Cad-ray has been amazing, not to mention they have an amazing product in the medit i500. Their training is great, customer service is quick and thorough, and follow up is consistent. I highly recommend using cad-ray for anything that you may need. - 6/19/2020
kenneth kim
Purchased Medit in 2019. Bang for the buck best investment and will get you started in digital dentistry with ease. No monthly subscriptions and Cad-Ray support is amazing. No regrets. - 6/16/2020
Needed help with scanner updates and Frank is the man! Once he was done the scanner was operating in hyper-drive!!thanks frankoffice of Glenmont Dental - 2/15/2022
David Stall
These guys are great. Always available and helpful. My scanning issues were dealt with quickly and courteously. - 10/01/2021
Michael Pagano (CPT Pagano)
I bought a Medit i500 from Cad-Ray. The service was fantastic. This group also does ongoing training to keep you up to date on how to use the technology.I had a minor issue with hardware and Cad-Ray resolved the issues no questions asked!They have a ...read moreI bought a Medit i500 from Cad-Ray. The service was fantastic. This group also does ongoing training to keep you up to date on how to use the technology.I had a minor issue with hardware and Cad-Ray resolved the issues no questions asked!They have a very active online forum that is supportive. I wouldn’t hesitate to purchase more equipment from them!read less - 10/23/2020
arthur lyford
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! Thanks 10/4/2023 And they did it again today with ten minutes before the pt came in 3Shpe server would not connect with the computer and Andy got to 3Shape directly and had us up and running...thankfully I didn't have to call anyone but CadRay...thanks again....read less - 10/05/2023
Anita Madhav
Absolutely love Laura. She was my initial contact and is an amazing resource for any questions even months later. Would highly recommend buying from Cad Ray especially Laura! - 6/28/2022
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
Bob D
Just got my Medit i700 from CAD-Ray and experienced what everyone raves about, the level of customer service by CAD-Ray. As you know you can buy this scanner from a lot of places but they won't offer you help and support. They called my cell and conn...read moreJust got my Medit i700 from CAD-Ray and experienced what everyone raves about, the level of customer service by CAD-Ray. As you know you can buy this scanner from a lot of places but they won't offer you help and support. They called my cell and connected to my laptop and configured everything at 7 PM.. Great great experience.read less - 12/08/2021
Eric Reum
I bought a i500 almost a year and a half ago. Sadly it ran into an issue with the cord after over a years use. Cad-ray was extremely quick to diagnose the issue and also send a replacement scanner. The quality and ease of scanning has been great! Als...read moreI bought a i500 almost a year and a half ago. Sadly it ran into an issue with the cord after over a years use. Cad-ray was extremely quick to diagnose the issue and also send a replacement scanner. The quality and ease of scanning has been great! Also very happy with the customer service.read less - 6/02/2022
Ryan Buckwalter
Couldn't have had a better experience. The training was excellent, and they've been great to work with. I recently had an issue that required a warranty claim. The process was super easy, and completely hassle free. In fact, I'm still in shock at...read moreCouldn't have had a better experience. The training was excellent, and they've been great to work with. I recently had an issue that required a warranty claim. The process was super easy, and completely hassle free. In fact, I'm still in shock at how great they were about the whole thing. I would (and do) highly recommend this company.read less - 2/09/2021
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
Kristian Dietz
My wife and I practice together and bought our first i500 in August of 2018. This was very early on before Armen had a vast number of technique and online support articles in his blog! Little was publicly known at the time about this new scanner bu...read moreMy wife and I practice together and bought our first i500 in August of 2018. This was very early on before Armen had a vast number of technique and online support articles in his blog! Little was publicly known at the time about this new scanner but I felt confident in my purchase for a few reasons: 1) Armen had validated the product and was standing behind it... I knew of Armen from DentalTown and had many years of public posts to evaluate his character; 2) Limited demos available at the time; 3) some clinical accuracy data out of Europe that required zooming in on a powerpoint presentation that was recorded second-hand via camera phone ha! SO needless to say, I put a lot of eggs in the "Armen is standing behind this product" basket. We have NOT been disappointed. From personalized service from both Frank and Armen, to our vast success and joy using the product and deciding in late 2018 to buy a second Medit i500, I have nothing but good things to say about the product and Cad-Ray. What a bunch of self-less individuals. Armen has offered to remote in and I even took him up on the offer once and he remoted in immediately to take a look at something. Good luck getting service like this from ANYONE else in the industry. Cheers to digital dentistry with the RIGHT partner. Kristian C. Dietz, DDSread less - 3/08/2020
