Emax-Press v cad

RileyS

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we did a ton on the sirona inlab cause we bought it and felt we should use it since we paid 100 g's for it. margins always sucked but contacts and occlusion were great. then we used Nobel biocare for one of their promotions and the margins were absolutely perfect each and every time.I want to say they were $55-60. we ended up doin close to 500 units with them. blocks for inlab are about $36 dollars each, come in pack of 5. Burrs were $165 for 6 and they recommended 15-20 units milled per bur
 
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paulg100

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what would i suggest?

my only experience with cad is though the CEREC inlab gear where ive done a good number. fits were not a patch on pressed, although crowns were OK.

Veneers and inlays/onlays were a complete waste of time, any time saved vs waxing/pressing was completely lost with CAD in fitting down time and even then the fits were poor in comparison.

I know there is better equipment around for milling glass, and i believe these systems are achieving excellent fits with emax cad crowns. Veeners and inlays/onlays is a different beast all together, due to the inherent limits of milling, and the varied/poor prep designs seen in the majority of mainstream dentistry.

theres a big shift towards veneers and inlays/onlays now where i am, maybe combined with short term ortho and bleeching...they call it conservative dentistry ;)

thats another thing emax press is great for, super thin minimal prep work. forget about doing that in CAD.

The idea of butchering everyones teeth and crowning the lot is becoming very un cool now, and rightly so, much of the time its unjustified.

Not good for us techs as it means another drop in prescribed lab work. But dont worry Tom that wont be coming to your end of the market any time soon, the butchering will be going on for a long time there yet.

id be happy outsourcing isolated posterior fc crowns as an overflow but multi unit smile design stuff and veneers inlays/onlays is best left to pressing, maybe in combination with wax milling at the moment in my opinion.
 
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Labwa

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Core3d here in Australia use DMG to mill to the margins are nearly perfect every time. i had maybe 1 out of 50 that i had to re-line. the problem I think is they use Ivoclars mill strategy and they have a 1.5mm offset so you have pretty big voids on the insical edges. On the plus side ivoclar give you 5 years warranty. But it sucks when you're trying to cut back to layer and you cant get back to .6 from the prep. I did four anteriors with it and will never do it again. as for posteriors they work great.
 
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dhdc

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The ones i have scanned are lower ants,with fairly thin preps,fit could be an issue???It will be a good test case to see how good they are,and testing my design skills.
 
BobCDT

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My problem was the quality of margin I get often on cases. A lot of up and down. I had some slight issues with marginal fit via cad compared to pressed. We mill wax posteriors and press. I felt like I got slightly better occlusal anatomy and fits due to the way wax can be milled compares to Emax CAD. I assumed the numbers were better milling wax and pressing compared to milling cad? Im asking not stating. :)

Jason
Hey Jason,
I must agree with you. Press fits better and cost less. When pressing the marginal integrity will be as good as your wax-up. For those of you that are getting better margins with CAD, I think you need to be looking at your wax-ups through a microscope. If your wax-up has a near perfect margin your pressing should be equally as good. We mill or print wax and press all e.max Inlays, onlays, veneers and crowns. Generally its better to print the veneers, inlays and onlays and mill the crowns.
The only advantage I can see with CAD is re-contouring in the blue block stage is certainly easier.
However, based n the original post in this thread, Yes, pressing is somewhat of a technique sensitive process. But, once you get it down it can easily be done very consistently.
 
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paulg100

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i always found with cad i was doing alot more adjusting to contour after milling, due to the limitations of cad design so the blue state was very handy.

obviously with pressing you get what you wax so theres never really any contour adjustment. if you cad and print/mill in wax then you can still make the adjustments in the wax stage before pressing, so the blue state benefit is moot really.
 
Tom Moore

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We still do a very large number of no prep veneers with emax press. I like cad on posterior but I want the secondary anatomy deepened when there is room. It's the ability of the tech with the stain brush that makes them pop but who knows what is coming down the pike.
 
NicelyMKV

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I go through the wax posterior anatomy with a .3mm bur and internally with a .6mm. A .3 does really well on a 1:1 ratio in wax where secondaries are concerned. Rough to do on cad due to the way you have to grind it instead of cut. I have to say though, I love the way a cad LT looks after crystallization. Better than anything I've seen offered in press.
 
rkm rdt

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"I only press veneers and inlays."

why not cad for inlays and veneers ?

There is a minimal thickness to milling cad which sometimes is too thick for a veneer. For inlays I find the funky shapes can get tricky for those round milling burs.The drill compensation can conflict with occlusal clearance , which is always a problem with inlays.
 
rkm rdt

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I loved working with cad; soft in blue state, cuts out lots of time of pressing steps, and the cad LT looks better than press LT and not as low value as HT so kinda in between. If you're outsourcing the milling then no inventory to keep up/worry about.
I love spending 12-15 minutes scanning and designing then another 5 in seating, 2 minutes staining in blue state and crystalizing and I'm done unless a slight adjustment in shade is needed. So 20-24 minutes in man hours. I've never done the math to see exact costs and time on both sides (a job for RKM and Tom instead of us lazy's) but I like the free time that cad creates.
Rkm, Can you share your costs from Diadem?

I pay $58 CDN which is like $2 US:)
 
rkm rdt

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If you are milling wax then you are getting the same results as milling the emax cad.

If you have to touch up your milled wax by hand then that is hardly moot Paul.

If you guys want to wax and press then fill your boots. My microscope loves my 3 shape.
 
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NicelyMKV

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If you are milling wax then you are getting the same results as milling the emax cad.

If you have to touch up your milled wax by hand then that is hardly moot Paul.

If you guys want to wax and press then fill your boots. My microscope loves my 3 shape.

No, milled wax is nothing like milled Emax cad....not at all... Unless your dealing with some new mill and Damond burs that I've never heard of or seen before?


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rkm rdt

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So how do you guys get such beautiful fits and margins with your zir but not your emax cad? Why do you struggle milling some materials and not others?

Doesn't make sense to me.
 
NicelyMKV

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Because it is the way and tools you have to use to mill Emax cad compared to milling Zr ( 20% give or take a few %larger) and wax( .3mm/ .6 mm burs etc) cad has to be ground not cut. Makes it have larger contact points with surface of cad as well as limits cutting depth etc.


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disturbed

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pressed E max are stronger than milled. plain and simple.
 
disturbed

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I pay $58 CDN which is like $2 US:)

check your facts before you make an ass of yourself ... again... your canadollar is worth less than the US dollar...again...
 
CatamountRob

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check your facts before you make an ass of yourself ... again... your canadollar is worth less than the US dollar...again...

RKM,
Vermont anxiously awaits your response :) .....and make it good, I've had a lousy day and I'm counting on you to liven it up!
 
BobCDT

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So how do you guys get such beautiful fits and margins with your zir but not your emax cad? Why do you struggle milling some materials and not others?

Doesn't make sense to me.
We did a bunch of milling of e.max. Had to use diamonds. Diamonds don't cut they grind. This results in chipping. Milling zirconia is done with carbide cutters that result in a very accurate product.
When you think about it, other than zirconia what all ceramic material would you use diamonds to finish margins?
None!
 
Labwa

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So its not just me getting slightly different looking crowns with cad compared to press of the same shade?
I swear they're a little more translucent??
 

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