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Lab talk, the good, the bad, and the ugly
Dental-CAD
Exocad crown occlusal problems with intra oral scans (Will mail top shelf Scotch if you can help me)
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<blockquote data-quote="Josh Claxton" data-source="post: 348920" data-attributes="member: 19893"><p>I would always suggest finding consistency first, then work on your settings. Too many times I've seen knee-jerk reactions and "this crown is too tight, let's bump up the settings" immediately.</p><p></p><p>For occlusion issues, yes it's the scans, yes it's also accuracy, yes it's fixable though. You have to know what you consistently want. Couple of starting questions and ponderances.</p><p></p><ul> <li data-xf-list-type="ul">Is the scan properly in occlusion</li> <li data-xf-list-type="ul">Do you equilibrate stone models when you work analog?</li> <li data-xf-list-type="ul">How much paper pulled for you is good, and how thick is that paper</li> <li data-xf-list-type="ul">Are you trying model-less?</li> <li data-xf-list-type="ul">If models - are you following the proper procedures for printing and cleaning.</li> <li data-xf-list-type="ul">Preps vs. Implants</li> </ul><p>in the same order- the reason why I ask those, and why it's important.</p><p></p><ul> <li data-xf-list-type="ul"><strong><u>First</u></strong> and foremost. check the scan. In Exocad and 3shape both, you can see when the teeth are collapsing through each other and when they touch exact. This is unique to digital, physically they cant collapse through each other. If they're messed up, print them, hand articulate, and scan that in as a bite. It's very tedious, but you can at least find consistency.<ul> <li data-xf-list-type="ul">Look for the same "colors" every time. If every scan you correct the bite on has dark blue marks (barely touch in Exo) then every case you cut out the same amount will fit the same if the scan is accurate</li> <li data-xf-list-type="ul">if you have red/green on one case's existing dentition and light blue on another, cutting them both out at .25 will result in different occlusions.</li> </ul></li> <li data-xf-list-type="ul"><strong><u>If </u></strong>you used to equilibrate stone models by hand when mounting, do it digitally. If you go into edit mesh in Exocad, if the bite is collapsing then you can make the models "equilibrate" by cutting away intrusions. this can mean the bite is more stable once mounted, and you can find better consistency through this.<ul> <li data-xf-list-type="ul">FIRST make sure you get the colors you're looking for consistent before cutting the occlusion with this method. You will have the same seating, but you will have different results in mouth. If you cut cut intrusions when it shows red, compared to blue, it will end up way more out of occlusion in the mouth, but be the same on the model.</li> <li data-xf-list-type="ul">You can correct antagonist to open or close the scans to get the consistent colors across the occlusion. Expert -> r'click the opposing. correct antagonist.</li> </ul></li> <li data-xf-list-type="ul"><strong><u>You</u></strong> can look up or measure the paper you use to pull as a starting point to what to cut your occlusion to. Once you have that starting point, begin to change it. You'll likely need "in occlusion" cuts, "regular occlusion", and "out of occlusion drive a truck between those bad boys". otherwise known as "let it grrrrrrooooooooow into occlusion" for all you Frozen fans. (please do full arch cases in occlusion. don't make them collapse weird)</li> <li data-xf-list-type="ul"><strong><u>Please</u></strong> don't try model-less until you've worked out a protocol for doing it with models where you can check it... please.</li> <li data-xf-list-type="ul"><strong><u>For</u></strong> printing, do not leave models in IPA overnight, most printers is 5min tops in IPA. I've seen it happen lots of times, it warps models. If you have major issues cross-arch differences between the scan and your model, consider a support pin on the distal of the arch for support. These help with those flexes. Basing models can also flex them some, since the stone will shrink or expand slightly which will bend the models cross arch as well sometimes. Don't over cure, just <strong><u><em>follow the guidelines</em></u></strong>...</li> <li data-xf-list-type="ul">Don't forget that your implants won't have the same periodontal ligaments to absorb shock, if only your implants seem high in the mouth, and you KNOW You lined up that flag right, cut it out of occlusion a pinch more.</li> </ul><p></p><p>Bonus fun:</p><p></p><p>When cutting contacts in the adjacents tab : freeform wiz step turn on "blockout neighbor collisions" this will take the height of contour of your contact and follow the path of insertion and cut your crown to that (make sure you have the POI correct for your contacts or the cut will be messed up).</p><p>No more grinding under the contact area to set the crown!</p><p></p><p>Also, if you're doing lots of single units, use the disc cutter (set to 0) to make perfectly flat contacts instead of that weird ( ) ) wraparound nonsense that happens if you just cut them to each other.</p></blockquote><p></p>
