There’s nothing like a company with top notch support like Cadray! Frank DeLuca is one of THE most helpful, non- condescending people I’ve ever dealt with! He ALWAYS strives to make us the BEST we can be and almost immediately helps us with any quest...read moreThere’s nothing like a company with top notch support like Cadray! Frank DeLuca is one of THE most helpful, non- condescending people I’ve ever dealt with! He ALWAYS strives to make us the BEST we can be and almost immediately helps us with any questions or problems ( which are minimal with the i700!) HIGHLY recommend this company and their scanner!!read less - 10/06/2022
Chirag Vaid
I ordered my Medit scanner from them in Feb 2020, so far no issues with support or the product. They are a great company with great support. Disclosure: they did promise me a scanner tip for this review, but in all honestly I was meaning to give it t...read moreI ordered my Medit scanner from them in Feb 2020, so far no issues with support or the product. They are a great company with great support. Disclosure: they did promise me a scanner tip for this review, but in all honestly I was meaning to give it to them anyway.... if you are looking to buy, this is a great way to go about it.read less - 7/19/2020
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
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
We have worked with Cad-ray for over three years. There tech support should be modeled as the gold standard for tech support. Let me tell you why. When you call in someone answers the phone and even better than that they solve the problem. Lauren...read moreWe have worked with Cad-ray for over three years. There tech support should be modeled as the gold standard for tech support. Let me tell you why. When you call in someone answers the phone and even better than that they solve the problem. Lauren solved my tech problem in less than 5 minutes! Thank you Cad-ray!!read less - 1/24/2023
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
Ernesto Carmona
When I decided to purchase a digital scanner I decided on user experience. They have provided the best experience I could have asked for, from online support, Facebook support, and in person courses. There is no better team to buy Medit from period...read moreWhen I decided to purchase a digital scanner I decided on user experience. They have provided the best experience I could have asked for, from online support, Facebook support, and in person courses. There is no better team to buy Medit from period. Do yourself a favor and buy from them if you are in the market for an intraoral scanner.read less - 6/16/2020
Dennis Wong
Best support ever. They are super responsive when a problem occurred, and immediately set up a support ticket with the vendor who contacted me within the hour to help me to solve the problem. - 7/27/2023
Scot Bruce
We found the digital training very informative - 8/20/2021
Trident Dental
Great help when you need it. Frank, Armen and team will take care of you. - 12/10/2021
Nate Cherof
Excellent customer service and communication. Could not recommend them more - 2/14/2023
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
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
Victoria Rinando
Danielle was super helpful and kind trouble shooting to get us back up and going very quickly this morning. We appreciate it! - 4/15/2025
Mike Davis
I have been very happy with the Medit I purchased from Cad Ray. Everyone has been very helpful and quick to respond to my questions. They have an awesome video library for the medit, I am new to scanning and have really enjoyed the tutorial videos. - 6/16/2020
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
Lauren Schulte
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
Jeff Muszynski
Fantastic customer service - 6/19/2020
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
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
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
Madhavi Chavda
Still beginner to use IO scanner. best customer service. Live training was very useful. Andy Nova was great in improving my skill for scanning and showing me all features. Thank you. - 5/19/2022
Fantastic folks. I'm an orthodontist and opened an office in 2020. They helped me find the perfect intraoral scanner to suit my needs. Not too much or too little, and a great price. Every time we have a technical question, a sharp human answers the p...read moreFantastic folks. I'm an orthodontist and opened an office in 2020. They helped me find the perfect intraoral scanner to suit my needs. Not too much or too little, and a great price. Every time we have a technical question, a sharp human answers the phone, troubleshoots, and remotes in when needed-- navigating MS updates and graphics card issues. My i500 died this week. They overnighted me a trade-in at a totally reasonable price, and even shipped me a laptop to drive the i600 while I got a new one (they knew my 2020 laptop wouldn't keep up!). CAD-Ray has consistently hit it out of the park.read less - 4/14/2025
jeff-J65
