CAD/CAM Milling or printing night guards (ClearSplint)

[Thomas H]

We are wanting to go digital and are thinking the first product we are wanting to outsource would be our night guard. Many of our clients love ClearSplint. I've noticed that there has been talk of both printing and milling ClearSplint nights guards. I saw a class on it at LabDay Online about 3D printing, but the presenter admitted they are still encountering issues.

Is there anyone that is doing CAD/CAM for ClearSplint night guards? Do you have any advice? (Is designing them digitally easy? What is your experience with manufacturing them digitally? Are programs able to get the bite so it just isn't like those vacuum forming soft night guards that are uniformly thick without regard to occlusion from the opposing arch?) Thanks for sharing your experience with me!

 

[CWilliams]

For me personally, they aren't worth the mill time/ disc and bur cost- I think that's why printing them is advantageous but I haven't jumped into printing yet (I'm not a large producer of ortho and call me crazy I prefer stone working models). By the time I import or scan models to design, I can make one by hand. I find my ZZ software hasn't evolved to have a flat plane flow option- so I have to import a plane, try to align it against the opposing, tinker with the bite etc it's a PIA (if anyone's figured out a better way DM me!). I'm not sure what vacuum form you use, but we've never had luck with soft NG's they always peal and are super thick, might as well use a mouth guard. I switched to use the Duran 1.5 mm from greatlakes and their mono/ poly-> salt pepper-> pressure pot for 10 mins-> adjust bite-> pumice and rouge. Comes out to be like $4 a NG by hand, while my mill is the work horse for production that keeps me at a high profit margin for other things

 

[Thomas H]

Thank you! You have given me some things to think about.

 

[ztech]

Designing the splints digitally is a piece of cake. Can do a design in less than 10 min and the occlusion is usually spot on, even the excursions are accounted for correctly if the doctor provides a correct bite. The bad news is most tooling of the mills can't mill the intaglio accurate enough. This problem is in the mills that use small diameter shaft burs. PMMA is one of the toughest materials to mill and when a small shaft bur goes across the surface it deflects and looses some of the accuracy. I mill zirconia and wax with .045 spacer with a perfect fit and if I mill a provisional I use .12 to get them close enough that I don't have to literally re-mill the intaglio. I have an AG machine and the final bur for PMMA is 1.0mm but the shaft of the bur is .94mm and that diameter is carried 16mm from the tip before it starts getting larger. So my advice is, get a machine that has hefty shafts on the burs if you want to make a living milling PMMA.

 

[Thomas H]

Designing the splints digitally is a piece of cake. Can do a design in less than 10 min and the occlusion is usually spot on, even the excursions are accounted for correctly if the doctor provides a correct bite. The bad news is most tooling of the mills can't mill the intaglio accurate enough. This problem is in the mills that use small diameter shaft burs. PMMA is one of the toughest materials to mill and when a small shaft bur goes across the surface it deflects and looses some of the accuracy. I mill zirconia and wax with .045 spacer with a perfect fit and if I mill a provisional I use .12 to get them close enough that I don't have to literally re-mill the intaglio. I have an AG machine and the final bur for PMMA is 1.0mm but the shaft of the bur is .94mm and that diameter is carried 16mm from the tip before it starts getting larger. So my advice is, get a machine that has hefty shafts on the burs if you want to make a living milling PMMA.

We are wanting to mill ClearSplint night guards, not PMMA. And, if we are wanting to outsource manufacturing for the time being, do you think it's unlikely that the milling center will be able to get it done correctly? I imagine if they agree to work with us, their machines should have the capacity to do it. And if their work isn't any good, we won't work with them anymore.

 

[ztech]

We are wanting to mill ClearSplint night guards, not PMMA. And, if we are wanting to outsource manufacturing for the time being, do you think it's unlikely that the milling center will be able to get it done correctly? I imagine if they agree to work with us, their machines should have the capacity to do it. And if their work isn't any good, we won't work with them anymore.

Most clear millable splint material is PMMA. I would try some of the milling centers that use the larger heavy duty mills. I use a motion 2 from AG. I never got a satisfactory fit from my machine. Closest I came was milling the same file twice and even then it was not the best fit. Provisionals are also not great in fits. They work with a large amount of spacer but not even close to wax or zirconia fits, which is as within microns of being as good as hand waxed.