Going model less.

[eyeloveteeth]

we stopped going model-less

all you've done is add way more headache to your QC.

Crowns can be mixed up esp when you end up with 6-9 #12's all sitting there.
Dr loses the box of crown - which you in the moment just remill and resend because "what the hell we didn't waste any more time"...but it happens more often than you'd like

Dr somehow feels it's of lesser quality...... yeah still scratching my head on that one.


We have a Carbon3D printer and a few Form2s, we print a small contact model for each case now and we don't offer a model-less discount. The Dr's who have taken the time to get their Trios up and running really well have saved money on their impression materials and chair time, and most understand that because we have spun our discount removal to mitigate any problems that may occur during case delivery.

 

[PDC]

Not sure about Itero, I use to have the system back in the day at another lab. I hated those milled models, and the fees were ridiculous, but that was many moons ago. I would like to add to my previous comment and give a shout out to those Canadian Trios members here. We have had incredible accuracy and consistency with the trios chairside scanner. I'm so anal, I don't even have 3shape anything in my lab, but we have a couple docs that have trios and even using a outside lab to do the model design, and printing, still very consistent. I'm almost to the point, and I can't believe I'm going to say this, where I get the 3Shape communicate for our lab. It's been so accurate, I wouldn't have a problem going modelless on those trios clients. Or maybe, that opens up the door to get a printer and start printing some models yourself.

So you are making the crowns for these Trios docs on printed models that were outsourced and having no issues?

 

[2thm8kr]

we stopped going model-less

all you've done is add way more headache to your QC.

Crowns can be mixed up esp when you end up with 6-9 #12's all sitting there.
Dr loses the box of crown - which you in the moment just remill and resend because "what the hell we didn't waste any more time"...but it happens more often than you'd like

Dr somehow feels it's of lesser quality...... yeah still scratching my head on that one.


We have a Carbon3D printer and a few Form2s, we print a small contact model for each case now and we don't offer a model-less discount. The Dr's who have taken the time to get their Trios up and running really well have saved money on their impression materials and chair time, and most understand that because we have spun our discount removal to mitigate any problems that may occur during case delivery.

Why not just print a single die with the patient name or case pan # on it? I'm not doing the volume you guys are, but there are ways to keep order if you drop a bunch of crowns on the floor.

 

[eyeloveteeth]

Why not just print a single die with the patient name or case pan # on it? I'm not doing the volume you guys are, but there are ways to keep order if you drop a bunch of crowns on the floor.

single die is ugly. We did try the single die but it looks so flimsy and didn't address the fact that Dr's didn't feel it was "luxe" enough.


esp a single unit lower bicuspid.




All anterior cases do not get a model-less discount and are required to have models

 

[rkm rdt]

Just received the new beta model from Argen printed on the carbon printer.
very nice and smooth.

 

[TheLabGuy]

So you are making the crowns for these Trios docs on printed models that were outsourced and having no issues?

Yes I am....and I hate to admit this (because now I'll have one, and that fact my angst for 3Shape) but we have done close to 500 of them now, not a single remake...and let me tell you, these clients are some of the nick-pickiest clients around. I realize even a blind squirrel finds a nut once in awhile, but 500 crowns, not a single one has come back.

 

[TheLabGuy]

we stopped going model-less

all you've done is add way more headache to your QC.

Crowns can be mixed up esp when you end up with 6-9 #12's all sitting there.
Dr loses the box of crown - which you in the moment just remill and resend because "what the hell we didn't waste any more time"...but it happens more often than you'd like

Dr somehow feels it's of lesser quality...... yeah still scratching my head on that one.


We have a Carbon3D printer and a few Form2s, we print a small contact model for each case now and we don't offer a model-less discount. The Dr's who have taken the time to get their Trios up and running really well have saved money on their impression materials and chair time, and most understand that because we have spun our discount removal to mitigate any problems that may occur during case delivery.

Good info...I appreciate the advice. I think if we decide to bring the models back in the house and get the 3Shape communicate, we would also buy the form2 as well. Especially after seeing your comments. good stuff.