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
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
Monika Reyes
For a few years I have been hesitating to get an intra oral scanner. I finally made the decision to get one and it turned out to be the best purchase I made in 2021!I love my Medit i700! - 11/23/2021
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
Meridien Dental
Got my Medit scanner from here. Purchase went very smoothly. Best part is the on going support. Cad-ray team is great with training and ongoing help if your scanner has hiccups here and there with various updates. - 12/11/2023
Cristy Duval
Kaila is an incredible Rep! Hope Cad-Ray knows what a great employee they have. Thank you Kaila! - 12/16/2021
Brent Hale
Been using my i700 for a month now and it's been great. The tutorials that Cad-ray provides have been very helpful. This scanner with a fast computer turns out great results. - 11/01/2021
i purchased medit intraoral scanner a year ago, other than the scanner is great, the customer service is outstanding whenever j need help or have a question they are ready instantly to answer my questions, cant ask for better customer service. - 6/16/2020
Eric Bailey
Couldn't be happier with the support I've gotten from these guys. Trouble-shooting a problem real time so you can call a patient and get them right back in with a solution is extremely hard customer service to match. Thanks a ton and no question wher...read moreCouldn't be happier with the support I've gotten from these guys. Trouble-shooting a problem real time so you can call a patient and get them right back in with a solution is extremely hard customer service to match. Thanks a ton and no question where I'll be going for any more purchases!read less - 10/06/2021
Overall great company to work with. They sell wondeful products and give stellar service for a much lower price than any of the supply houses. I can't recommend them enough. - 8/19/2022
Collins Woodside
I purchased my Medit i500 scanner almost a year ago from CAD-Ray. Laura and the team there have been so responsive and ready to help. It is so nice to have a person answer the phone and be willing and able to assist! - 12/09/2021
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
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
Mike Holt
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
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
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
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
This product is the best out there. Do the math and your ROI makes more sense than most products we purchase as dentists. Get on the digital train or you’ll be left behind. This is the best product to make the jump with. - 6/16/2020
Awesome service. Bought a Medit and was able to learn how to use it simply by watching Cad-Ray's support and education videos. Three thumbs up! - 6/16/2020
Sean Landgraf
Truly Great Service. Glad I purchased my scanner here. - 8/03/2023
Alexandra Lentz
Cad-Ray has been awesome to work with, very knowledgeable and quick to respond. Nick has been answering all my questions since day 1 and made the entire process of purchasing the Medit i700 a breeze. Can't believe how quick the product shipped and ca...read moreCad-Ray has been awesome to work with, very knowledgeable and quick to respond. Nick has been answering all my questions since day 1 and made the entire process of purchasing the Medit i700 a breeze. Can't believe how quick the product shipped and cannot wait to start scanning with it!read less - 12/15/2021
Got Medit scanner from CAD-ray 5 months ago. Today got help from Rayan. Rayan has a lot of patience ,explained everything I asked him . Absolutly satisfied. Great service, great support. - 10/19/2023
Yu Gan
Great company. Pioneer in digital dentistry. Armen knows his stuff. Hands down the go to scanner reseller in the US. Support and training courses are incredible. - 10/02/2022
Eric Turner
I bought my Medit from Cad-Ray a little over a year ago. The very few times I've needed any kind of help with it, Cad-Ray has been absolutely ON IT. Issues get completely resolved within minutes. It's great!! - 11/01/2021
David Wheeler
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
Aaron - Cooleysmiles
fantastic experience with this company for over 7 years! Top customer service and support! Its great having them as part of our team! Highly recommend! - 3/22/2022
