All on X in house milling issues , scan marker accuracy

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stefan

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Hi guys, got a new metal milling machine for my all on X cases and of course as every new thing first attempts were not a success. I receive inaccuracies (not a passive fit) on my first long span implant restorations and convinced I mess up something with the marker scanning as cement retained cases are coming perfect. I use OpenTechnologies Deluxe scanner and Medit SE, 5 axis Yenadent mill with 2,7kW IMT spindle ,250W servos and Mayka CAM. I have no experience milling implant connections till now I used VHF to mill zirkonia and emax mainly, so any suggestions would be helpful. Basically I did 3 times one all on 4 case, first time scanned with the Deluxe scanner, scan markers on 2 stages and scanning software merged everything. Second time again with Deluxe but scanned all markers together and merged data in Exocad. Third time used the old Medit SE , again all markers together and merged data in Exocad. Unfortunately nothing fitted perfectly, there was always one bar pillar not fitting (not on the same implant). Believe it or not best result was with the old Medit scanner, inaccuracy was lets say 50-100 micron in the middle implant , rest fitted perfect. I assume scanning of the markers is the issue, as did few smaller implant bridges and were fitting perfect . As I mentioned have zero experience with long span implant restoration scanning and manufacturing , but the scan markers scans does not seem smooth enough . I tried using nano scan gel , but mesh doesn't seem good as when you scan plaster for example. Would appreciate any advice, thank you.
 
CoolHandLuke

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i wish i knew what Mayka CAM was. i might be able to help if i did.
 
2thm8kr

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What system and scan bodies/library are you using?
 
TheLabGuy

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Did you say Medit SE? That is a very old scanner if so and not accurate enough for roundhouses.
 
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stefan

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i wish i knew what Mayka CAM was. i might be able to help if i did.
Its pretty much standard CAM, not very different than Hyperdent. Its unlikely to be the CAM as did few custom abutments , not premilled and connection was perfect. Thank you
 
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Did you say Medit SE? That is a very old scanner if so and not accurate enough for roundhouses.
Yes Medit SE, but decided to try after the first two times done scans with OpenTech scanner. Accuracy of OpenTech is 5mu and of SE 10mu . What scanner you are using for wide span implant restorations and metal scan bodies?
 
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stefan

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What system and scan bodies/library are you using?
For that particular case I used 3 x Yenadent scan markers( I believe rebranded ) and 1x Elos accurate. I use exocad, think the biggest difficulty is that most cases I have are not on multiunit abutments and that the scan markers are metal. The scanners are not capturing perfect even the PEEK scan markers so I used nano scan gel.
 
cadfan

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which Yenadent , Deluxe should work in one shot which impl. system which scan marker load up files to compare SE could work depends on a few things. But no mater what implants always in one shot !!!!!!
 
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which Yenadent , Deluxe should work in one shot which impl. system which scan marker load up files to compare SE could work depends on a few things. But no mater what implants always in one shot !!!!!!
Thank you for the reply , Its a brand new D15S , with 2,7 kw spindle. Its cutting the metal like butter, not a lot vibrations the weight including the stand is 270 kilos. Anyway I will do some more tests. Would appreciate some advice on scanning. You mentioned SE could work depending few things - would you share I am super curious how the old scanner can perform well ? If you are owning a Deluxe scanner will be great if you can share a scan of markers, so I can compare the mesh. I am not excluding the chance scanners to need replacement, as few years passed .
 
Affinity

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No offense but hyperdent is one of the top 2 dental cams in the industry. no ones ever heard of mayka, so I doubt its like hyperdent. CAM matters and the scanner also. For doing this type of work regularly, get a DOF freedom UHD, or some would say go back to an older steinbichler.
 
TheLabGuy

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Yes Medit SE, but decided to try after the first two times done scans with OpenTech scanner. Accuracy of OpenTech is 5mu and of SE 10mu . What scanner you are using for wide span implant restorations and metal scan bodies?
No way Medit SE can do cross arch to be accurate enough for metal. Trust me, I've tried so many times and I have two Medit SE's. Finally bought a Steinbechler for that kind of work. Even bought a Medit T500 which came close to Steinbechlers accuracy...but bought a Medit T710 as well and that does work as good as the old Steinbechler for roundhouses. In my opinion, your problems are coming from your scanners. Only a few on the market have that kind of cross-arch accuracy needed for metal roundhouses.
 
