E.max or Cad/Cam?

[NicelyMKV]

I must agree. I have had the cad emax option a while and have finally started doing it that way on more cases. If they dentists does not stipulate pressed I do cad now. They seem to fit better and I think the shades come out better. I may try to change some of those wanting press to cad. less labor is less labor no mater where its used and deviation caused by hands is not as prevalent.

Tom, with a little practice I was able to pretty much get the base color and completely finish the occlusal staining during the crystallization stage. Saves a lot of time and I like the contrast the stains have against the blue block for accurate application.

 

[TheLabGuy]

Are you doing more of your E.max with blue block than pressing these days Jason?

 

[NicelyMKV]

Are you doing more of your E.max with blue block than pressing these days Jason?

Not yet. I am doing about 70/30 press to CAD. I still press my full arch cases. Much cheaper that way. I have started designing my full arch with CAD and having them wax printed for practice. I just make minor adjustments to the wax and invest and press. That way I am not wasting blue block units if I screw up. Getting more comfortable with larger cases though.

 

[TheLabGuy]

Not yet. I am doing about 70/30 press to CAD. I still press my full arch cases. Much cheaper that way. I have started designing my full arch with CAD and having them wax printed for practice. I just make minor adjustments to the wax and invest and press. That way I am not wasting blue block units if I screw up. Getting more comfortable with larger cases though.

That's good to hear and makes me feel more comfortable as well doing the full arches I get.

 

[ts4341]

I am not a fan of e.max CAD. The margins, anatomy & contour are much better with my e.max press. As for Zir, it really depends on the amount outsourced.. T

Oh yeah, e.max CAD's cost over e.max press units is a lot higher!

 

[NicelyMKV]

I am not a fan of e.max CAD. The margins, anatomy & contour are much better with my e.max press. As for Zir, it really depends on the amount outsourced.. T

Oh yeah, e.max CAD's cost over e.max press units is a lot higher!

I am still going back and forth on cost for CAD vs Pressed. I think it can be situational as well. If I have a full contour posterior Emax in that one shade only, I can scan and design it in about 12 minutes. When it comes back, I check contacts and I like to run a diamond 35 quickly
Through the primary grooves. Then I stain during crystallization. It comes down basically finished minus the glaze. I personally have about thirty minutes TOTAL in design/wax up, stain and glaze. I also think they look better than pressed. Just my opinion though.

 

[RileyS]

NicelyMKV, you know you can have the emax cad glazing during crystalization too? Ivoclar sells a crystalization glaze paste that comes out perfect, not like the spray glaze.
Also, how are your costs coming out about even between cad and press? Press takes longer due to burnout and press but thats not hands on time there. And who is your milling center for cad?

 

[NicelyMKV]

RileyS, I have not been glazing yet just in case I had to make color adjustments afterwards. Still tip toeing into the blue block staining. The course I took awhile back introduced the spray glaze which I did not care for. I think pressing is still much more cost effective if doing multiple units in one ring. I also think it depends on the skill level and speed of your waxing dept. a posterior crown can take me a little while to wax and takes some other good waxers even longer. You also have to figure in blocking out and painting dies on the pressed units. So I guess it's blocking out/ painting the die, waxing, sprucing up and investing, bench set, burnout, (time consuming) divesting, cutting off and finishing sprue, acid soak and another sand blast, finish skin layer off surface, stain and then glaze. Vs scan, design, mill, go over primary grooves, stain and glaze if you want, crystallize, than glaze if needed. Just how I see it.

 

[NicelyMKV]

Forgot to mention the milling center. I use Diadem. So far I am getting 100% consistent results from them on Emax and Diazir.

 

[2thm8kr]

Forgot to mention the milling center. I use Diadem. So far I am getting 100% consistent results from them on Emax and Diazir.

Are the margins closed consistently?

 

[NicelyMKV]

Occasionally I might have a microscopic spot or two on the margin to allow the restoration to fully seat. This would be more the scan and design phase than the milling I would think. Especially because it is not involving some weird angles etc. I timed myself earlier due to this conversation. Scan and design took close to fifteen minutes. I happened to have a CAD unit here and took ten minutes to adjust and stain. Most of that time was staining. I normally use four to six stains on a unit. I will apply glaze and that's it. I would like to think that my work is not considered typical production class work either. Here is the big BUT, I only have a few accounts that give me descent shoulder margins that are not up and down and disappear half way around. So I could not utilize this method on all my Emax accounts. I know..... CAD and press should follow the same parameters...,

 

[amadent]

Here is the big BUT, I only have a few accounts that give me descent shoulder margins that are not up and down and disappear half way around.
:amen:to that

 

[paulg100]

" BUT, I only have a few accounts that give me descent shoulder margins"

BINGO!

Most of the preps we see at our production lab are not suitable for the CAD technique, this is why pressed is still the best way to go for labs.

Dont see this changing any time in the near future.

 

[Brett Hansen CDT]

Presently, I am waxing and pressing all of our e.Max cases. We have a 3 Series DWOS that we use scanning Full Zir cases, Zir copings, and Atlantis abutments. I would like to use the scanner to do some e.Max cad. Is anyone using a 3 Series to scan for full Zir and e.Max cad right now? How long does it take, on average, to scan a single unit case? Our "Cad/Cam Guy" is leaving tomorrow so his job is now mine. I know the basics of how to scan and design a full contour case, but I don't have a good feel for how long it will take me to do a case once I become proficient. Even if you don't use a 3 Series, what is your opinion of how long it should take to scan and design a full contour case?

One other question...what determines the quality of the anatomy you can put in a crown?

 

[TheLabGuy]

Brett, (FC) full contour single unit takes my guys about 11 minutes, that includes scanning and designing. FC Zirconia, or FC e.max, or FC PMMA makes no difference, it's still approximately 11 minutes. That's on a origin scanner though, not sure about 3 Series w/DW's.

 

[rkm rdt]

Are the margins closed consistently?

I have found similar results to Nicely although I am scanning with a 3Shape D700.

Very accurate margins more consistantly than other milling centres.I have slowed down my scan speed and reduced the point distance on my margin design.

I have done 2 Emax cad crowns and found the margin result very good.I have my Emax pressing dialed in thanks to Labguy's advice and parameters.

One thing I like about pressing is that I can overextend a margin if I need to with ease whereas cad milled is difficult.

I am looking forward to Bego cad cast copings.

 

[NicelyMKV]

I have found similar results to Nicely although I am scanning with a 3Shape D700.

Very accurate margins more consistantly than other milling centres.I have slowed down my scan speed and reduced the point distance on my margin design.

I have done 2 Emax cad crowns and found the margin result very good.I have my Emax pressing dialed in thanks to Labguy's advice and parameters.

One thing I like about pressing is that I can overextend a margin if I need to with ease whereas cad milled is difficult.

I am looking forward to Bego cad cast copings.

The Bego laser melted copings are great. I have done several units now and so far I have been pleasantly surprised. I know they are doing cad cast semi and noble copings. Have not tried that yet. I still imagine myself alone and surrounded by my magic machines

 

[BobCDT]

Easy choice, forget closed systems!
Go for model base outsourcing and fab e.max in house. After he builds up the e.max he will be able to afford a open scanner.