Customer service has always been top-notch! I personally worked with Wayne Glassoff and he has been super helpful getting our office up and running with 3D printing and has always been a great resource and highly responsive whenever I need anything o...read moreCustomer service has always been top-notch! I personally worked with Wayne Glassoff and he has been super helpful getting our office up and running with 3D printing and has always been a great resource and highly responsive whenever I need anything or have any questions.read less - 9/24/2022
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
Delicate Dentistry
Cad-Ray's support is truly exceptional. While the equipment represents a significant investment, the peace of mind that comes from knowing they stand firmly behind their products is invaluable. Their support team is efficient, professional, and remar...read moreCad-Ray's support is truly exceptional. While the equipment represents a significant investment, the peace of mind that comes from knowing they stand firmly behind their products is invaluable. Their support team is efficient, professional, and remarkably persistent in ensuring everything runs smoothly. I'm especially grateful to Destaney and Laura for their ongoing assistance- their dedication and expertise have made a world of a difference!read less - 5/15/2025
Robert Crosby
The i700 is the second scanner I have purchased. It is hands down far superior in terms of quality and ease of use than my first scanner (3M Tru Def). I was hesitant to enter the market again but wanted to mainly for implant reasons. After talking...read moreThe i700 is the second scanner I have purchased. It is hands down far superior in terms of quality and ease of use than my first scanner (3M Tru Def). I was hesitant to enter the market again but wanted to mainly for implant reasons. After talking with Laura and watching her presentation with my staff, we were sold! The i700 was extremely reasonable in price while being similar to units costing twice as much. CAD-Ray made this possible. I found their on line training to be adequate in learning the necessary skills to start scanning, I continue to watch these videos as I sharpen my skills. Initially I was concerned about the on line training. But now I actually prefer this way of training as it is self paced and you always have the library of videos to watch when needed. Laura has been there to answer questions and help me whenever needed and I’m talking on nights and weekends too! I admit I was was extremely hesitant to get another scanner, especially with an online outfit; but I have no regrets and highly recommend CAD-Ray and Laura for anyone needing a scanner! They provide excellent services.read less - 4/23/2022
Yordanka Ivanova
I had been on the market for a scanner for a while and the i700 is my first intraoral scanner purchase. We are still new to the scanning world and its capabilities. Frank DeLuca was my main contact from the beginning and the person who did our traini...read moreI had been on the market for a scanner for a while and the i700 is my first intraoral scanner purchase. We are still new to the scanning world and its capabilities. Frank DeLuca was my main contact from the beginning and the person who did our training. The scanner is incredible and has surpassed our expectations even though we haven’t used it to its full potential yet. Frank has been amazing and always there to guide us every step of the way. Having such fabulous customer service and support from CAD-Ray was key for us when making this purchase decision. Thank you!read less - 6/23/2022
Laura
Very helpful and attentive when setting up my new Medit scanner. Seamless process from start to finish - 10/28/2024
Shawn Van de Vyver
Most amazing customer service I've experienced with any dental office related company. It reminds me of the legend about the lady returning car tires to Nordstrom and getting a full refund, but with intraoral scanners. I've moved all my related purch...read moreMost amazing customer service I've experienced with any dental office related company. It reminds me of the legend about the lady returning car tires to Nordstrom and getting a full refund, but with intraoral scanners. I've moved all my related purchases (and all future equipment purchases) over to CAD-Ray. I couldn't ask for anything more.What else is there to say?read less - 6/02/2022
Yuriy Yakubov
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
Sonrisas Dental
Support was our main concern, and we chose very carefully. Frank is 100% every step of the way - 1/25/2023
Jay Siddiqui
Amazing support and install, Jesse went through everything and made sure I was comfortable with my equipment before leaving. He also introduced me to the world of anodizing and now I am hooked! Highly recommend them for any tech you may need. - 8/23/2022
Michelle Duong
Our office is new to using the Meditscan so far we love it. Our rep andy was so detailed and great with the training. Everything has been good so far and easy. Defenitely recommend. - 9/23/2022
Great support services and training from Cad-Ray, they are always very helpful and responsive. I have been using the I500 in my offices for the last two years and loving it. - 11/01/2021
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
Great staff and support when needed! There is a bit of a learning curve like with any new tech, but I highly recommend the Medit i500 and the Cad-Ray staff is great. Special thanks to Laura and Jeff for helping out! You guys rock. Great company and ...read moreGreat staff and support when needed! There is a bit of a learning curve like with any new tech, but I highly recommend the Medit i500 and the Cad-Ray staff is great. Special thanks to Laura and Jeff for helping out! You guys rock. Great company and product!read less - 11/11/2020
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
Alex Vo
Great service and scanner support! Company delivers well above my expectations! Love my medit scanner. - 1/29/2023
