Which digital impression scanner should I direct my clients to?

[LucentDesign]

I have a few clients interested in purchasing a digital impression scanner. We have exocad, but haven't used it for any .stl files from a clients scanner. I know of the trios, itero, 3m, e4d and sirona. My client knows he needs to send us a .stl file. (open file). He is leaning towards the 3m and the e4d, he wants to scan implants and singles, along with short span bridges. Who here, has experience with this and what should I recommend for him and maybe future clients. We are also on the verge of purchasing a mill, so we can hopefully steer our clients away from cerec. . Also found out they are now teaching cad/cam in dental school to dental students in our area. Any help would very much be appreciated!

 

[RDA]

You may want to look up E4D. It is similar to Sirona's Cerec, so steering your clients that way could spell trouble.

 

[ceram1]

This is a situation where you will find out how strong your relationship is.... these technologies are not fully dialed in and will limit your outcomes. They are better in repeatability on paper but we have many generations of techniques to compensate for the problems with impressions. Most distorted impressions have positive flaws that allow crowns to seat. Scanners fall on their nose when sulcus depth increases or preps are not shouldered or heavily chamfered with excellent retraction. The only reason this works predictably for sirona ect. is prep technique. There is no doubt that this can be done but you will lose time and treasure getting there. We have plenty of success with tru def and sirona connect with only one remake so far. But that being said those models are not consistent enough and you will struggle being as predictable to the mouth if these docs are good at traditional impressions. I wish it were different but at this point I think the only good workflow is monolithic modelless. I wouldn't steer any of my clients this direction yet. The cost is also way too high on all of these systems. I dont know what you get for your crowns now but with cost of licensure, model manufacture costs, labor(yours),and general bs figure $45 plus dollars per case going somewhere other than your bottom line. I have seven clients with either 3m or sirona. Sirona is actually better because they have to mark their own margins and they are way better trained, but the bread and butter will be gone. Good luck:\

Sent from my SAMSUNG-SGH-I537 using Tapatalk

 

[CoolHandLuke]

in perfect seriousness i would far sooner opt for trios than anything else out there based solely on ease of use.

being a great shade system as well as scanner, and photo taker, you can almost never go wrong. give them a set of intraoral scan bodies and away you go.

with the selection of mill you make, you can pick up almost any file and make it.

as to CADCAM being taught in schools - maybe taught as a textbook process but not bloody likely they would teach any hands-on without the school being a major supporter of one brand over another i.e. funded in part or in whole. if so, we'd end up with students walking out of the classroom thinking the mod50 is a futuristic design tool. *shudder* and kids who think nobel leads the pack in new tech.

 

[LucentDesign]

I have already lost two accounts to cerec already, believe me if I could steer them as far away from this as possible I would. The problem is the one wants cerec and I'm trying to convince him to just go with a scanner and we will provide the restoration. The other just wants a scanner and not a mill and is looking to get the scanner within a month, he's been with us for 10 years and we can't afford to lose him being a two person lab. This business has me so discouraged and stressed out at times I question myself do I want to continue and embrace and invest in the new technology or is the technology going to be so good that companys like sirona are going to convince Dr's they don't need us anymore, which I know the are already doing this. How do we keep the accounts we have and survive as such a small lab? Any small labs have any advice for me on what you find to be working?

CHL-I heard trios is sweet, but how easy to get a .stl file out of it for exocad? I heard there's a new update for exocad to get this to work, anyone doing this?

 

[rkm rdt]

3M requires powder
cerec is closed so your dr can't send files to Invisalign
Itero is the size of a dustbuster

 

[Smithwick0208]

TRIOS WITHOUT A DOUBT!!! It integrates well and the scan data is very clean. If Trios wasn't around, I'd say 3M. The problem with 3M is if you have a doctor that doesn't retract properly or leaves debris around the margins, your stuck with a nasty STL file. The same people that developed the 3M scanner, worked on the Trios. The fact that there is no scan spray and flawless color scanning will really impress the doctors. They are growing more and more and willing to expand the capabilities of the system. I've used the scanner myself and it is so easy to use. If I were a dentist, I'd be crazy not to go that route.

 

[rkm rdt]

I hear Nevo is pretty neato too!

 

[Smithwick0208]

I hear Nevo is pretty neato too!

E4D was setup for the doctor's to mill in office. If your looking for a system for the doctor to do his own work and just send you what he can't mill, then that's the system to go with.

 

[CoolHandLuke]

I hear Nevo is pretty neato too!

no, it really isnt.

and as to getting STL files out of trios, give me a little while to get back to you.

 

[eyeloveteeth]

while we can banter back and forth about best - although we can honestly say Trios is up there in quality - while iTero is the most used...


you need to pick what best works for you and your lab. If you are a sirona lab then you should direct them towards a sirona product...etc etc


I can say the Lab I work for prefers iTero and Trios.

 

[rkm rdt]

Sirona is no good if the dr wants to send scans to Align.

I don't think he would appreciate having to buy another scanner just for Invisalign.

