Intraoral scanner crown margins

[bigj1972]

If digital is that much more accurate then PVC, millions of people have been screwed with crowns that do not qualify to go in the mouth and I disagree big time. The end results should be the same wether it was a PVS material or a digital scan. The process of fabricating the crown is where the difference is. Now if we are talking about the assistant taking the scan vs the Doctor, this is where the catch is because production can go up and this is one of the approaches the sales reps pitch and I was there when they did it.

I 2nd....Digital and vps, if both are done correctly, are equal or passing. The variables are being introduced after the scan or impression. Since the impression is used by the hand and eye, digital's variables are much harder to locate and correct. You can have a 3micron scanner and a prep fully exposed, but if the milling unit is at 50, the model printer at 75-100, and factoring in a shrinkage for the firing, calibration adjustments for all.....your going to have to do a lot of tweaking to dial in the levels consistently. Then hope the spindle stays in tolerance, the UV stays consistent, the furnace operates clean, and the resin is mixed.

Everything works great until it doesn't.

 

[bigj1972]

I'm guessing you didn't actually read my post. The prep is always acceptable, the tissue retraction and isolation are excellent. I capture excellent margins
with PVS. I will take 4 PVS impressions if necessary but the lab NEVER receives a questionable impression from my office.

My reason for reaching out to all of you it to become better and to gain more knowledge about scanning. Not to place blame or whatever else is being suggested. Good grief.

 

[sidesh0wb0b]

It really doesn't take much nowadays. $5k rifle or $500 rifle, its about practice and aim like JW said.

while i agree there are worthy options on the market for significantly less than leasing the carbon....there's a balance of labor hours involved with setup and troubleshooting and all the rest of the headaches that come with the price shopping. wouldn't you agree? i mean, you've been going on (and i agree with you) about how we don't value our time and skill sets enough on another thread.....shouldn't the same apply here?

i just want to know if there is truly a $2k printing option that offers all the same functionality and ease as carbon. i haven't been privy to it yet, nor do i know anyone with a $2k printer that can compare directly to the carbon. that said, i don't own a $2k printer OR a carbon. i just know folks with all ranges of printers from el-cheapo all the way up to carbon$$$. i would prefer to exchange a few extra bucks for a printer that saves me hours of headaches and TIME. because my time is more valuable than trying to cut corners and step over dollars to pick up dimes.

 

[sidesh0wb0b]

I'm guessing you didn't actually read my post. The prep is always acceptable, the tissue retraction and isolation are excellent. I capture excellent margins
with PVS. I will take 4 PVS impressions if necessary but the lab NEVER receives a questionable impression from my office.

My reason for reaching out to all of you it to become better and to gain more knowledge about scanning. Not to place blame or whatever else is being suggested. Good grief.

I'll attach an example. I'm not sure how hi res it will be but if you look at where the arrow is pointing, you would think there is moisture present and the exact edge of the margin is blurred. Silly dentist should've dried the prep, right? However, intraorally, there is nothing there. No moisture, no tissue, nothing. Just a solid mm of pure air, begging for PVS to flow into it. So I would have to say that the scanner or the software is erring here.

I'm grateful to all of you interested helping me help my patients. I'll see if I can find more visual examples.

that image looks super clean, is this an example of where the margin was NOT marked properly by the lab?

 

[sidesh0wb0b]

I guess I have no problem marking the margin even though I would rather go home and play with my kids. But why is it necessary if scanning is so superior?

Additionally, I've been told that, in the lab software, it is possible to have a more direct view of the mesial and distal margins by trimming away parts of the scan (adjacent teeth/tissue) to see better. I can't do that in my software chairside.

i would refer to scanning technology as another tool in your belt for treating patients.

 

[bigj1972]

while i agree there are worthy options on the market for significantly less than leasing the carbon....there's a balance of labor hours involved with setup and troubleshooting and all the rest of the headaches that come with the price shopping. wouldn't you agree? i mean, you've been going on (and i agree with you) about how we don't value our time and skill sets enough on another thread.....shouldn't the same apply here?

i just want to know if there is truly a $2k printing option that offers all the same functionality and ease as carbon. i haven't been privy to it yet, nor do i know anyone with a $2k printer that can compare directly to the carbon. that said, i don't own a $2k printer OR a carbon. i just know folks with all ranges of printers from el-cheapo all the way up to carbon$$$. i would prefer to exchange a few extra bucks for a printer that saves me hours of headaches and TIME. because my time is more valuable than trying to cut corners and step over dollars to pick up dimes.

Same as you. And that extra time involved in setup and configuring is added value and rarity..