A Palmer
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
Carter Weber
I had a great experience with CAD RAY. I was lucky enough to have Frank DeLuca come down to my office to demo the Medit I700. Needless to say, we were in love with the technology and the great hands on demo. CAD RAY overnighted me the scanner and we ...read moreI had a great experience with CAD RAY. I was lucky enough to have Frank DeLuca come down to my office to demo the Medit I700. Needless to say, we were in love with the technology and the great hands on demo. CAD RAY overnighted me the scanner and we were off to the races. Any time we have had a technical question, Frank has personal helped me or put me in touch with one of his colleagues if he wasn’t available. All around, it was as 5 star experience!read less - 12/16/2021
Marc Prince
We’ve been using the Medit i700 in our office for approximately a year now. It has been a game changer and hard to remember what it’s like without using the intra-oral scanner. The Cad-Ray support team has been remarkable as well! - 9/11/2022
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
ryan ku
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 love my medit scanner. I purchase many dental equipments each year and by far it’s the best thing I got for the bucks I spent ( beating my 6 digits equipments ).
We have omnicam and I hated it, multiple crushes, expensive monthly service fee, hor...read moreI love my medit scanner. I purchase many dental equipments each year and by far it’s the best thing I got for the bucks I spent ( beating my 6 digits equipments ).
We have omnicam and I hated it, multiple crushes, expensive monthly service fee, horrible support, etc. I was so frustrated and had to look for an alternative. Many mentioned itero to me and I was about to purchase it and suck another monthly fee until I came by Armen’s video about medit on one of the Facebook group in 2018. I was surprised with the image and the speed and started digging more and contacted Frank to explain the scanner more. Ended purchasing it late 2018 and I’m a happy user Since after. The support is excellent, Frank is there when you need any help plus the Facebook community is there to answer anything. Recently, I attended Armen’s course to learn how to mill from the medit and I got shocked by the AI and the options that the software has. This machine is a beast and you won’t regret it getting it from Armen and Frank. They go beyond and not like other salesman or equipments where you are left behind after they sale you and finish their training. We are in 2020 and I still get the same support as I bought it in 2018.read less - 1/09/2020
Cad-ray has been awesome with support and training! I got the medit in 2018 and couldn’t imagine practicing without it! Armen and frank somehow seem to be available at all hours of the day, and I can typically have them remote in same day if I need a...read moreCad-ray has been awesome with support and training! I got the medit in 2018 and couldn’t imagine practicing without it! Armen and frank somehow seem to be available at all hours of the day, and I can typically have them remote in same day if I need any help.read less - 6/16/2020
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
William Neurauter
As a small office, making the move to digital impression dentistry was a rather large commitment. After much research we settled on the Medit i500. We almost purchased from our implant supplier but were less than impressed with their training and...read moreAs a small office, making the move to digital impression dentistry was a rather large commitment. After much research we settled on the Medit i500. We almost purchased from our implant supplier but were less than impressed with their training and support options. After additional research we found Cad-Ray and couldn't be happier that we purchased from them. Their online tutorials and live support have been second to none. Having such a great support network behind the Medit made the transition and purchase so much better than it could have been had we gone a different route.read less - 11/30/2021
I have just recently purchased the Medit i700, and although it is "on its way" I have to comment on the support that I have already received, especially from Nick. He walked me through the benefits and features of the scanner and the transaction was...read moreI have just recently purchased the Medit i700, and although it is "on its way" I have to comment on the support that I have already received, especially from Nick. He walked me through the benefits and features of the scanner and the transaction was extremely easy. I can only think that the rest of the onboarding will be the same and in six months I will revisit this site and be extremely grateful I made the purchase.read less - 12/09/2021
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
One of the best companies I've dealt with in decades of dental practice. Not only is the product excellent but the support both personally and online has been just wonderful. - 8/08/2021
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
Scot White
It's rare to find a company that actually has its customer's best interests in mind. They took all the intimidation out of the equation for me as I took the leap into the "digital dentistry." Frank Weinstein is the right person to know if you are try...read moreIt's rare to find a company that actually has its customer's best interests in mind. They took all the intimidation out of the equation for me as I took the leap into the "digital dentistry." Frank Weinstein is the right person to know if you are trying to learn about and buy and use digital tools in your office. It's so mush easier when you have knowledgeable people who are really on your side.read less - 7/07/2021
Robert Loughlin