You guys are great! I have been a Cerec user for about a decade and wanted to expand my horizons. I bought the I700 and have just loved it. We don't do impressions any more, only scanning, even for the full arch. The customer service has been excelle...read moreYou guys are great! I have been a Cerec user for about a decade and wanted to expand my horizons. I bought the I700 and have just loved it. We don't do impressions any more, only scanning, even for the full arch. The customer service has been excellent, even though I haven't had any problems with the scanner. I really like the online learning modules, they have been awesome getting me up to speed with the scanner quickly. I am looking forward to some of the in person courses to maximize the usefulness of this scanner. -- Jeff Allred, DDS FAGD DABOI FAAIDread less - 9/28/2021
Finally going digital and Cad-Ray was the place to start. Got the Medit i500 and began scanning right away. Now I am doing digital dentures, making my own surgical stents, etc. The support available is the best. "Frank" is always available! :) - 10/09/2019
Great service even if you own a Primescan. Company is built on customer service. Thanks for the help guys…. - 1/05/2022
Mitchell Rubinstein
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
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
Andrew Cole
The D.I.Y. Medit i500 package was right for me. I bought a nice gaming PC for my 2 operative rooms, downloaded the software, watched some videos, and started scanning. It's really easy to use, my crowns fit better with fewer adjustments, and they cos...read moreThe D.I.Y. Medit i500 package was right for me. I bought a nice gaming PC for my 2 operative rooms, downloaded the software, watched some videos, and started scanning. It's really easy to use, my crowns fit better with fewer adjustments, and they cost less because they are made model-less and without impression materials. I will start to see a return on investment in less than 2 years and it makes my work more fun, and I can deliver better results. Armen puts on a 2 day course which is very helpful to refine your technique. Start with watching the videos, scan your employees, and then use it on patients. I considered buying an iTero Element 2 and I'm so glad I didn't. The Medit is smaller, as good or better, and it costs ~$25,000 less over the course of 5 years. Ongoing fees for other scanners are a joke. Medit keeps providing updates that make the software even better and there are no additional charges.read less - 3/29/2020
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
Jason Oh
Everyone at CAD Ray has been amazing. Glad I chose them for my Medit and Sprint Ray purchase. Our training with Kaila was awesome. Thank you - 1/04/2023
William Daily
Excellent support and price on our medit IOS! Bought a second one a year later. Can always count on Armen and Frank for help when we need it. - 6/16/2020
Gabriel Joel
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
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
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
Alec Keon
I was on the fence on getting a scanner for years and finally pulled the trigger. CAD-Ray's support and knowledge has made this one of the best investments in my practice to date. When I spoke with Damien on the phone about my options he literally sa...read moreI was on the fence on getting a scanner for years and finally pulled the trigger. CAD-Ray's support and knowledge has made this one of the best investments in my practice to date. When I spoke with Damien on the phone about my options he literally saved me thousands after figuring out what my exact needs were. I went with the Medit i600, MSI laptop and 3D dental systems cart. The final product looks and feels as premium as it gets.read less - 2/21/2024
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
Kaila is an incredible Rep! Hope Cad-Ray knows what a great employee they have. Thank you Kaila! - 12/16/2021
Daniel Hwang
Fantastic scanner and best company to buy from. They make sure you are happy with your product. Armen, Frank, and team are the best. High recommendations for CADRAY and the i500. - 7/18/2020
Extremely good customer service. From start to finish buying my Medit was flawless and they were very helpful in offering me information. When I got my scanner I had questions and my phone calls were returned immediately. They knew my name and guided...read moreExtremely good customer service. From start to finish buying my Medit was flawless and they were very helpful in offering me information. When I got my scanner I had questions and my phone calls were returned immediately. They knew my name and guided me through what I would need. Very impressed. Would recommend!read less - 2/02/2020
Erica Zolnierczyk
Purchased the Medit right before the COVID shut down, which gave us time to train on it by watching all the awesome videos CAD-Ray provides. If I couldn’t figure something out, our questions were answered quickly. Now we’re back and using it like cra...read morePurchased the Medit right before the COVID shut down, which gave us time to train on it by watching all the awesome videos CAD-Ray provides. If I couldn’t figure something out, our questions were answered quickly. Now we’re back and using it like crazy. It’s quick, my assistant picked it up quickly and my cases have been coming back perfect. Super happy with the Medit!read less - 6/16/2020
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
Robert Mabry
I don't scan in my practice my assist does. She says it's awesome. Better than the trios or cerecs we have had in the past. The image quality while designing cases is amazing. Haven't seated a restoration from it yet but expect it to be great as well...read moreI don't scan in my practice my assist does. She says it's awesome. Better than the trios or cerecs we have had in the past. The image quality while designing cases is amazing. Haven't seated a restoration from it yet but expect it to be great as well.read less - 6/16/2020