[QUOTE="Josh Claxton, post: 348920, member: 19893"] I would always suggest finding consistency first, then work on your settings. Too many times I've seen knee-jerk reactions and "this crown is too tight, let's bump up the settings" immediately. For occlusion issues, yes it's the scans, yes it's also accuracy, yes it's fixable though. You have to know what you consistently want. Couple of starting questions and ponderances. [LIST] [*]Is the scan properly in occlusion [*]Do you equilibrate stone models when you work analog? [*]How much paper pulled for you is good, and how thick is that paper [*]Are you trying model-less? [*]If models - are you following the proper procedures for printing and cleaning. [*]Preps vs. Implants [/LIST] in the same order- the reason why I ask those, and why it's important. [LIST] [*][B][U]First[/U][/B] and foremost. check the scan. In Exocad and 3shape both, you can see when the teeth are collapsing through each other and when they touch exact. This is unique to digital, physically they cant collapse through each other. If they're messed up, print them, hand articulate, and scan that in as a bite. It's very tedious, but you can at least find consistency. [LIST] [*]Look for the same "colors" every time. If every scan you correct the bite on has dark blue marks (barely touch in Exo) then every case you cut out the same amount will fit the same if the scan is accurate [*]if you have red/green on one case's existing dentition and light blue on another, cutting them both out at .25 will result in different occlusions. [/LIST] [*][B][U]If [/U][/B]you used to equilibrate stone models by hand when mounting, do it digitally. If you go into edit mesh in Exocad, if the bite is collapsing then you can make the models "equilibrate" by cutting away intrusions. this can mean the bite is more stable once mounted, and you can find better consistency through this. [LIST] [*]FIRST make sure you get the colors you're looking for consistent before cutting the occlusion with this method. You will have the same seating, but you will have different results in mouth. If you cut cut intrusions when it shows red, compared to blue, it will end up way more out of occlusion in the mouth, but be the same on the model. [*]You can correct antagonist to open or close the scans to get the consistent colors across the occlusion. Expert -> r'click the opposing. correct antagonist. [/LIST] [*][B][U]You[/U][/B] can look up or measure the paper you use to pull as a starting point to what to cut your occlusion to. Once you have that starting point, begin to change it. You'll likely need "in occlusion" cuts, "regular occlusion", and "out of occlusion drive a truck between those bad boys". otherwise known as "let it grrrrrrooooooooow into occlusion" for all you Frozen fans. (please do full arch cases in occlusion. don't make them collapse weird) [*][B][U]Please[/U][/B] don't try model-less until you've worked out a protocol for doing it with models where you can check it... please. [*][B][U]For[/U][/B] printing, do not leave models in IPA overnight, most printers is 5min tops in IPA. I've seen it happen lots of times, it warps models. If you have major issues cross-arch differences between the scan and your model, consider a support pin on the distal of the arch for support. These help with those flexes. Basing models can also flex them some, since the stone will shrink or expand slightly which will bend the models cross arch as well sometimes. Don't over cure, just [B][U][I]follow the guidelines[/I][/U][/B]... [*]Don't forget that your implants won't have the same periodontal ligaments to absorb shock, if only your implants seem high in the mouth, and you KNOW You lined up that flag right, cut it out of occlusion a pinch more. [/LIST] Bonus fun: When cutting contacts in the adjacents tab : freeform wiz step turn on "blockout neighbor collisions" this will take the height of contour of your contact and follow the path of insertion and cut your crown to that (make sure you have the POI correct for your contacts or the cut will be messed up). No more grinding under the contact area to set the crown! Also, if you're doing lots of single units, use the disc cutter (set to 0) to make perfectly flat contacts instead of that weird ( ) ) wraparound nonsense that happens if you just cut them to each other. [/QUOTE]
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Exocad crown occlusal problems with intra oral scans (Will mail top shelf Scotch if you can help me)
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