I Love it !!! I needed to replace my Omnicam because the computer hardware was old and not able to keep up with the software upgrades. The computer upgrade costs from Sirona were cost-prohibitive (another reason why the Medit is so good) and I wasn...read moreI Love it !!! I needed to replace my Omnicam because the computer hardware was old and not able to keep up with the software upgrades. The computer upgrade costs from Sirona were cost-prohibitive (another reason why the Medit is so good) and I wasn't about to make the same mistake twice and replace it with another system from Sirona. I was a bit unsure about making a big switch but after speaking with Nick Statly at Cad-Ray, he eliminated all of my reservations and I ordered it. I've used it for the past week and love it. Setting it up and getting it running was simple. I would not describe this as a do it yourself process, it's much easier. If you can make a cup of coffee you can set the scanner up and start making excellent scans. All one needs to do is watch the very well laid out and easy to follow videos and save a lot of money. The image quality and ease of use hands down beats the Omnicam. Also during the current pandemic, I really feel better about being able to cold sterlize the tips vs the omnicam's just "wiping down." I almost hope my desktop scanner craps out so I can get the Medit desktop. I'm glad I listened to you Nick!!!read less - 6/04/2020
These guys are great. My favorite part about them is they set you up for success with your products. A lot of dental companies will be happy to sell you big ticket tech item but don't have much to set you up for success. I bought the Medit i500 and t...read moreThese guys are great. My favorite part about them is they set you up for success with your products. A lot of dental companies will be happy to sell you big ticket tech item but don't have much to set you up for success. I bought the Medit i500 and they have tons of videos on how to get it working and working well for you in your office. If you need a much of hand holding they have that our if you are like me and like the do it yourself videos they have that. I am sure you can buy these products all over but it is there service that sets them apart. If to are looking to buy some dental tech use these guys!read less - 6/05/2020
Matt v
Matt Newman was excellent solving a cable problem.! Quick response and good follow up! - 9/11/2024
David Paquette
Cad-Ray has been super-efficient and very easy to work with! Highly recommend them for Medit sales and support! - 11/09/2021
I was dragging my feet before purchasing my first scanner because I was apprehensive of the effort required to change to a digital workflow. Laura assured me my fears were overblown and because of her patience and exceptional training abilities it h...read moreI was dragging my feet before purchasing my first scanner because I was apprehensive of the effort required to change to a digital workflow. Laura assured me my fears were overblown and because of her patience and exceptional training abilities it has been a rewarding and relatively seamless transition to the world of scanning. I never dreamed implementation would have been this easy and its attributed to Laura's skillful training ability. The scanner is wonderful and powerful, but we would have never been able to unlock its potential without her assistance.read less - 8/31/2021
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
Norman Knowles
I have had the original iTero, a Trios 3, and a Carestream CS3600. A staff member broke the lens on the Trios and while waiting 3 weeks for an RMA to send it to Poland for six weeks to get it repaired, Carestream was sniffing around and suggested tha...read moreI have had the original iTero, a Trios 3, and a Carestream CS3600. A staff member broke the lens on the Trios and while waiting 3 weeks for an RMA to send it to Poland for six weeks to get it repaired, Carestream was sniffing around and suggested that I trade in my Trios so I did which began a 4 month nightmare with their piece of junk scanner. Absolutely awful customer service from both 3Shape and Carestream. I needed a scanner and had heard great things about it the Medit i500 at the Florida Academy of Coesmetic Dentistry so I got one. It works really well and Medit keeps adding new and useful features and their architecture is completely open. Two weeks ago, my i500 died so I contacted Cad-Ray surrport and I had a new unit in my office 24 hours later! That's absolutely unheard of in the industry!!! Both Cad-Ray and Medit have positioned themselves to be industry giant killers and they're doing it. The i500 is a phenomenal scanner at a phenomenal price point and service and guidance at Cad-Ray is just plain excellent.If you are thinking about getting a scanner, do it! Just contact Cad-Ray and go for it. You will only be happy about your purchase! Highly recommended!read less - 3/09/2021
Matt Stratman
only dental company that I have no complaints about - 11/03/2022
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
Maggie Sh
I’ve been using Medit 500 since spring of 2021 and really like it. The support system has been very good so far. I just called yesterday and spoke with Frank Deluca, he was very informative and helpful. - 12/07/2021
Kristine Keshishyan
My Intraoral scanner was not working. It wouldn’t scan, during the scan the screen was completely blue. I contacted Laura and she logged in remotely and took care of the problem. She was extremely helpful and knowledgeable. Thank you Laura for your o...read moreMy Intraoral scanner was not working. It wouldn’t scan, during the scan the screen was completely blue. I contacted Laura and she logged in remotely and took care of the problem. She was extremely helpful and knowledgeable. Thank you Laura for your outstanding service. Thank you.read less - 12/07/2021
michael kim
Great scanner, even better customer support. I text John everyday and he always gets back to me in a timely manner with all my questions. - 7/09/2020
Just purchased i700 and had training with Andy.