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my zirkonzahn 600 scanners has always been accurate enough for full archs 1st one is 12 years old now slow but accurate.
 
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hmartek

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For that particular case I used 3 x Yenadent scan markers( I believe rebranded ) and 1x Elos accurate. I use exocad, think the biggest difficulty is that most cases I have are not on multiunit abutments and that the scan markers are metal. The scanners are not capturing perfect even the PEEK scan markers so I used nano scan gel.
this might sound weird to you but, I'm using an athletic foot spray called Tinactin, when scanning metal, abutment or somthing shiny, i just spray it to cover the shine and it really works well.

or try this one https://dentallabnetwork.com/forums...conomical-than-spray.30554/page-2#post-320994
 
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CoolHandLuke

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do NOT use Tinactin on large bridges, and NEVER spray scan bodies. with anything. ever. period.
 
cadfan

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Medit SE didnt work with the normal scan mode even second die doesnt work correct but with some modified workflow matching things for example in Exocad it worked a lot better some although run them with other software vs algos like Delcam but these things could be easy checked before even one burr is turning with metrology . I am always confused if guys think on a 2,7 kw spindle in a D 15 they could mill bars maybe with chiller and a few other things it could work either your Z Spindel extrusion is bigger than you can imagine . Scan spray on markers no go check lateral and height matching in Exocad how good are your markers compared to the zero data if you optimize all these things sometimes a wonder happened. ;) :Hello:
 
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Hey Stefan, I have the same desktop scanner as you, the Open Technologies Deluxe, and I use Exocad, I do full arch cases all the time with it and they come out pretty much passively perfect, but I don't mill metal, just Zirconia and PMMA. Definitely some things to watch out for though to verify your scan accuracy. This is what I'd do:

First, just good practice, verify the model analogs are clean and not distorted because they've been reused/bent. Often I found Dr's will reuse a bent/warped analog to save money only screw up the master model because the scan marker won't seat evenly in it.

Sometimes the scan markers might not thread in perfectly. It may feel right when you screw down, but then when you unscrew it kind of 'pops' out, because it was torqued down but got in a bind and not evenly seated. Pay close attention to feeling this and if something didn't feel right, chances are it probably wasn't :) Verify under magnifier that the scan marker is truly all the way seated. I had a case not long ago where a DESS titanium scan marker didn't fully seat because it kind of gets in a bind and you think its solidly down, but it's not quite. Double check.

If your scan markers seat evenly in the analogs, go ahead and scan away. I always, always verify that the alignment of the master model and the alignment of the scan markers overlay perfectly. If you are using the Revenge software, after you align your scans, left click your master model scan, then select your scan marker scan by holding control click. This will show you how they both are aligned to each other. When you do this, if you see the image shift, even slightly, then it's not perfectly aligned, You will need to perform some techniques to get them to perfectly align which I can go into detail if you don't know how to do this.

Ok, assuming you got all your scan markers in one scan, if you are having misalignment problems in different implants from different scans, that tells me that most likely the problem is your scan marker matching in exocad. When you select your abutment library and match to the scan marker, there is a little slider to the right. In my experience, I always adjust the slider upwards because other wise It might be trying to match too much data and actually misalign at this step. When it comes to accurate alignment, often less is more. I told a digital Dr. guru (I'll withhold his name) this tip while he was presenting Exocad dentistry to our study club, and I had to correct his case in front of the study club because I could tell his scan marker alignment was off:) Because it was for a live patient, he was very grateful for the tip! Basically, after your orange scan marker placement is overlayed on the green scan marker of the model, they both need to be perfectly matched. Often I will see they are not if I do not adjust the slider upward. If you don't see even orange/green splotchy mottling across the top of the scan marker, then it's vertical is off, and it also might be tilted. This is the most crucial CAD verification step to implant passivity. Play around with the slider until you get a perfect alignment, if you can't achieve that then you need to rescan your marker because there is not enough data for exocad to get an accurate alignment.

Finally, if you are still not getting passivity, then it could be the CAM, however I doubt it based on my experience, it's usually in the desktop scan alignment or CAD alignment. If I were you I'd double check by milling your full arch out of pmma. If that fits the same as your metal, then you can rule out your cam as the problem.

Hopefully this sorts it out for you!

-Matt
 

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