Ordered some scanner parts. Laura was super helpful and replied very quickly. Great customer service! - 6/02/2022
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
Purchased a Medit i500 from CAD-Ray earlier this year and I really like the scannner. It has great features at a great price point. And the support of the CAD-Ray team has been awesome. They have a great amount of online resources for the DIYers and ...read morePurchased a Medit i500 from CAD-Ray earlier this year and I really like the scannner. It has great features at a great price point. And the support of the CAD-Ray team has been awesome. They have a great amount of online resources for the DIYers and have helpful employees to help after the sale as well. I highly recommend them.read less - 6/16/2020
AMISH DESAI
Awesome! Great support. If you are planning on getting a scanner, make sure you have Cad-Ray on your side ! - 4/20/2022
Ramin Goshtasbi
Great service even if you own a Primescan. Company is built on customer service. Thanks for the help guys…. - 1/05/2022
Levy Do
I'm a repeat customer because Cad-Ray's customer service is fast, efficient, and no nonsense. The classes offered for training for particularly for the Medit is awesome and it comes included which is phenomenal. All the classes that I've gotten to at...read moreI'm a repeat customer because Cad-Ray's customer service is fast, efficient, and no nonsense. The classes offered for training for particularly for the Medit is awesome and it comes included which is phenomenal. All the classes that I've gotten to attend so far has been well organized and I left learning very practical things. Remote support team solves my problem right then and there. Recently I had an issue, and instead of me talking to a sales rep who doesn't know what to do, Kaila remoted in and got it fixed just like that. Thank you and great job guys!read less - 4/19/2022
Alvin Aquino
I'm a dentist in NJ, and I purchased the Medit i700 from CAD-Ray. Hands down they have the best support team. Laura is awesome with helping us using the Medit and with providing any support we may need. One of my best decisions so far was working wit...read moreI'm a dentist in NJ, and I purchased the Medit i700 from CAD-Ray. Hands down they have the best support team. Laura is awesome with helping us using the Medit and with providing any support we may need. One of my best decisions so far was working with CAD-Ray.read less - 4/15/2022
Rafael Dimayuga
Have been chatting with the CADRAY group for at least a year now even though I did not buy anything from them. They are very receptive, prompt and helpful. Finally bit the bullet and received my Medit yesterday! Now my Bluecam has a new buddy!! - 7/17/2020
Karam ALrousan
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
John Pisacane
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
Frank and the CAD-Ray team are fantastic! They go above and beyond to help their doctors be successful. The CAD-Ray team doesn't just sell you a product and leave you high and dry. Frank is always ready to answer questions and offer support when need...read moreFrank and the CAD-Ray team are fantastic! They go above and beyond to help their doctors be successful. The CAD-Ray team doesn't just sell you a product and leave you high and dry. Frank is always ready to answer questions and offer support when needed. I highly recommend!read less - 1/24/2023
Shant Aharonian
Cad-ray has to be the best company to work with when it comes to digital dentistry solutions. Here are the reasons why: 1. Experience. Everyone in the company has extensive experience in dentistry. They have used all digital platforms and offer custo...read moreCad-ray has to be the best company to work with when it comes to digital dentistry solutions. Here are the reasons why: 1. Experience. Everyone in the company has extensive experience in dentistry. They have used all digital platforms and offer customers first hand experience. 2. Honesty. Based on their experience they share all the good/bad of different systems. They work with you to find a solution that works best for you. Not sell you the piece of the equipment that gives them the biggest commission. 3. Support. Cad-ray offers the missing piece of the dentist/digital manufacturer puzzle. Many other distributors sell you a piece of equipment but don’t have true day-to-day experience with that equipment. Cad-ray’s team openly share their expertise to help customers optimize their workflows with great technology. 4. Passionate. The Cad-ray team is extremely passionate about their craft. They truly believe in what they have to offer. I took Armen Mirzayan’s course on intraoral scanning and it was truly mind blowing. Armen’s insights will help any dentist optimize their craft. I purchased the full sprintray 3d printing ecosystem the help of Frank. I plan to purchase more equipment from cad-ray. Also, Jesse is a genius in regards to all aspect of digital workflows. I’m truly grateful for this company and everyone who I’ve worked with so far.read less - 10/07/2022