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
Samir Rana
Ive had the medit since 2018. One of the best decisions in dentistry ive made. I met some of the great trend setters in digital dentistry(armen, jonathan ab and others through social media platforms). Medit Has changed The way i practice, live and ...read moreIve had the medit since 2018. One of the best decisions in dentistry ive made. I met some of the great trend setters in digital dentistry(armen, jonathan ab and others through social media platforms). Medit Has changed The way i practice, live and think! Happy not to have a monthly fee as i did for years. Support is always a message or call away. Would be glad
To further share my experience with you if u need.read less - 6/16/2020
Aaron Olson
This product is the best out there. Do the math and your ROI makes more sense than most products we purchase as dentists. Get on the digital train or you’ll be left behind. This is the best product to make the jump with. - 6/16/2020
I have had zoom training with Andy today. I can honestly say that he was the best. He was patient and very throughal. I learned a lot I would ask him again when I need support again Thanks Rodger - 3/15/2023
Rebecca Booth
Great scanner easy to use with the software. Definitely recommend the i700 scanner. Great customer service from Laura. - 12/09/2021
Michael Conte
Needed help with scanner updates and Frank is the man! Once he was done the scanner was operating in hyper-drive!!thanks frankoffice of Glenmont Dental - 2/15/2022
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
A good maintenances practice for any milling machine is to check that the tip of the drill is getting adequate water, otherwise you may see sparks flying as you are essentially dry milling material that is not supposed to be dry milled leading to drill and block breakage. We recommend that you run the water for a minute or two at the start of the day and check and make sure the spray is right on the tip of the drill. A simple ortho wire can help unclog the ports and redirect the water spray to where it belongs.
This article features the new Meditlink 2.3 software which has some advanced functionality. One of the greatest achievements is he ability to tell the scanner to avoid imaging certain colors like green and blue. This greatly facilitates the imaging of full arches as you can let your gloves / fingers guide the camera and displace all the soft tissue that impedes image capturing. We also feature how easy it is to launch CAD software to design the restoration and mill it out of lithium disilicate material
Case set up: here we enter the patients name and a simple tab appears where we chose the material and restoration tab. Once you image, you can place an order to the lab or you can advance to the CAD tab:
After the Rx has been filled out, you can launch the Medit Scan and image the upper and lower arches. Please note how we tell the camera to avoid the color blue and it ignores the clinicians fingers during imaging. The upper jaw and lower jaw were captured, then the bite registration even before the preparation was finished. This allows the verification of proper reduction and space for the ceramic material
Lower Arch Scan
The lower arch is the most difficult area to scan as you frequently have to battle the tongue, saliva, and the lips. The optragate can be of great help but notice how we use the color filter to hide the blue gloves while we advance the camera. It is a great aid in facilitating the capture of the lower arch
The same principle is applied to the upper arch. Notice that the software does not care if you start with the upper or lower arch. Here, you can visualize how the blue glove was used to displace the cheek and capture the pre-op condition of the upper second molar. The rest of the arch was easily imaged. It is not necessary to capture full arch impressions and this was done just for demonstration purposes. For a single unit case, generally imaging distal from the canine is adequate.
Checkingthe reduction and aquiiring the bite registration
We recommend that you capture the bite before you finish imaging the preparation. This gives you one last chance to verify that you have reduced enough to accommodate material thickness. You can see how we just take regular photos to document the lack of clearance and we continue to adjust the height of the preparation until we achieve the required space. We then activate the imaging process and capture the occlusal relationship between the upper jaw and the lower jaw
Image the preparation and place margin in native MeditScan Software that transfers to CAD Software
The preop condition is then transferred to the arch model and the tooth in question is cropped out. The rest of the arch is protected so no extra data is added unnecessarily to the equation. This protect feature is used for demonstration purposes and is subsequently removed. The prep in question is then highlighted and the local area is processed and the margins are placed. This margin line can be sent to the lab or it can be automatically carried to the design software
The Meditlink software allow you to launch a variety of CAD programs that include 3shape, exocad, cerec, etc… Here we launch exocad which automatically imports and aligns the models and marks the margins. The restoration is then designed to completion.