 

[TheLabGuy]

I've been studying this same topic for a new lecture coming up and a quick shout out to Bob at CAP for being unbiased and sharing his knowledge on this topic with me, thank you!!!. Trios is by far the best from my studies. However, it has it's flaws too... one is the price, nearly 40K, plus a yearly license fee of 3,700 and the shade matching ain't exactly spot on, but the pictures are there. What really turns me off (and maybe it won't for the Dentists) is all the extra fees. Similar to 3Shape, they all have licensing fees, and my philosophy on that is if I go buy car off the dealers lot, It's mine, it should work. Sure, you might need some maintenance but it shouldn't automatically shut off if I don't pay the yearly license fee, especially if I don't want to update it. Heck, most days I'm just happy it gets me to work and back. As for different systems, you have Tru-Def (3M/Jensen) 12K, plus 250 a month to open .stl, plus marking margin fee (unless you get certified to do it) Which pisses me off, I can do a full mouth resto but can't mark a margin??? Come on 3M!!! E4D is similar to the monthly cost to open a .stl. I believe the last time I checked it was around 250 dollars/month. As others stated, E4D and Craperec was meant to be a chairside mill and although you can get Cerec sent to you and a model milled, the accuracy is junk. It might work for some labs, but microscope labs won't do it, including me. Itero has worked great, the accuracy was very reasonable, but at the time we were doing them, they milled the models and it that ruined the surface texture and all the additional fees associated with the models, software, and it's a bulky machine. Still looking into CareStream, waiting to hear the cost and workflow of this system. I will say more Dentists are asking me about this and there seems to be some hoopla about intraoral scanners, that way out of state clients don't have to ship, the legalities of the assistants, and eventually going modelless. Please feel free to comment or add to this, as any information is helpful.

 

[eyeloveteeth]

Sirona is no good if the dr wants to send scans to Align.

I don't think he would appreciate having to buy another scanner just for Invisalign.

actually blue cam is fine... only omnicam somehow failed... (which makes you wonder)

 

[rkm rdt]

I've been studying this same topic for a new lecture coming up and a quick shout out to Bob at CAP for being unbiased and sharing his knowledge on this topic with me, thank you!!!. Trios is by far the best from my studies. However, it has it's flaws too... one is the price, nearly 40K, plus a yearly license fee of 3,700 and the shade matching ain't exactly spot on, but the pictures are there. What really turns me off (and maybe it won't for the Dentists) is all the extra fees. Similar to 3Shape, they all have licensing fees, and my philosophy on that is if I go buy car off the dealers lot, It's mine, it should work. Sure, you might need some maintenance but it shouldn't automatically shut off if I don't pay the yearly license fee, especially if I don't want to update it. Heck, most days I'm just happy it gets me to work and back. As for different systems, you have Tru-Def (3M/Jensen) 12K, plus 250 a month to open .stl, plus marking margin fee (unless you get certified to do it) Which pisses me off, I can do a full mouth resto but can't mark a margin??? Come on 3M!!! E4D is similar to the monthly cost to open a .stl. I believe the last time I checked it was around 250 dollars/month. As others stated, E4D and Craperec was meant to be a chairside mill and although you can get Cerec sent to you and a model milled, the accuracy is junk. It might work for some labs, but microscope labs won't do it, including me. Itero has worked great, the accuracy was very reasonable, but at the time we were doing them, they milled the models and it that ruined the surface texture and all the additional fees associated with the models, software, and it's a bulky machine. Still looking into CareStream, waiting to hear the cost and workflow of this system. I will say more Dentists are asking me about this and there seems to be some hoopla about intraoral scanners, that way out of state clients don't have to ship, the legalities of the assistants, and eventually going modelless. Please feel free to comment or add to this, as any information is helpful.

That's why I have purchased my own 3 Shape Trios scanner. Any client that shares Labguy's views on license fees can use my scanner for their cases without the extra fees.

This is the service that my lab offers to those who don't wish to wait around for the seas to part.

 

[eyeloveteeth]

I've been studying this same topic for a new lecture coming up and a quick shout out to Bob at CAP for being unbiased and sharing his knowledge on this topic with me, thank you!!!. Trios is by far the best from my studies. However, it has it's flaws too... one is the price, nearly 40K, plus a yearly license fee of 3,700 and the shade matching ain't exactly spot on, but the pictures are there. What really turns me off (and maybe it won't for the Dentists) is all the extra fees. Similar to 3Shape, they all have licensing fees, and my philosophy on that is if I go buy car off the dealers lot, It's mine, it should work. Sure, you might need some maintenance but it shouldn't automatically shut off if I don't pay the yearly license fee, especially if I don't want to update it. Heck, most days I'm just happy it gets me to work and back. As for different systems, you have Tru-Def (3M/Jensen) 12K, plus 250 a month to open .stl, plus marking margin fee (unless you get certified to do it) Which pisses me off, I can do a full mouth resto but can't mark a margin??? Come on 3M!!! E4D is similar to the monthly cost to open a .stl. I believe the last time I checked it was around 250 dollars/month. As others stated, E4D and Craperec was meant to be a chairside mill and although you can get Cerec sent to you and a model milled, the accuracy is junk. It might work for some labs, but microscope labs won't do it, including me. Itero has worked great, the accuracy was very reasonable, but at the time we were doing them, they milled the models and it that ruined the surface texture and all the additional fees associated with the models, software, and it's a bulky machine. Still looking into CareStream, waiting to hear the cost and workflow of this system. I will say more Dentists are asking me about this and there seems to be some hoopla about intraoral scanners, that way out of state clients don't have to ship, the legalities of the assistants, and eventually going modelless. Please feel free to comment or add to this, as any information is helpful.