 

[TheLabGuy]

Next thing you know you'll be eating esrom cheese.
Seriously, is there really a reason to purchase communicate? I understand if you want the client to have the ease of just click and send, but it is really easy to bypass.

Oh, I know that...dropbox and you're done. However, the client (for whatever reason) feels like they don't want dropbox and wants to use communicate. So, I've been adding a few dollars to each of their invoices for their printed models for the past year till I reach the 2,500 price tag on the communicate. Which is coming up.

 

[sidesh0wb0b]

i am still on the fence about moving toward model free. i see it coming down the line....but when is the key. is it ready? i know very few ppl that are model free on most cases and having great success with it. anyone want to speak up?

had a few clients recently ask me if i could design and mill from their cerec scans too. i really dont want to connect with sirona/cerec connect....but i may have to move that way. dont really want a sirona scanner either, just think theres much better options out there. really want to replace the 3shape with a DoF and exocad i think....but can it accurately impression scan? can i accurately receive i/o scans and import them, design, mill?
are there any solid answers to these questions yet or are we still wandering around the vehicle kicking the tires to see if it will do what we want?

 

[2thm8kr]

i am still on the fence about moving toward model free. i see it coming down the line....but when is the key. is it ready? i know very few ppl that are model free on most cases and having great success with it. anyone want to speak up?

had a few clients recently ask me if i could design and mill from their cerec scans too. i really dont want to connect with sirona/cerec connect....but i may have to move that way. dont really want a sirona scanner either, just think theres much better options out there. really want to replace the 3shape with a DoF and exocad i think....but can it accurately impression scan? can i accurately receive i/o scans and import them, design, mill?
are there any solid answers to these questions yet or are we still wandering around the vehicle kicking the tires to see if it will do what we want?

Can your current 3Sheep scanner scan most of your impressions accurately? What about setting the bite correctly from scanned impressions?
There have been improvements on scanning impressions someone shared a stl file of an impression scan from a sub $6k desktop scanner that was quite impressive.

Here is what my exo station is configured to import as far as IO scanners go. When the new version is released I wouldn't be surprised if more are available.



These are done via zip folder with xml file, but any set of open format scans can be imported manually.

I think if you want to play with Sirona your only choice is to get one of their scanners. There are people here in the know.

 

[sidesh0wb0b]

Can your current 3Sheep scanner scan most of your impressions accurately? What about setting the bite correctly from scanned impressions?
There have been improvements on scanning impressions someone shared a stl file of an impression scan from a sub $6k desktop scanner that was quite impressive.

Here is what my exo station is configured to import as far as IO scanners go. When the new version is released I wouldn't be surprised if more are available.

View attachment 27889

These are done via zip folder with xml file, but any set of open format scans can be imported manually.

I think if you want to play with Sirona your only choice is to get one of their scanners. There are people here in the know.

thanks for that.
no, my scanner is not up to the task. its old and outdated. part of the reason we will upgrade

 

[2thm8kr]

thanks for that.
no, my scanner is not up to the task. its old and outdated. part of the reason we will upgrade

The DOF Freedom can scan impressions as can most other desk top scanners. It's just not going to work perfectly
on every case. I haven't put the time into testing. If I get impressions for single crowns I usually just pour and scan a solid
cast, no pins or base or sawing. I know by looking at a case if it needs the solid trimmed or not to get a good scan.
I'll try to scan a couple of impressions with the DOF and send to your inbox so you can have a look.

 

[sidesh0wb0b]

The DOF Freedom can scan impressions as can most other desk top scanners. It's just not going to work perfectly
on every case. I haven't put the time into testing. If I get impressions for single crowns I usually just pour and scan a solid
cast, no pins or base or sawing. I know by looking at a case if it needs the solid trimmed or not to get a good scan.
I'll try to scan a couple of impressions with the DOF and send to your inbox so you can have a look.

that would be awesome. i asked on another thread for a person to post pics of impressions that worked and didnt work. would love to see some examples.
as far as scans go, can you tell easily which ones will work and which wont? besides the obvious i/o scan issues. do you print or mill a model for each or do you do that for a time and then move forward without a cast of any sort?