Andy was very patient and informative . He went through everything and made sure I was comfortable with my equipment before leaving. I am really excited about this new technology. - 1/05/2023
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
Great company with even better customer service. Premier dental business with digital dentistry and scanners! - 11/03/2022
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
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
Cody Kriegel
Frank and the Cad Ray team have been nothing short of amazing. I continue to purchase digital equipment from Cad Ray because their support is unlike any in the dental industry. Frank has been instrumental in helping my team get the most out of our pr...read moreFrank and the Cad Ray team have been nothing short of amazing. I continue to purchase digital equipment from Cad Ray because their support is unlike any in the dental industry. Frank has been instrumental in helping my team get the most out of our products.read less - 1/25/2023
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
Cana Pasierb
Cad-Ray has been excellent with support and training. They respond promptly and have a vested interest in your success with the products that they supply. - 6/17/2020
We are very pleased with millbox and the imes icore coritec one for a chairside milling solution. We’ve been testing it for a long time and its CAM (millbox) is very intuitive and the results are always predictable. It can mill titanium abutments, emax, and zirconia blocks.
The following videos illustrate how you can image a scanbody intra-orally and then design it in cad software. Here we used exocad to identify the biomax RP implant and designed both the custom titanium abutment and the suprastructure, both of which were milled with the CORiTEC ONE
There are so many implant and component libraries in cad/cam dentistry which can lead to a lot of confusion. What we highly recommend is that you visually compare the part numbers that you will be using with the part numbers displayed on the millbox software. One letter or number difference and the mistakes will have a profound impact on the bottom line of a dental practice
Medit has launched a software that is the greatest advancements in digital dentistry in more than a decade! With artificial intelligence, you can identify the scanbody during intra-oral digital scans. This has many implications for accurate scan captures and skipping multiple steps in the design process in CAD software like exocad.
But there is more! This will knock your socks off. You can build your own custom library for scanbodies or you can use geometries of abutment libraries from your favorite implant line. In this article we show how to import the stl file for a physical impression abutment (Closed Tray- Blueskybio Part #MIJH) and use it as a scanbody. Just watch the following videos
A lot of implant manufacturers will readily distribute their libraries of abutments and scanbodies. Here, we just chose the MIJH impression abutment and previewed it in one of the many free 3D viewer programs included in windows 10.
Once the data is imported into the library, you can preview it and incorporated into your own library of abutment. Please note that the abutment libraries are stored in the arch catalog boxes while the scanbody libraries are stored in the scanbdoy library, which means the abutment itself may be taken into consideration when capturing the buccal bite.
