Going model less.

[rkm rdt]

No aggressive tools being used.

You know where I could go with this.

 

[2thm8kr]

No need to be an aggressive tool. Lol

 

[rkm rdt]

No need to be an aggressive tool. Lol

It's what sets us apart .

 

[zero_zero]

 

[Joshua R. Baldwin]

Now that we are receiving more IOS each day, I would like to know your thoughts on going model less.

I see the benefits to the lab but what advantage does it give to the dr and patient other than saving a few dollars? I am not against it but I have a hard time working without a safety net too.

Is this a wise direction so early on in the IOS game?
...or do I just suck at cad design?

I've been completely modeless since adopting my 100% digital workflow. The key for me was working with one doctor first and partnering with them on troubleshooting the process. Because we knew there would be adjustments/obstacles from the start, it made the process a lot easier on both of us. Once we got things right I added a second doctor and continued this process until all of my doctors were comfortable and our results were consistent. Another added benefit of selecting an initial "trial" doctor is that they are able to provide best practices to other doctors making the process faster and easier for each provider going forward. My doctors rarely request models anymore and are very satisfied with our results.

 

[sidesh0wb0b]

As far as I know, Im having good results with modeless. Ive offered a small discount, but I do say its not my preferred way to work. You get 3 remakes and then you start paying full price if it doesn't work.

3 remakes over what type of time period?

 

[sidesh0wb0b]

The mouth is a dynamic environment, anything more than a few hours they should expect some adjusting. We're talking adjusting with rubber points. No aggressive tools being used.

i agree there. we have had great success getting prob 85% of our clients down to 5min or less adjustment time with points only. no stinking diamonds in high speeds!!!

 

[sidesh0wb0b]

I've been completely modeless since adopting my 100% digital workflow. The key for me was working with one doctor first and partnering with them on troubleshooting the process. Because we knew there would be adjustments/obstacles from the start, it made the process a lot easier on both of us. Once we got things right I added a second doctor and continued this process until all of my doctors were comfortable and our results were consistent. Another added benefit of selecting an initial "trial" doctor is that they are able to provide best practices to other doctors making the process faster and easier for each provider going forward. My doctors rarely request models anymore and are very satisfied with our results.

can you tell me more? how long did it take for you to go model free? are you strictly no models? or do you pour a model from a pvs impression for checking?
are you getting digital scans only or traditional imps?

 

[Joshua R. Baldwin]

Bob,

I was lucky that most of my doctors have high volume offices so we were able to fabricate a lot of cases and get things going within a couple weeks at first and faster for the following doctors.

The lab in completely modeless. We do accept scans. However the majority of cases were fabricated by scanning the triple-trays. Large Anterior or complex cases would be received in lab with an articulated model from the practice.

The new high end scanners are getting better and better at scanning impressions. I have a Medit T-500 and it is great.

 

[user name]

3 remakes over what type of time period?

Not a specific period of time. Im expressing to them that we need to get this nailed down in fairly short order. Its not a guessing game, and Im willing to work through the process with you, BUT...my time has value too, and my crowns aren't just a 'click the button' and shoot out another one cheap commodity. We need dialogue, esp in the beginning. If we get repeated mistakes and re-dos, there is shared interest and responsibility to get it dialed in and working. Im not going to bear the brunt of you not realizing that deep feather edge margins don't scan well.
So, 3 in a calendar year? a 12 month period? Ever?! No. 'Prices subject to change without notice'.

Youre going to call your HVAC guy to come out and do a job; not ask him to swing by the office and see if he thinks it feels warm. My time has value. If your not profitable and don't accept that you are part of success or failure, then Youre going to get a bill.

 

[sirmorty]

What kind of spray are you using to scan the impressions?

I have tried a few modelless with my DOF scanner but I'm not confident enough to send out the case. Always seems to be some adjusting when I try it on the model.

 

[sidesh0wb0b]

What kind of spray are you using to scan the impressions?

I have tried a few modelless with my DOF scanner but I'm not confident enough to send out the case. Always seems to be some adjusting when I try it on the model.

good question.
i feel prettygood about my designs now as they stand.....but i always touch them before glazing. either on the working model or an unsectioned cast for contact verification. my brain just cant wrap my head around no models yet......yet....

 

[sirmorty]

I sometimes have discrepancies from working model to the second pour.

I mean sure it's good enough but is it excellent? That's the question I'm asking.

Let's all remember that Cerec crowns are good enough and we have all seen those.

I did buy a DOF scanner with the intention of having a 100% digital workflow but I'm still working on the learning curve. Lots of settings to try and dial in.

 

[2thm8kr]

I sometimes have discrepancies from working model to the second pour.

They are not the same. Ever.

 

[user name]

No matter how perfect everything is able to be seen and worked, model free is a step down. Better than a crappy PVS?

Looks like a turd. Smells like a turd. Must be a turd.

Clinical acceptability varies widely. I do every job to the best of my ability, but every day I say to myself...that poor patient.

 

[2thm8kr]

Better than a crappy PVS?

In some instances yes. PVS and gypsum are hugely variable.
You never have remakes with the old technique due to dimensional inaccuracies?
Don't get me wrong I still use models for complex cases, but for singles or multiple adjacents the process of making models from an impression is a waste of time imho.

 

[user name]

Sometimes my scans look like they sneezed on it. Im having a rough day, so not much is going to get my approval. I need some of that sleep JMN was talking about in the other thread.

 

[2thm8kr]

Scan a model and the second pour. Match them in exocad and use the 2d slice tool. Take a look at the differences.

 

[sidesh0wb0b]

I sometimes have discrepancies from working model to the second pour.

I mean sure it's good enough but is it excellent? That's the question I'm asking.

Let's all remember that Cerec crowns are good enough and we have all seen those.

I did buy a DOF scanner with the intention of having a 100% digital workflow but I'm still working on the learning curve. Lots of settings to try and dial in.

how long ago? what have the major hurdles been?

 

[sirmorty]

I bought the scanner in March. Been doing tests here and there with a client.

I would do one the traditional way of pour/scan model make the crown. Fit and adjust any areas.
Then one I would scan the impression and make it completely model-less. No touching the crown occlusion or contacts.

Have the doctor try it in and give me feedback if it's any good or not. Sometimes he could not get the model-less crown to fit. Others would need some adjustments.
A couple were great but there doesn't seem to be any consistency.

It's tough because there are lots of variables. Impression accurate ? How is the temporary? Is the scan spray causing any issues?

I then tried 3d printing models from the impression scan and that just opens more variables.

I think people that have got it to work have put in work on the testing. It takes time and can be frustrating.