The CAD software allows you or the lab to alter the marked margins if necessary. The restoration is aligned in the arch for and the contacts are adapted to the adjacents and the oppising
Milling of Lithium Disilicate with Imes Icore Coritec One
The final restoration design can be exported as an stl and taken to a variety of mills or printers. Here we designed it millbox and milled with the coritec One. The material used was Amber Mill and it was crystalized and seated
The following pictures depict the sequence of burs we recommend that you use to finish a preparation quickly. While patient is getting numb, take a quick look at the clearance you will need to reach proper material thickness. Once the quadrant is isolated with isolite and optragate, take an occlusal router bur and create a trough to gain the proper depth. Follow that with a flat disk, and you can quickly reduce the occlusal height.
A shoulder bur of .8 mm thickness can help you reduce the interproximal areas as well as the buccal and lingual margin lines. Before finishing the prep, place hemostatic agent like expasyl in the sulcus and place retraction cord. while it is setting, check your reduction. If you need more space, now is the time to reduce some more.
Once you have adequate clearance, retraction, and hemostatis, you can readily image and find your margins in the CAD software
Shining3d has a projector and a single camera that takes photos of the surfaces it is scanning. at first, you may think this is a shortcoming, but in many ways, it dramatically reduces errors a new user can introduce.
in the early days of cerec, all you needed to do was capture the margins and the area above the height of contours of the adjacent teeth. This made the try-in and the contacts really easy as the design software just dropped straight a straight wall down to make contacts to. same concept here!
also, after you image and place margins, A SINGLE CLICK takes you to design software where you can finish the case and mill it right away.
This molar’s suggested mill times with the MCXL are for either Size 12 or 14 blocks:
Sprue on distal in normal speed mode is 14:05 minutes, fast speed at 7:54
Sprue on buccal in normal speed is 13:48 minutes, fast speed at 7:46
This molar would only fit in a size 14 block of Amber Mill in Imes Icore Coritec
Sprue on distal in normal speed mode is 14:15 minutes, sprue on buccal in normal speed is 14:42 and speed crown is proosed at 13:23
For our advanced users who mill in house or what to speed up their digital impressions we advocate taking advantage of digital dentistry’s unique features that allow you to take impressions over a period of time and segments, building larger models over different sequences and time. In this particular case we have two molars in the lower left quadrant that warranted replacement. The traditional method would be to prep both, isolate both, retract both, and take your final impression, but we will approach this as if there are two separate patients involved
Case Presentation on how to manage two crowns with a single milling machine
For the second molar, we will take advantage of the anesthesia time and capture the first bite, the opposing, the pre-existing situation and then crop out the preparation area digitally. Once the tooth is prepared, we will check for proper reduction. We will then take the second bite to verify the vertical dimension has not changed.
While the second molar is being designed and milled in the first case, we will launch a second window by cloning the first case. All the data remains the same and this time we crop out the first molar digitally and protect the rest of the arch. Once the first molar is isolated, it is digitally captured and then designed and milled.
image first molar while second molar is being milled
To manage the contact between the two crowns, there are many advanced applications. Here is a simple explanation of how we use the prep model from case 1 as the pre-op model for case two. Since the second molar in case 1 made contact with the distal wall of the first molar, when we design the crown for the first molar in case 2, all we have to do is make sure the distal wall is flush to the pre-op. This guarantees us a contact between the two. There are lots of shortcuts to this puzzle once you get the basics of digital impressions under your belt.
One of the big limitations of CEREC (a registered trademark of denstply sirona) with tibases and implant crowns is that it is limited to very few implant lines and the antirotational notch can just ruin your day as it needs to go into a specific location. You also have to deal with making sure the tibase is seated all the way and the scanbody is properly indexed. The one benefit is that you are dealing with just crown and bridge and you do not need to know implant position or timing at all when doing the design.
In this case, we demonstrate how we utilize the Medit i500 to capture a Tibase from Blueskybio, Biomax NP Conical Connection. Once the tibase is seated, we simply start scanning and then use the artificial intelligent implant suprastructure identification system to identify the location of the tibase. This in essence allows you to capture your margins OUTSIDE the mouth and you don’t have to bother with imaging the tibase, which is highly reflective in the patient’s mouth.