load digital abutment and identify physical abutment
Once the abutment is identified in Medit it is directly transferred into cad software like exocad to proceed with design. Note in this footage how little of the physical abutment impression was brought into cad software. This greatly reduces errors and your imaging time intra-orally. You can also place a stock abutment and scan it in the same manner and be able to find margins with great ease without having to reach hemostasis or good tissue retraction
In this article we demonstrate how two separate implants are placed with guided surgery and then scanbodies are used immediately after placement to capture the location of the fixtures. While the patient is healing for the next 4-5 months, an upper tibase restoration will be fabricated with a lower custom titanium abutment. Digital impressions were taken with the Medit i500 for implant planning and Blueskybio software was used for the two surgical stents. Two 4.3 mm biomax implants were placed
To start the case, the job is defined for an upper tibase and a lower implant restoration. Proper labeling here is important so that the cad software, exocad, can launch the appropriate design components
While the patient was anesthetized, the edentulous arches on the patient’s left side were imaged. The bite was also taken, which ignores any information that is present in the scanbody catalogs. It is important to understand this as a new user because usually, the scanbodies are taller than the occlusal heights of the adjacent teeth. If these were captured in the wrong catalog boxes, the upper and lower jaw alignment could be mal-aligned
After sufficient anesthesia is achieved, the two surgical stents were seated and verified for fit. It is up to the clinician’s discretion to either lay a flap to access the area or to do the surgery flapless. Since the implant designs showed ample bone, and the fixtures were going to be placed sub-crestal, a tissue punch technique was used here as the area will granulate in. At uncovery, a flap can be used to advance the tissue to the buccal to enhance keratinized tissue appearance
One of the greatest benefits of digital dentistry is that you can capture parts of a model independent of time and sequence. In this particular situation, we opted to capture the scanbody for the upper arch even before the lower arch received the implant.
We utilized Medit i500’s Artificial Intelligence to spot and mark the scanbodies. Once these data points are plotted and synchronize with what appears intra-oral, you no longer have to worry about distortion or artifact in the scanbody itself. Color coding is a good indication of an accurate identification of the DESS scanbodies.
The significance of these identified scanbodies is that you can directly import them into the cad software and the fixture locations are readily identified and the design process can proceed.
In this case presentation, we utilize the medit i500 to image the pre-existing crown and to fabricate a restoration that is a replica of the pre-existing condition. The patient was advised that the recurrent decay was in close proximity to the canal space and that endodontic treatment may be a possibility. The CBCT showed no evidence of any peri-apical radiolucency and the premolar tested vital prior to treatment
CT used to evaluate apex of premolar for crown replacement
Case set up involved imaging the pre-existing condition in the pre-op catalog box. Excess information was cropped to reduce file size. The data was then copied to the maxillary arch catalog box and the area to prepared was edited out in preparation for final optical impressions.
Immediate Post Op
The remaining decay and previous build up material was removed just prior to bonding the restoration with NX3 dual cure resin cement so the dentin was exposed for the least amount of time possible.
At CAD-Ray, we are big proponents of open architecture and the doctors control the flow of their patients’ digital data, whether it is a CT scan or an digital impression system. We have put the Aoralscan through a battery of tests. For single unit, it delivers on quality that equals any other scanner on the market. We were particularly impressed with this deep margin and how well the graphics could differentiate tissue from tooth structure on the distal of the prep
In this case presentation, we feature a crown that needs to be replaced due to open margins and recurrent decay.
With the Medit i500, after the patient is anesthetized and the area is isolated, the pre-existing crown is imaged in the pre-op catalog box. The area to be prepared is cropped out in anticipation of the imaging the modified preparation.
Once the crown is removed, expasyl is packed into the sulcus with a Number 2 cord. With the pre-op bitewings X-ray it was readily apparent that the tissue should be positively displaced in order to capture the margins. It took two layers of cord to achieve hemostasis for imaging with the Medit i500.
While placing the margin in the native imaging software, it was noted that some tissue was obscuring the margin on the lingual side. The area was isolated both clinically and in the software. It was cropped out and filled in with ‘good data’ after proper protection of the adjacent teeth and margins so that we did not obscure their geometry.
Once the margins are identified and the case is processed it is automatically imported into exocad for design and then sent to the Imes Icore CORiTEC Once for manufacturing. The emax restoration was tried in and then delivered after crystalization.
On September 5, 2019 Medit will officially launch the 2.1 software that will allow dentists to mark their own margins before sending to the lab. Since most images captured from models are inherently large in file size, you can selectively focus on the area where the raw images are taken. You highlight the area and you process the data sets as shown in the first video.
Once the area is identified, you can utilize the margin marking tool. You have many aids to help with margins, including the ability to visualize the transition from one plane to another, along with colors in the models.
margin line drawn in Medit i500 native scanning software
Once you have captured this detail you can click on the cad software and continue with design or submit it to your lab so they can proceed with the design and fabrication.
