This scanner is amazing! It’s hard to believe that it is less then half the price of 3 shape with zero yearly charges. I highly recommend you give it a try! - 10/09/2019
Medit i500 is an incredible scanner. I have experience with other types of scanners including IO and Desktop but this one is really impressive. It is blazing fast and takes beautiful scans. But more importantly is the company itself. Medit is an amaz...read moreMedit i500 is an incredible scanner. I have experience with other types of scanners including IO and Desktop but this one is really impressive. It is blazing fast and takes beautiful scans. But more importantly is the company itself. Medit is an amazing company and is constantly trying to improve. They are always on the cutting edge and releasing new improvements all the time. They are always LISTENING to the customers on how to improve the scanning experience and change accordingly. The customer service is second to none. I highly recommend this scanner but even more highly recommend considering buying the scanner as a result of the great company and PEOPLE that stand behind it.read less - 10/09/2019
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
Steve Acker
We received our i700 scanner from CAD-Ray yesterday. It was an upgrade from our i500. The scanner is amazing and Laura was amazing in helping us get up and running in no time. Their support, professionalism, and expertise is unmatched. Thanks CAD-Ray...read moreWe received our i700 scanner from CAD-Ray yesterday. It was an upgrade from our i500. The scanner is amazing and Laura was amazing in helping us get up and running in no time. Their support, professionalism, and expertise is unmatched. Thanks CAD-Ray!- Helena from Elite Dentalread less - 12/23/2021
David Jump
I can't even find the words to express how incredible CAD-Ray has been with their customer service. I've never worked with a company in ANY industry that has been as helpful and responsive at they have been. Based on their customer service alone I ...read moreI can't even find the words to express how incredible CAD-Ray has been with their customer service. I've never worked with a company in ANY industry that has been as helpful and responsive at they have been. Based on their customer service alone I would buy every piece of equipment I ever needed from them if they sold it. Truly a unique experience! Oh, and the medit i500 has been fantastic, super accurate and patients are blown away by digital impressions. Love it, great product and incredible customer serviceread less - 12/09/2021
larry bybee
We have been using an intra-oral scanner (not a medit) in our practice for 4 years and it was decided that we needed to purchase another scanner due to practice growth. After a thorough review we decided on the Medit i700. Due to the great team at Me...read moreWe have been using an intra-oral scanner (not a medit) in our practice for 4 years and it was decided that we needed to purchase another scanner due to practice growth. After a thorough review we decided on the Medit i700. Due to the great team at Medit I have learned more about scanning 1 week than i received from the other company in 4 years. i700 great price, great scanner and amazing customer service.read less - 12/23/2021
W Timothy Brooks
Excellent fast color scanner. A great improvement over my old proprietary scanner. Easy to learn software and great free technical support. - 6/18/2020
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
I purchased my Medit scanner after the ADA meeting in 2018. I did it primarily on the personal recommendation of Armen Mirzayan, the owner of Cad-Ray. I have known Armen for over 15 years (we both were CEREC trainers) and he has always been unbeli...read moreI purchased my Medit scanner after the ADA meeting in 2018. I did it primarily on the personal recommendation of Armen Mirzayan, the owner of Cad-Ray. I have known Armen for over 15 years (we both were CEREC trainers) and he has always been unbelievably knowledgeable about dental technology and was always moving on the cutting edge.
When you see Armen's daily FB posts, it’s obvious that he is constantly pushing the envelope and exploring the limits of the Medit and the processes we use to idealize our push towards completely digital dentistry. Medit owners are fortunate to have Armen finding glitches and pushing for improvements in our scanner.
As far as after sale service, I can’t find a flaw with Cad-Ray. You won’t find a more supportive and dentist-centered company. Armen and Frank do everything to make purchasers happy and back up their sales.
I’ve heard of horror stories when people shopped elsewhere and only positive comments about Cad-Ray.
In summary, buy your Medit and other high tech equipment from Cad-Ray, you will be totally satisfied.