As far as printers, the technology is identical outside of SLA. printers. It then becomes about particulars like voxels,, leds, screens, etc.. I just don't see the justification for Carbon. Now if it was really as fast and accurate as advertised, then maybe.

 

[sidesh0wb0b]

Same as you. And that extra time involved in setup and configuring is added value and rarity..

As far as printers, the technology is identical outside of SLA. printers. It then becomes about particulars like voxels,, leds, screens, etc.. I just don't see the justification for Carbon.

i am not a fan of spending a large sum of cash per year for something that you could own elsewhere by paying less once hahahah. but i think their biz model is sturggling as can be seen by the decreases in costs per annum they have been coming down. maybe i am wrong, who knows.

i just want to know what the $2k printer option is that is comparable to the carbon. speed, quality, reliability, service, training, support, etc. all around....what is that option. please share if you know.

 

[Mike2]

Hawkeye, I see the margin perfectly in your scan, but there is a option to view in greyscale. That being said sometimes the salivia is clear and the color image/picture looks great and in greyscale you'll see the light has bounced off of the salivia. I tell all my clients that scan to look at it stone mode/greyscale, that way they'll see what I do? I have very large offices that jumped in and I haven't changed much for parameters etc.? I would suspect the analog lab you're using may not have bought into digital soon enough and is playing catch up, maybe outsourcing so they don't have spend the capital on new equipment and software licenses. I would do as stated above, send to 2 labs and see if results are the same. Send your lab an invite to this forum, then they might see what they've missed. Just saying, most trying to help here as that prep is a slam dunk, kudos for caring!!!!

 

[JohnWilson]

Holly fukin ****, let's all just go and get a drink of what ever and all of us STFU and enjoy life. We all have opinions some of us are just right and others are well just wanting to be.

 

[rkm rdt]

I've earned the right to express my opinions as have everyone else.
Not a good time to tell anyone to stfu

 

[Jack_the_dentureman]

Where did we lose the idea of sharing knowledge and techniques and showing skills?
now it's just expression, opinions and 'it seems to me'

 

[FASTFNGR]

Where did we lose the idea of sharing knowledge and techniques and showing skills?
now it's just expression, opinions and 'it seems to me'

Well it is knowledge to someone who is looking to get into digital. They are questions that everyone asked of should before investing their money into a market like this.

 

[bigj1972]

I'm sorry...I thought this was a forum for Lab Techs to hangout to discuss topics and socialize. Share some knowledge and experience as well as some help and comical nudging.

I guess we're just here to be a rag tag drunken AI for the occasional Dentist, or worse Assistant to find the site, type in a question when their lab, rep, training video can't help them after the check cleared, and we're all supposed to scramble over each other, for FREE, so we are good lab soldiers, and if we help enough and we are lucky, we might can get that great 5k account, As long as we don't charge too much, do it real fast, and act real nice.

 

[Diablo]

You can have the most beautiful scan in the world, but if the tech is adjusting the margins to an inaccurate printed die then there is your problem. In my lab I noticed all our margins looked bulky on the printed die but not on a traditional model that had been scanned. We quit trusting the dies and just print a solid and opposing to check contacts and occlusion. I hate not having that die to verify the margins before it goes out the door.

 

[Affinity]

I think this is the big failure of digital for me, if you cant trust the model for the margins, how can you trust it for contacts and occlusion? Actually, if digital IOS and CAD is as accurate as everyone claims, there should be no need to introduce another variable of a blob of light cure that is only as good as its last calibration. Printing models seems like a waste of time and money to me. If a milled crown has an open contact on the printed model, that was closed in CAD , which is the only reason you print the verification model, doesnt that tell you that its in fact, not entirely accurate somewhere in the process? Same with crowns in the mouth. Were talking about a difference of 8 microns for shimstock between open and closed. The trios has accuracy +/- 11 microns at best, then add mill tolerance to the crown, then a much larger tolerance for a printer. Yes its the same with PVS.
Ultimately were transferring what is represented in the mouth with a picture or a mould, its never going to be 1:1 until we start implanting tooth buds, so Im starting my farm now.

 

[Markyboy]

Holly fukin ****, let's all just go and get a drink of what ever and all of us STFU and enjoy life. We all have opinions some of us are just right and others are well just wanting to be.

I don't see why anyone would tolerate this kind of language. Totally inappropriate.

 

[bigj1972]

 

[rkm rdt]

I miss the thrill of finding a blood pocket in a PVS.

 

[JohnWilson]

I don't see why anyone would tolerate this kind of language. Totally inappropriate.

Well I have been called worse, lighten up francis

 

[cadfan]

just a few numbers for the micron believers on both sides impression and ios