Exocad Full Arch or Mouth Diagnostic Copy

[RileyS]

THis has always driven me nuts. I feel like i always end up redesigning the entire thing cause you can't get the previously designed diagnostic wax up to align with the now fully prepped arch. There's no major landmarks and the tissue gets all jacked up. I keep telling myself there is an easy and fast way to align the different meshes for a fast and easy copy. Does anyone have tips? Links to awesome videos or articles? I'd gladly pay you back for your secrets!!
Also, I really want to take a master design course. Anybody know of something coming up? I think I'm ready to travel the world to make this easier and less time consuming.

 

[CoolHandLuke]

have the dr prep half the face and take a bite, then prep the rest of the face.

alternatively, prior to prep have the patient do excursives with bite paper in place, then have the doc prep everywhere EXCEPT bite paper marks, take a new centric bite or scan at this stage, and then reduce the islands.

 

[Contraluz]

THis has always driven me nuts. I feel like i always end up redesigning the entire thing cause you can't get the previously designed diagnostic wax up to align with the now fully prepped arch. There's no major landmarks and the tissue gets all jacked up. I keep telling myself there is an easy and fast way to align the different meshes for a fast and easy copy. Does anyone have tips? Links to awesome videos or articles? I'd gladly pay you back for your secrets!!
Also, I really want to take a master design course. Anybody know of something coming up? I think I'm ready to travel the world to make this easier and less time consuming.

I hear you!

Depending on the type of case, I ask the client to scan the provisionals or PMMA on the master cast. That works especially with implant cases. it's easier than using a flask to duplicate the provisional. I also ask the them to articulate the case at the same time, with the provisional on the model, as bite. That way you don't have to rely on a wonky bite. Tell them to remove the soft tissue mask, so that the provisional seats passively on the model.

What I have done too, when I have a model of provisionals that I can not align in the design software, due to the lack of landmarks, I cross mount the the provisional model, master model and opposing on the articulator. Assuming it is an upper model, and with the articulator in closed position, I then make a big matrix of the upper model 'interlocking' with the lower model. Next is exchanging the provisional model with the master cast. I then fill in the void with either wax, acrylic or stone. I hope this makes sense... I know it is time consuming, but In cases where I rely on the provisional, this technique has saved me a couple times.

The above techniques may still require you to start from scratch, as far as the design goes, but at least you have a solid merge with the provisionals.

 

[RileyS]

I hear you!

Depending on the type of case, I ask the client to scan the provisionals or PMMA on the master cast. That works especially with implant cases. it's easier than using a flask to duplicate the provisional. I also ask the them to articulate the case at the same time, with the provisional on the model, as bite. That way you don't have to rely on a wonky bite. Tell them to remove the soft tissue mask, so that the provisional seats passively on the model.

What I have done too, when I have a model of provisionals that I can not align in the design software, due to the lack of landmarks, I cross mount the the provisional model, master model and opposing on the articulator. Assuming it is an upper model, and with the articulator in closed position, I then make a big matrix of the upper model 'interlocking' with the lower model. Next is exchanging the provisional model with the master cast. I then fill in the void with either wax, acrylic or stone. I hope this makes sense... I know it is time consuming, but In cases where I rely on the provisional, this technique has saved me a couple times.

The above techniques may still require you to start from scratch, as far as the design goes, but at least you have a solid merge with the provisionals.

The cross mounting is something I forgot about. But I think it’s basically what I’m doing digitally. Except you lost me with filling the voids when putting the master model on?


For this case…it was a real cluster cuss. Too much to explain. I ended up importing a lot of saved meshes from the Diagnostic design: the final diagnostic (dx) model alone, dx model and opposing (which the opposing was also designed as a full mouth) together to import as a bite alignment scan, the opposing dx model was imported to replace the current preOp mesh (doctor is prepping uppers after liters seated)…as I said, it was just a real cluster cuss. In the end I had the original VDO of the full mouth dx with the other messages lined up fairly close. I did adapt to preOp to keep anatomy but had a lot of gingival area to fix and some slight repositioning. I need to write down the steps to keep that streamlined and it’d be pretty good.

As far as asking doctors to perform those steps is 50/50 depending on the doctors.

 

[CoolHandLuke]

have we not always said that communication needs to occur between doctor and lab for best results?

communicate your needs - an accurate bite. demonstrate the issue of not being able to align data. if they listen, adapt and help themselves by helping you they are worth keeping.

if not, cut them loose. you don't need that kind of pig headed ness.