.read less - 10/08/2019
I got my 3Dshape scanner, great support , my training with Destany was excellent. Great team!! - 2/15/2024
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 had a training session with Laila this morning and she was fantastic! Very organized training, easy to follow and was able to get my scanner up and running. Thank you Kaila! - 1/06/2022
Anthony Vu
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
JCarlos Mendoza
Had a good experience when purchasing my scanner, it was very easy, and to date after three months of using the scanner no support is a plus, anytime I call me I will answer and troubleshoot - 7/10/2022
Jansen Bean
Heather with CADRay provided wonderful assistance with setting up our new scanner, and was able to work around a minor scheduling issue on my part. Top notch service! - 6/28/2024
Aram Grigoryan
I'm really grateful with the service CAD-Ray has provided! I'm also very happy with Laura's presentation with the Medit i700, and overall help in choosing the right scanner for my practice. I'm really happy with the scanner and the SprintRay Pro 95 P...read moreI'm really grateful with the service CAD-Ray has provided! I'm also very happy with Laura's presentation with the Medit i700, and overall help in choosing the right scanner for my practice. I'm really happy with the scanner and the SprintRay Pro 95 Printer as well. Thank you.read less - 8/31/2021
Frank and the CAD-Ray crew are awesome! They are always available for support with the technology you purchase from them. - 1/25/2023
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
Service is extremely quick and on point. Highly recommended to join the Cad Ray facebook group! - 6/01/2022
Nate Cherof
Excellent customer service and communication. Could not recommend them more - 2/14/2023
Aaron LaRock
Dentist here. Bought a scanner, mill and 3d printer with Cad-Ray. I don't know what I'd do if I bought these items without their support. They've helped me so much and are awesome. I felt I had to repay by writing them this nice review. You won't reg...read moreDentist here. Bought a scanner, mill and 3d printer with Cad-Ray. I don't know what I'd do if I bought these items without their support. They've helped me so much and are awesome. I felt I had to repay by writing them this nice review. You won't regret getting whatever you need through Cad Ray.read less - 3/15/2024
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
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
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
Alex Compton
I had been looking into scanners for a while and I could not deny the good reviews of CAD-Ray, so I gave them a call. I was pleasantly (not) surprised by the excellent service I received. Laura Geney set up a call quickly and very simply and plainly ...read moreI had been looking into scanners for a while and I could not deny the good reviews of CAD-Ray, so I gave them a call. I was pleasantly (not) surprised by the excellent service I received. Laura Geney set up a call quickly and very simply and plainly discussed with me my options. She gave me all the information I needed as well as told me about all the available specials I would be able to take advantage of! I ordered my Medit i700 and very soon after received training for myself and dental staff. We have been very happy with the service from CAD-Ray and look forward to maintaining a long lasting relationship with them. Would strongly recommend Laura and CAD-Ray!read less - 4/07/2022
Suzanne Stock
Excellent experience, customer service has been stupendous! - 11/20/2023
Matt McReynolds
These guys are ALWAYS there to help if you get stuck. I’ve been happy with the mill (coritec one) and scanner (i500) I bought from them 2 years ago. I’d do business with them again. - 7/01/2021
Dr. Terry Zervos, DDS,PA.
Today I had to order new tips and Laura was EXTREMELY helpful, Cad-Ray has all the products you need for digital dentistry and they do Education, if you buy Medit scanner from them they include 12 CE training course. Cant just buy a Lamborghini you h...read moreToday I had to order new tips and Laura was EXTREMELY helpful, Cad-Ray has all the products you need for digital dentistry and they do Education, if you buy Medit scanner from them they include 12 CE training course. Cant just buy a Lamborghini you have to learn how to drive it!read less - 7/02/2020
Armen Mirzayan
Are you happy with the support and training you have received with our team at CAD-Ray.com?
Our business grows much like yours, with referrals and recommendations. We would greatly appreciate a quick review / testimonial
NOTE: ...read moreAre you happy with the support and training you have received with our team at CAD-Ray.com?
