restored them with Multi Unit Abutments (MUA) and photogrammetry, yet there are no parts manufactured for such an endeavor. The problem is complex because a manufacturer needs to mass produce these parts and get them past regulatory matters.
Some have found a simple solution, which is to have the parts custom made specifically for the implant. If they need the MUA part before the procedure, they just send a digital or physical model into a lab that can custom make the part. The lab itself needs a prescription form on the lab analog. Since it is custom made, you have direct input on how tall you want the height of the margin, how much you want to displace the tissue, how much would want the restorative head angled, etc..
Most people will order a variety of them to address any situation on the same model and keep it in stock. What’s important to realize is that from the restorative standpoint, all your CAD software needs to know is the location of your abutment margins. It doesn’t care where fixture is and how the timing is lined up in the arch form. As long as it knows where the margins are, you can proceed with the design of the prosthesis.
Contact Andrew Seddler to send a digital or physical model and an Rx to get your custom made MUA’s