Once processed, you can then modify the tissue digitally and gain access to the tibase margins. You can print the model if you want and manufacture the restoration. In this particular case, we took the design to the CEREC mcxl inlab cam, nested it, and milled it out to demonstrate how we can image with one device from one manufacturer and fabricate a restoration by another company’s manufacturing machine. But the single greatest benefit is that you can place the sprue wherever you want.
IMPORTANT NOTE: The Tibase that you use MUST be wider than the drill milling the intaglio and the sprue must be thick enough to handle the milling process.
Once you understand how the digital workflow goes, you can image with one device, design in another, and then either print or manufacture with yet another device. Here we mill a sectional stent with the cerec that was designed in Blueskybio plan, although printing makes more sense because it is less wear and tear on your drills
For our coritec users: new users often mislabel restorations in the Rx form that leads to a lot of trouble. like calling a crown and onlay or vice versa. this can lead to all kinds of trouble
first sign of trouble is if the two purple lines don’t define the borders of the the restoration. sometimes it is missing, other times it is off the restoration. so always double check this step and usually the missed nomenclature is what causes the trouble.
the next problem people have is that the default setting for the sprue design is poor. it makes the sprue thicker at the mandrel than the restoration. this creates a crevice that the drill can’t get to. this leads to quick drill breakage as it tries to drill into that space (red circle). it is easy to set change these settings so the drill “flows” with the design of the sprue and you get a lot of use out of it. it’s annoying to do this manually so a subsequent video shows you how to change this by default.
another problem is the offset. the last video shows the distance from the restoration to the mandrel as 2mm. the drill is 2.5 in diameter. if you set it at 2, the calculation doesn’t allow enough space for the drill that also breaks it off. set it at 2.7 or 3 and it will last you a long time.
two subsequent videos will show you how to create your own blocks and change their orientation, so you can fit a taller design into a smaller size block
In this clinical case a patient lost a pre-existing crown. The remaining tooth structure had recurrent decay and a new crown was warranted.
After anesthesia was administered, the clearance from opposing dentition was assessed. The preparation was reduced to accommodate the necessary thickness of the material.
Once adequate clearance was achieved an Optragate was placed and an isolite was used to isolate the area. The preparation was scanned and then the lower arch was captured. The buccal bite was then taken to along the arches together
With Meditlink software, you have the option of designing the case yourself or sending it off to your partnered lab. The following video shows what happens to your case once the lab downloads the case
In this particular case, we designed our own crown and milled it with the coritec one milling machine
Once the amber lithium disilicate material was milled, its for was verified clinically. The crown was then crystallized and seated with NX3 resin cement
In this clinical presentation, we demonstrate the removal of a crown that has recurrent decay. The bleeding tissue was managed with a double cord technique and expasyl and the margin was captured with the medit i500. The margin was also defined in the native imaging software which allows the user to visualize the detail before designing it or send it off to the lab. Once the case is transferred to cad software, the designed margins carry through and there is an opportunity to modify it
Have you ever compared the milled product with the designed restoration?
We scanned with the medit i500, designed with exocad and milled with coritec. after try-in, we scanned the restoration in the bluephase and then merged it with the design in exocad to see how well our material, or design, and our margins measured up against the proposal. we also documented the fit clinically and with radiographs. you can download the 3d models of the case and compared them yourself
In this video we demonstrate a simple premolar case that is prepared and imaged with the Medit i500, designed in the cad software named exocad and then milled with the imes icor coritec one machine. Pay attention to the order and sequence of events and how we leverage anesthesia time with scanning time.
We have a large library of instructional videos on our site that can be found on our support page that can help you learn everything there is to know about the Medit i500
Every distal extension case I have to accomplish the following:
take two bites to make sure my vertical dimension does not change with pre-op and prep images
make sure I have proper clearance
We usually take the bites and all other images BEFORE I have even imaged the prep- I usually grab the prep images last
most of this you can delegate to your team and just take the prep images and make it simple for yourself
this video shows the clinical steps. to see what the lab does with your case, click in the link to see the subsequent steps. you can also choose to design and mill it, which is what I did
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
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.
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.
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