Our business grows much like yours, with referrals and recommendations. We would greatly appreciate a quick review / testimonial
NOTE: All testimonials are submitted by verified owners.read less - 5/08/2021
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
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
John Pisacane
This is my second review. I posted the first after having Medit for about 9 months. Loved it then, had great success with using the scanner to take full arch scans for clear aligner therapy, study models, removable partials, and crown and bridge. ...read moreThis is my second review. I posted the first after having Medit for about 9 months. Loved it then, had great success with using the scanner to take full arch scans for clear aligner therapy, study models, removable partials, and crown and bridge. Have kept using it and am still very happy with the Medit and with Cad-Ray. The scanner takes care of so many things in a way that impresses patients and pleases lab techs. Whenever I hit a computer glitch, I call Armen, Frank or any other members of the gang and my problems are solved quickly and without drama.read less - 6/16/2020
Just got my Medit IOS delivered last week and the service from Jon was great! I had a ton of questions before placing the order and he happily answered. This is the type of customer support many dental suppliers are missing. Great company to work wit...read moreJust got my Medit IOS delivered last week and the service from Jon was great! I had a ton of questions before placing the order and he happily answered. This is the type of customer support many dental suppliers are missing. Great company to work with.read less - 6/19/2020
Kip Covington
Customer support! I've had handfuls of scanners over the years and support has always been the biggest variable. We recently had a scanner bought through and implant company and received limited to no support. Through recommendations from several fri...read moreCustomer support! I've had handfuls of scanners over the years and support has always been the biggest variable. We recently had a scanner bought through and implant company and received limited to no support. Through recommendations from several friends, I purchased a second scanner through cad-ray and had them transfer over our support for the first. I wish I would have done this years ago. Destaney, has been incredible helping us troubleshoot a hardware issue that came up. It was on 3-shapes side but not only did she run it up the ladder there and get us back up and running quickly, but she promptly answered all questions and continuously checked in to make sure things were moving along. I won't purchase from anyone else going forward.read less - 8/14/2024
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
Jacob Rogers
I love this scanner. Seriously, how can you fit so much quality into the scanner, software and support and such a low price? Magic?!?! Probably. But, for real, we really like using this scanner and it produces great results. Best dental purchas...read moreI love this scanner. Seriously, how can you fit so much quality into the scanner, software and support and such a low price? Magic?!?! Probably. But, for real, we really like using this scanner and it produces great results. Best dental purchase I've ever made!read less - 10/09/2019
I recently made a purchase from Cad-Ray and the experience was truly outstanding. From my initial enquiry, Nick was incredibly supportive and knowledgeable, answering all of my questions thoroughly and guiding me to the product that would best meet m...read moreI recently made a purchase from Cad-Ray and the experience was truly outstanding. From my initial enquiry, Nick was incredibly supportive and knowledgeable, answering all of my questions thoroughly and guiding me to the product that would best meet my needs. What really set this experience apart was his non-pushy approach. Nick showed genuine interest in understanding my specific requirements, ensuring that I would be fully satisfied with my choice. This type of customer service is rare and it made the whole process much more enjoyable. I can confidently recommend Cad-Ray to others not just for their high-quality products, but for their exceptional customer service. A big thank you to Nick and the entire Cad-Ray team for their professionalism and dedication.read less - 5/17/2023
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
A newcomer to scanning, I have been impressed with the ease of the process. The commitment shown by each CAD-Ray team member to successful customer training and their skill levelhave been extraordinary. Thank you Kaila, Frank and Andy!! - 5/15/2022
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
Jonathan Van Dyke
Cadray is excellent and their medit scanner is amazing! - 6/16/2020
Greg Camfield
CAD-Ray keeps knocking it out of the park. Upgraded from i500 to i700. Transition was seamless! Thanks again guys! - 11/15/2022
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
Diego Humberto Marquez Rodriguez
I am a very happy customer, the team behind cad ray, is amazing. Ive had small issues, and tech support is always available. I always call for them to help me use new apps, or updates and they stay on the phone with me all thru out, until fixing the ...read moreI am a very happy customer, the team behind cad ray, is amazing. Ive had small issues, and tech support is always available. I always call for them to help me use new apps, or updates and they stay on the phone with me all thru out, until fixing the issue. Andy has helped me several times, and he's a really nice guy too, great attitude, doesn't make me feel dumb when I don't understand. Sometimes it feels like he's part of my office team! Thank you Cad Ray, thank you Andy!read less - 2/01/2023
Melissa Poynter
Very pleased with Heather :) She has been able to solve any and all issues I may be having, and does so within the same day if not right away! - 6/16/2022
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
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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