John Eum
Love all the staff there. Great support and instruction from Armen, Laura, Damien. We are very grateful for Kaila who has been incredible in getting us going - very friendly, professional and responsive. Thank you! - 7/03/2024
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
Graham Reed
I got the Medit scanner last fall and I have been nothing but impressed by it and the support by CAD-Ray. The level of support, training videos, and continuously upgraded software is really impressive. If you are on the fence, you should feel confide...read moreI got the Medit scanner last fall and I have been nothing but impressed by it and the support by CAD-Ray. The level of support, training videos, and continuously upgraded software is really impressive. If you are on the fence, you should feel confident in moving forward with CAD-Ray.read less - 6/16/2020
Jorge Gonzalez
Armen is a dentist and knows what a dentist need, on other words cad ray sells technology that works for dentists! - 6/16/2020
If you are looking to buy a Medit, you shouldn't look anywhere else to buy it. My Medit i700 was having issues on a Friday and I was able to get Heather from Cad-Ray to troubleshoot the issue. She remoted into my computer to try and troubleshoot the ...read moreIf you are looking to buy a Medit, you shouldn't look anywhere else to buy it. My Medit i700 was having issues on a Friday and I was able to get Heather from Cad-Ray to troubleshoot the issue. She remoted into my computer to try and troubleshoot the issue and helped with getting Medit on board as well. Once it was confirmed it was a hardware issue, I got sent a BRAND NEW Medit i700 OVERNIGHT.Can you believe that? Service and warranty that Cad-Ray offers is really TOP NOTCH.Highly Recommend Cad-Ray for all things MEDIT. Thank you Heather from Cad-Ray for all your help!!!read less - 2/02/2022
Value Dental
Excellent customer service and support. Kaila was extremely pleasant and professional over the phone. She sent us the replacement part in a timely fashion. Will recommend this product and their business to fellow colleagues. Thanks again! - 12/06/2021
Yaqi Mu
I absolutely love using the Medit i500 Intra-oral scanner!!! The i500 scanner is small and easy to use on all patients. It is fast and gives a very clear image. I also think its very cool that you can change the music setting to whatever song you m...read moreI absolutely love using the Medit i500 Intra-oral scanner!!! The i500 scanner is small and easy to use on all patients. It is fast and gives a very clear image. I also think its very cool that you can change the music setting to whatever song you may like! I have used a few different scanners since i have been a dental assistant and have had several complications as far as: how long the scanner would take to load the image, The scanner not catching the image and even the system constantly kicking me out. With the i500 intra-oral scanner i have the BEST experience. I am happy and my patients are happier! I recommend the Medit i500 Intra-oral scanner to anyone who has never used it before! You wont be disappointed! 5 Stars for sure!!!!
- Samantha Brown @ Southern Oak Dental in Conway SC.read less - 6/17/2020
Cad-Ray is great! Great customer service and they are consistent with their followthrough . Always helpful when you need questions answered and helping to lower the learning curve with newly purchased equipment. I’m very satisfied with my medit i-...read moreCad-Ray is great! Great customer service and they are consistent with their followthrough . Always helpful when you need questions answered and helping to lower the learning curve with newly purchased equipment. I’m very satisfied with my medit i-500 intraoral scanner. Armen and Frank are solid!read less - 6/16/2020
Matt St George
I had 3 Cerec machines and switched to medit. It’s awesome and do not regret the switch one bit. This is the place to buy it bc Armen and Frank are a wealth of knowledge and Frank is awesome with support. He’s always there whenever I need him! - 10/10/2019
We have been using the Medit i700 for about a year now. Frank and his customer service team has made it a smooth transition. He is always quick to reply and is friendly and professional! - 1/26/2023
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
Are you interested in an office build out or incorporating technology into your practice? feel free to visit us when we are conducting courses or sign up to take a...
There is a concept in digital dentistry that is called “mixing good and bad data”. What you have to appreciate is that two different objects can’t occupy the same space...
In this presentation we detail the implant suprastructure identification system where an existing abutment is removed and scanned extra-orally to capture the margins readily after the abutment is anodized...
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