We have tried carestream, and the scan file is pretty decent - again.... all of this relies on the doctor being care... packing cord, clean site.. etc etc - I had a very easy time with the carestream file, but what i didn't like was that their site is not well done, and is not easy to work with.

Again, although 3Shape has a charged premium, it is quite honestly so easy to work with for doctor and myself.

everything you wrote is accurate, except the new E4D / Planscan i think has a new license fee platform i think.

We wont even work on the 3M scan, it's too low quality in quality

we've even tried to have the Sirona files stitched together in rhino and imported into 3Shape... that was a disaster...although the doc claimed it fit wonderfully....


end of the day, unless Carestream steps up their integration and UI experience, it's Trios vs iTero - to me

 

[Smithwick0208]

while we can banter back and forth about best - although we can honestly say Trios is up there in quality - while iTero is the most used...


you need to pick what best works for you and your lab. If you are a sirona lab then you should direct them towards a sirona product...etc etc


I can say the Lab I work for prefers iTero and Trios.

Exactly right. Do what's best for the doctors you serve. Itero's integration is pretty simple into 3shape. If the margins are correct in case manager and the ditch is there, there is no need to mark margins in model builder. The files for the most part are clean. Saves a few steps. If you are new into the digital dentistry, Trios is the way to go. If you are a Sirona lab...I feel for ya ha

 

[Smithwick0208]

I've been studying this same topic for a new lecture coming up and a quick shout out to Bob at CAP for being unbiased and sharing his knowledge on this topic with me, thank you!!!. Trios is by far the best from my studies. However, it has it's flaws too... one is the price, nearly 40K, plus a yearly license fee of 3,700 and the shade matching ain't exactly spot on, but the pictures are there. What really turns me off (and maybe it won't for the Dentists) is all the extra fees. Similar to 3Shape, they all have licensing fees, and my philosophy on that is if I go buy car off the dealers lot, It's mine, it should work. Sure, you might need some maintenance but it shouldn't automatically shut off if I don't pay the yearly license fee, especially if I don't want to update it. Heck, most days I'm just happy it gets me to work and back. As for different systems, you have Tru-Def (3M/Jensen) 12K, plus 250 a month to open .stl, plus marking margin fee (unless you get certified to do it) Which pisses me off, I can do a full mouth resto but can't mark a margin??? Come on 3M!!! E4D is similar to the monthly cost to open a .stl. I believe the last time I checked it was around 250 dollars/month. As others stated, E4D and Craperec was meant to be a chairside mill and although you can get Cerec sent to you and a model milled, the accuracy is junk. It might work for some labs, but microscope labs won't do it, including me. Itero has worked great, the accuracy was very reasonable, but at the time we were doing them, they milled the models and it that ruined the surface texture and all the additional fees associated with the models, software, and it's a bulky machine. Still looking into CareStream, waiting to hear the cost and workflow of this system. I will say more Dentists are asking me about this and there seems to be some hoopla about intraoral scanners, that way out of state clients don't have to ship, the legalities of the assistants, and eventually going modelless. Please feel free to comment or add to this, as any information is helpful.

What margin marking fee on 3M? The lab marks the margins...

 

[Smithwick0208]

We have tried carestream, and the scan file is pretty decent - again.... all of this relies on the doctor being care... packing cord, clean site.. etc etc - I had a very easy time with the carestream file, but what i didn't like was that their site is not well done, and is not easy to work with.

Again, although 3Shape has a charged premium, it is quite honestly so easy to work with for doctor and myself.

everything you wrote is accurate, except the new E4D / Planscan i think has a new license fee platform i think.

We wont even work on the 3M scan, it's too low quality in quality

we've even tried to have the Sirona files stitched together in rhino and imported into 3Shape... that was a disaster...although the doc claimed it fit wonderfully....


end of the day, unless Carestream steps up their integration and UI experience, it's Trios vs iTero - to me

I agree 100% on 3shape Trios. I feel it's worth the money for the smooth flow. Just had a meeting with my Sirona rep the other day to let them know how disappointing it is to have to design in Inlab. We are a 3shape lab with 8 scanners and about 14 design stations. Training people on Inlab is a joke. It's not anywhere near as user friendly as 3shape. They expect me to spread the word on their equipment..ha! I'm going to do what I can to keep the work flow with 3shape.

 

[Smithwick0208]

Anyone having luck integrating E4D scans into 3shape model builder?