Provinces Dental
Cad-Ray has provided a great product! They have been super helpful with getting all of our questions answered and products to us in a timely matter! - 3/01/2022
Dr Grace Simco
I bought I500 scanner two years ago. The scanner is great and the service is excellent. I have contacted Heather Gramley and Andy Nova about the updates of my scanner recently. They are absolutely amazing people. They go above and beyond. They repres...read moreI bought I500 scanner two years ago. The scanner is great and the service is excellent. I have contacted Heather Gramley and Andy Nova about the updates of my scanner recently. They are absolutely amazing people. They go above and beyond. They represent the company very well.read less - 7/05/2022
CAD-Ray provides the best support around. I started scanning with Medit i500 in 2018 and my dental practice immediately changed for the better.As a rookie, I had a lot of questions and I calledCAD-Ray a lot in the beginning. They were great!Jonathan...read moreCAD-Ray provides the best support around. I started scanning with Medit i500 in 2018 and my dental practice immediately changed for the better.As a rookie, I had a lot of questions and I calledCAD-Ray a lot in the beginning. They were great!Jonathan Acker helped me get set up. Frank Weinstein answered tons of questions. Laura Geney became an important source of information as I moved into scan bodies, AI library, and had hardware questions. I’ve attended classes in Dallas featuring Armen Mirzayan who is incredibly knowledgeable and will tell you the good, bad, and the ugly about digital workflow. The possibilities are endless with scanning technology. I also want to mention Nick Statly who has visited my Dallas office and is a wealth of information. I have to admit that I frequently view the CAD-Ray User Group Face Book page just to pick up a few pearls here and there.I highly recommend CAD-Ray because their support is by far the best in the IOS industry and because their people honestly care about the customer and are truly committed to your success.read less - 12/23/2021
All Clear
Great experience with CAD-Ray, specifically Damien, with purchasing and customer service with servicing a scanner that needed replacing under warranty. All around excellent service and I will definitely come back for future technology we'll eventuall...read moreGreat experience with CAD-Ray, specifically Damien, with purchasing and customer service with servicing a scanner that needed replacing under warranty. All around excellent service and I will definitely come back for future technology we'll eventually be adding to our practice.read less - 10/23/2024
Jennifer Goodale
Fantastic class. Amazing scanner.Cad Ray has been helpful not only with my purchase of the Medit i500, but every step of the way.Level 2 seminar with Armen and Damien was extremely informative, useful and practical! ⭐️⭐️⭐️⭐️⭐️ - 8/08/2021
David Chong
Digital dentistry has changed my work flow for the better and could not imagine going back. So important that I have the support when things don't work as expected. CAD-Ray has been there every step and trust their expertise and knowledge! - 4/20/2022
Aaron S
Great ongoing support and customer assistance. Been working with Frank for years, even before cad ray. Always there for any help i ever need. Cad ray support is like no other. - 1/26/2023
Donghyun Noh
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
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
Brent Hale