In this article, we demonstrate how to manage a crown replacement on a second upper premolar with the Medit i500, exocad, and the imes icore CORiTEC ONE milling machine. The pre-existing crown was over 2 decades old and the recession revealed a supra-gingival margin. Furthermore, there was no room to improve the anatomy or its outline form as it was in occlusion with the opposing dentition.
A powerful design technique is the copy of the pre-existing crown. Images of the pre-op are taken while the patient is numb and its contours are copied onto the final design of the restoration. This process usually takes a minute or so, after which we milled a size 12 emax block restoration.
One of the most dreaded procedures in dentistry is to cut off a bonded lithium disilicate material. With zirconia, since the bond strength is weak, just “rattling” the crown helps it pop off. You could also debond the restoration with a laser pretty quickly. With emax, you must use copious amounts of water so you don’t fry the pulp. You must also refrain from splitting the crown with a crown remover because you can damage the remaining tooth structure catastrophically.
In this sequence of photos, you will see how we recommend the removal of the bonded restoration. You must first create a trough across the occlusal surface of the crown. Ideally, use a 1.6 mm disposable bur to reach the interface between tooth structure and restorative material. As soon as you reach this junction, take a flat ended diamond bur and start working that same location and remove all the ceramic on the occlusal surface. Staying right at the junction of the material and tooth is the critical part of the process.
After you have removed the occlusal surface, you can take any bur and work the junction one the axial wall. By this time enough work has been done where the walls of the restoration start to break and peel off on their own.
All milling machines have guidelines for proper cleaning and maintanance. The imes icore CORITEC ONE’s spray channels must be kept clean, otherwise they will spray off the target block materials. Essentially you will dry mill ceramic which will damage the material and break the drills very quickly.
You can see how little particles of ceramic and titanium dust can clog the lines.
Here we just used an ortho plier and orthowires to unclog the lines. It’s easiest to have the water spraying so you can identify the channels and see the immediate results.
In this particular case, we are restoring a lower left molar with a full coverage crown. The pre-existing condition has multiple fracture lines and the patient currently wears a retainer. The pre-op optical impression is taken while the patient is reaching anesthesia. Once enough reduction has been achieved, the preparation is captured and an immediate proposal is rendered that replicates the pre-op condition perfectly.
Note how the settings for the start of the adhesive gap influence the cement line that you see on the post-op bitewing after immediate delivery, even though it was milled with the CEREC MCXL.
A new feature coming to Medit i500 is the automatic detection of scanbodies while you are imaging. In this clinical case, two implants are placed in the lower left quadrant in a fully guided fashion. Spacing limitations and proximity to vital anatomy did not allow for proper parallelism. This can create all kinds of headaches with analog dentistry where the trays can inadvertently lock in the mouth of distort upon poor up.
With the digital approach, you can scan the gingiva, the arch with easy access to adjacent contacts, and then the scanbodies themselves. What is great is that you do not disturb the primary stability you just achieved by placing physical forces on freshly placed implants.
Once the images are captured and the scanbodies are identified, we launch exocad and the data is not only automatically imported into the Computer Aided Design Software, it also plots the fixtures in the correct position and identifies their location and timing so you can proceed with the design of the custom abutment and / or tibase restoration.
This 4 unit case was imaged in Medit i500 and designed in exocad. The final restoration was taken to CEREC inlab cam. When the construction file is imported into cam, it contains data such as the margin line which is important for the milling machine to know for its tool path calculations.
In this particular situation, the construction file dictated the position of the restoration in the block which would have not allowed for proper milling. Instead of loading the construction file, we imported the stl design, redrew the margins really quickly and were able to mill the two separate (4 unit) case out of a single emax block.
Same visit crowns can be a practice builder. We had a patient referred for in house fabrication of a restoration because she did not want to go through the procedure twice. A family member made the referral for a broken tooth.
After the tooth tested vital and the patient consented to treatment, she was anesthetized. While waiting for the onsite of anesthesia, the upper arch was imaged along with the lower arch and the bite in the occlusal one window box. The case was set up for just imaging the preparation. Most of this can be delegated to team members.
We highly recommend that you capture the final bite after you have finished preparing the most distal tooth. You can use your camera to visualize your clearance. You can keep reducing the occlusal surface until you have enough clearance.