 

[2thm8kr]

that would be awesome. i asked on another thread for a person to post pics of impressions that worked and didnt work. would love to see some examples.
as far as scans go, can you tell easily which ones will work and which wont? besides the obvious i/o scan issues. do you print or mill a model for each or do you do that for a time and then move forward without a cast of any sort?

With some experience you will be able to see which cases will work and which will be trouble, but you will have to take your lumps like the rest of us who have tried this.

If you want to get a work flow debugged you will need a clinician that doesn't have their head in their arse or a revolving door of assistants, etc.
Have them take a small impression on the prep and adjacent teeth. Design your crown from the IO scans and see how it fits on the model for the
proximal contacts. Go back to your design and make a note of the color map of the contact intensity and adjust accordingly, keep notes.
Print or copy some screen shots to a mobile device. Go to the office for the crown seating and take a look after they use the articulating ribbon
compare the marks in the mouth to the screen shots. Let the doc make adjustments and keep notes of the contact intensity for the occlusion.
make adjusts, etc, etc. It won't take long to get that doc dialed in. Keep a dossier of the settings, I kept screen shots in a folder to compare until
I got it just right. Work you way around your regular clients, you know who will be able to do it and who won't.

I do not print or mill models for these types of cases. The only models I get printed are for digital dx work ups and/or scan appliances, layered cases, etc.

 

[sidesh0wb0b]

With some experience you will be able to see which cases will work and which will be trouble, but you will have to take your lumps like the rest of us who have tried this.

If you want to get a work flow debugged you will need a clinician that doesn't have their head in their arse or a revolving door of assistants, etc.
Have them take a small impression on the prep and adjacent teeth. Design your crown from the IO scans and see how it fits on the model for the
proximal contacts. Go back to your design and make a note of the color map of the contact intensity and adjust accordingly, keep notes.
Print or copy some screen shots to a mobile device. Go to the office for the crown seating and take a look after they use the articulating ribbon
compare the marks in the mouth to the screen shots. Let the doc make adjustments and keep notes of the contact intensity for the occlusion.
make adjusts, etc, etc. It won't take long to get that doc dialed in. Keep a dossier of the settings, I kept screen shots in a folder to compare until
I got it just right. Work you way around your regular clients, you know who will be able to do it and who won't.

I do not print or mill models for these types of cases. The only models I get printed are for digital dx work ups and/or scan appliances, layered cases, etc.

i am guessing each office or dr themselves will have a difference in their preferences just as they do now. so a certain contact intensity might work for one but will need to be different for another.
how do you handle the glaze side of things? especially if youre not the one glazing each individual crown i could easily see different thicknesses causing tight or looser contacts than designed.

 

[2thm8kr]

i am guessing each office or dr themselves will have a difference in their preferences just as they do now. so a certain contact intensity might work for one but will need to be different for another.
how do you handle the glaze side of things? especially if youre not the one glazing each individual crown i could easily see different thicknesses causing tight or looser contacts than designed.

Create a dossier for each client.
Hopefully you have an extra details oriented person glazing. It's better if the contacts are a little heavy. My guys adjust with rubber points. You don't want a bunch of crowns coming back for add ons and mucking up you schedule.

 

[eyeloveteeth]

actually - if the model-less crowns go out in 72 hours or less, we have contacts set to 0 - and never have had any problems. Luxatemp tends to expand very aggressively after a week it seems or rather it doesn't settle and has expansion that seems to be prolonged.

Most of our "light" contact crowns were from cases that were seen 3 weeks onwards. our dr's would have a cow if all of our model-less cases had the expectation to slightly dust off

 

[user name]

As far as I know, Im having good results with modeless. Ive offered a small discount, but I do say its not my preferred way to work. You get 3 remakes and then you start paying full price if it doesn't work.

 

[zero_zero]

We have no discount on model less crowns...no warranty either

 

[2thm8kr]

The mouth is a dynamic environment, anything more than a few hours they should expect some adjusting. We're talking adjusting with rubber points. No aggressive tools being used.