I bought a scanner from Nick Statly at Cad-ray a few months back and have nothing but good things to say about them. They were very helpful with setting up my computer that's linked to the scanner and since then have been very eager to help with ques...read moreI bought a scanner from Nick Statly at Cad-ray a few months back and have nothing but good things to say about them. They were very helpful with setting up my computer that's linked to the scanner and since then have been very eager to help with questions that I had regarding the system.read less - 12/08/2021
Dana Mallard
Heather Gramely provided excellent costumer support today. She went above and beyond the reason I even called to update our computer and software and aid in warranty information/repairs. - 2/08/2022
Deryck Pham
best customer service on the planet. very easy to use. and always fine tuning to make the user experience better. - 6/16/2020
Jordan Bower
Frank helped me out when 3dbiocad could not help me with my trios issue. Thank you cad-ray. - 9/15/2024
Richard Salvatore
I purchased a Medit Scanner from Cad Ray and the entire experience has been phenomenal. Their customer service is top notch and always accessible by text! I have FaceTimed Frank more than once during a hectic day to help me with my scanner. Thanks te...read moreI purchased a Medit Scanner from Cad Ray and the entire experience has been phenomenal. Their customer service is top notch and always accessible by text! I have FaceTimed Frank more than once during a hectic day to help me with my scanner. Thanks team!read less - 6/19/2020
Jennifer Hastings
Andy was wonderful with setting everything up and explaining everything. The Medit i700 has been great thus far, easy set up! The only "issue" is that it can be occasionally glitchy. - 1/11/2022
Cad ray has been very nice to work with. Excellence service and support since I bought my Medit scanner - 6/16/2020
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
Jim Ellis
I've only worked with this company for a short time but I have found them to be wonderful in every way. Call, emails, and texts are returned very quickly and the equipment that we have purchased works wonderfully. I would highly recommend. Dr Jim Ell...read moreI've only worked with this company for a short time but I have found them to be wonderful in every way. Call, emails, and texts are returned very quickly and the equipment that we have purchased works wonderfully. I would highly recommend. Dr Jim Ellisread less - 5/12/2020
Nate Cherof
Excellent customer service and communication. Could not recommend them more - 2/14/2023
Stephen S
Choosing an digital intraoral scanner these days can be quite a daunting task. When I reached out to CAD-Ray, as was recommended by many colleagues, I was connected to Frank DeLuca, and he made my decision-making process very simple. Upon receiving...read moreChoosing an digital intraoral scanner these days can be quite a daunting task. When I reached out to CAD-Ray, as was recommended by many colleagues, I was connected to Frank DeLuca, and he made my decision-making process very simple. Upon receiving my 3shape Trios 4 scanner, Frank and the entire tech support team/customer service were very helpful every step of the way. Frank makes himself available when he can in order to address all of the questions I have regarding the digital workflow. I highly recommend CAD-Ray. It will make your transition to digital scanning a positive experience.read less - 1/24/2023
Steven Cisternas
The future of digital dentistry is here now. Cad-ray provides all the tools needed to make it possible for us to provide digital care to our patients. Thanks Damien and Armen for a great course. - 8/07/2021
Thomas Lim
5 stars for a great product and great service. After much research I knew I was set on the Medit 500. I considered some of my local equipment reps, as well as cad-ray. Cad-ray won out due to their efficiency, speed of service, and knowledge. The...read more5 stars for a great product and great service. After much research I knew I was set on the Medit 500. I considered some of my local equipment reps, as well as cad-ray. Cad-ray won out due to their efficiency, speed of service, and knowledge. Their online presence makes it easy to get help via messaging, social media, or phone.
The scanner itself works great, but make sure to contact them to get the minimum specs required for a laptop -- it will make a difference in how the scanner performs.
To make the scanner mobile, I purchased this cart from Staples: https://www.staples.com/Oklahoma-Sound-Premium-Audio-Visual-Presentation-Cart-40-1-2-H-x-18-W-x-30-D-Black-Ivory-Wood/product_932437.