In this particular case, when we took the second occlusion images, the models would not turn green. When this happens, you should immediately ascertain if you have captured the first or second bite correctly. Double check to see if the jaw settled or if the patient moved their jaw during this acquisition step.
You can watch how we troubleshoot the bite and manually choose the second bite to relate the arches together.
At CAD-Ray we are constantly testing milling machines that can render ceramic or metal abutment restorations. In this particular case, we are testing the conelog line of tibases and utilizing the automated identification of the scanbody with the new Medit i500 V2.1 Artificial Intelligence program. Not only does the software identify the scanbody and locate the fixture but it also imports the whole complex into the cad software where the fixture and digital tibase are already identified and aligned.
We scanned the tibase as well on the model and merged it to the digital proposal to see how closely the digital proposals matched the physical model.
It is very important to properly identify the scanbodies and to label them accordingly. A single mis-step can result in ill fitting restorations and cause disappointment. If the nomenclature or the math doesn’t add up, it is always a good idea to contact the manufacturer of the scanbody to verify your findings.
In the first set of videos, we demonstrate how the scanbody is imaged with the Medit i500. For this particular demonstration, we placed a tibase on a conelog 4.3 mm diameter fixture and then a peek scanbody on top of it. Indexing and making sure it is seated is of paramount importance. Once the software identifies the complex it can automatically import it into exocad software so you can proceed with the design.
This test case is milled for record keeping and FDA compliance as we are distributors of multiple scanners and milling machines. We are only concerned about the fit of the restoration. After the design was completed it was then imported into milbox CAM software, nested, and the sprue was configured for the mill.
The first produced restoration did not seat completely and the internal was relieved in an analog manner. It did finally seat but by then, it lost its anti-rotation mechanism. The case was then reloaded in millbox and the internal relief was increased by – 0.05 mm. That simple adjustment allowed for proper seating without any analog adjustments. You can also appreciate some residual material that may keep you from seating. Both the software and the carbon marks left on the intaglio of the restoration can be clear indications of what needs to be adjusted.
In CAD-Ray’s version of exocad, we have dramatically reduced the steps necessary to get a final proposal with copying a pre-op, mock up, or wax-up. We’ve configured the wizzard to walk you through the steps of defining your path of draw after margin placement, trimming away material you don’t want your proposal “to touch” and giving instant proposals.
There is one difference you need to be aware of in design modes; Anatomic Crown vs. Anatomic Wax up. When designing a crown, you can choose to include the pre-existing model in the equation. When you select “YES” to “Scan Pre-Op Model?” you tell the design software to incorporate that into the equation, but you will get a free form proposal and then you adapt it to the pre-op model. Alternatively you can choose Anantomic Wax Up and you will design an restoration in under a minute that is to your liking.
In this article, we feature an upper left lateral crown that needed to be replaced due to recurrent decay. While the patient was getting numb, we defined the job description in the Medit i500 software and imaged the pre-existing crown, the opposing and the bite. We digitally cropped out the tooth to be prepared and proceeded with crown removal. Once the margins were refined and the tissue was displaced, we imaged the preparation in HD mode and processed the case.
Once the digital models were rendered, we launched the integrated CAD software that automatically imported the pre-op, the opposing, the prep model, and the bite. Their relationship is preserved in the CAD software and no modifications were necessary. You have two ways to copy the pre-op; one way is to program the CAD software so it replicates the pre-op perfectly while the other gives you a raw proposal that you can then choose to adapt to pre-existing situation.
Direct Import of Models into CAD Software for Design and Mill
Once the case is designed in the CAD software, you can then take it to any CAM and Milling Machine to produce a restoration. Here we milled an emax restoration with the CEREC MCXL and the imes icore CORiTEC ONE at the same time so we can compare the final results. The CEREC milling machine produced a restoration faster by about 90 seconds but the final results of the margins by the CORiTEC Machine was far superior. Also, the CAM software, Millbox in this situation, allows us to choose a third drill that is 0.6 mm in diameter. This increases milling time but results in less overmilling than the 1.2 mm burrs that milll the intaglio of the CEREC Machine.
Please, take a seat, you should not be standing while you watch this.
Artificial intelligence by Medit i500 now identifies the location of your scanbody but it also automatically launches all that proper information into CAD software for instant abutment designs. Make sure to watch both videos. Enjoy.
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