Lastly, I purchased "3M Dual Lock Fastener" to keep the power module attached to the wand from falling off the cart. I carry the scanner between two offices, so I wanted something sturdy, but removable. (see in photos). The hockey puck shaped holder (comes with the scanner) works great for holding the wand itself.read less - 10/10/2019
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
Jeff Keh
I love my medit i-500. Cad-Ray has wonderful customer support, I can not imagine getting a scanner from anyone else. Armen and Frank are great! Thanks again. Will recommend cad-ray to all my friends. - 6/16/2020
Yoav Taub
I purchased my Medit from Cad-Ray just prior to Covid and they have been fantastic in getting me the proper training on the machine, both through there 2 day class as well as the many video's they post on the website. I recently purchased some acce...read moreI purchased my Medit from Cad-Ray just prior to Covid and they have been fantastic in getting me the proper training on the machine, both through there 2 day class as well as the many video's they post on the website. I recently purchased some accessories for a different office and they accidently sent it somewhere else. After a quick email they had my stuff at my door within 24 hrs and they threw in a box of tips which I was not expecting (around $300). It is a pleasure to deal with them!read less - 7/19/2021
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
Matt McReynolds
Great scanner (medit i500) and mill (coritec one). They were great for an open system that allows me to do just about anything. - 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
This summer I decided that it was time to purchase a scanner and train with my team. We could not be more excited as our experience with Laura at Cad-Ray has been just amazing. From the initial sales discussions to the support and training after the ...read moreThis summer I decided that it was time to purchase a scanner and train with my team. We could not be more excited as our experience with Laura at Cad-Ray has been just amazing. From the initial sales discussions to the support and training after the purchase I am very thankful to have purchased my Medit scanner from Cad-Ray. Every text and phone call has been given prompt attention and the after the sale support is first rate. It is a pleasure to leave a 5 star review for both the technology and for Laura!read less - 12/16/2021
Michael 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 - 10/13/2020
Jaspreet Ghuman
Shout out to Nick, Frank and Armen ! Cheers . Great customer service by Nick and Frank. Too early to make a comment about the scanner but these guys are awesome. - 9/19/2020
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
I purchased my medit i500 scanner about a year ago from CAD Ray, and I have been extremely happy with both the scanner and the service / support.
Armen and Frank consider your purchase to be the beginning of your relationship with them, not...read moreI purchased my medit i500 scanner about a year ago from CAD Ray, and I have been extremely happy with both the scanner and the service / support.
Armen and Frank consider your purchase to be the beginning of your relationship with them, not the end. They do their best to make sure you learn everything you need to know in order to get the best possible results .
They answer calls and messages promptly, and it never takes me very long to get my questions answered.
I am VERY glad I bought from them, and not from one of the "big box" Dental Mega retailers.read less - 10/09/2019
Worked with Laura and she is incredibly knowledgeable. She gave me all the right advice and steered me in the right direction. Her ongoing support is as good as it gets. I feel like I have a 24 hour team at my beckoning call. For the meat and pot...read moreWorked with Laura and she is incredibly knowledgeable. She gave me all the right advice and steered me in the right direction. Her ongoing support is as good as it gets. I feel like I have a 24 hour team at my beckoning call. For the meat and potatoes. I got an Icam 4D from her and now I am printing all on 4 arches same day surgery at our practice in Denver(NUSET). We are going to put ICams and Trios’ in all our offices thanks to Laura and the Cad-Ray team. If you have any questions about the workflow and the success we are having with the Digital work flow call Laura and I will help you succeed with her product support.Thank you Laura and Cad-Ray!read less - 4/28/2022
Lisa Greenstein
Exceptional customer service - 7/26/2023
William Huszti
Nicely done Cad-Ray- Thanks for helping me get back to work! The new i700 is our tech fav! - 3/03/2022
Archstone Weatherford
Medit i700 intraoral scanner is the first scanner that I actually used on my patients. Before I put my hands on it, I had some prejudices against all scanners. They were bulky, laggy in capturing the images, etc. When I finally had the chance to use ...read moreMedit i700 intraoral scanner is the first scanner that I actually used on my patients. Before I put my hands on it, I had some prejudices against all scanners. They were bulky, laggy in capturing the images, etc. When I finally had the chance to use an intraoral scanner and get introductory training with Laura from CAD-RAY a few weeks ago, I totally changed my view of this product. Very soon, I was able to scan crown, bridge, and even denture cases. Of course, I have had some knowledge about the digital scanner from CEs provided in the past, but being able to apply it in the daily practice in such a short time was beyond my expectations. I would highly recommend MEDIT i700 and training from CAD-RAY.
Big thanks to Laura!
-Lei Fu, D.D.S.read less - 9/12/2021
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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