Instead of polishing with Composite-base, light curing Colors very good results can be achieved in a short time.
The surface of 3D-printed restorations must be improved before the application to the mouth. The can be done by polishing. A very interesting alternative ist staining and glazing with composite-based systems. In his case we are using the VITA AKZENT LC light curing stains system. The surface before should be smoothened- especially the bases of the supports. After this, sandblasting is a very useful pre-conditioning. Similar to ceramic at first a layer of glaze should be applied. Within the glaze some colors can be added. If necessary , all can be fixed with an in-office light curing device. For the final curing a professional light curing unit should be used. This is normally available together with each 3D-printer. After the curing the restoration can be polished additionally.
Primescan Connect is a system, which contains the Primescan intraoral camera connected to a Laptop.
Primescan Connect is a set of the proven camera together with a laptop. The connection ist established with a Coupling Box. The system must be connected to the DS Core Online Data Platform. The scandal will be uploaded there. Of course a local storage and use is possible. The system is only working with the Connect Software. That means a design of restorations and a connection to milling machines is not possible.
From time to time for a lot of devices a new firmware is released. This update is important because it solves a big problem of the furnace. The problem was, that you have to wait a long time before it's possible to start a new firing process when the firing chamber is hot.
You can download the new firmware from the website Ivoclar.com. There you can find a section for updates. go to CS-4 / CS-6 and select the file for download. After downloading you must unpack because this is a zip-file. You should do this directly on a USB stick, because this is needed later. Start the furnace and go to software updates from the home screen. After plugging in, the process starts automatically. At the end of the process it is necessary to restart the furnace.
The key-factor for long-term success of bridge restorations is the connector size. Anatomic Connector design can help.
Very often in the first proposals the connector size is too small. 16 mm“ is the minimum. the reach this - or more - at first the connector type should be Anatomic not Intersection. With the help of the additional tools (Connector lines / Connector move) a re-design of the primary proposals possible. The Connector lines must be extended and the the form of the connector must be changed with the help of the Smooth Tool.
Finally the cleaned and disinfected Abutmentcrown can be fixed with a screw and the screw hole can be closed.Before insertion the question of cleaning, disinfection and/or sterilization must be solved. Abutmentcrowns are semi critical or critical medicine products. Before fixing the screw a disinfectant should be added to the inner part. The torque wrench should be known and respected. Before closing the screw hole with composite resin the screw should be protected with teflon tape. To prevent a greyish look use an opaque composite.
After the design follows the setup for the milling of the restoration
Both milling machines MCXL as well as Primemill are able to mill such abutment-restorations. Standard milling mode for glass ceramic is a good selection, extra fine is possible. The referring block must be selected and fixed in the machine. Then the milling process can be started.
After the milling the surface of the Abutmentcrown must be optimized. The next step after this is staining and glazing. Finally the crown goes to the furnace for crystallization.
At first the sprue but be cute with a diamond disk. Then, with a big stone wheel, the surface should be smoothened. With smaller stones we can add individual characteristics. For the try-in in the mouth TiBase and Abutmentcrown must be fixed with a light body silicone impression material. Especially the contact points must be checked and improved. When the fit is perfect and the TiBase ist removed again, a crystallization pin must be fixed with the help of object fix paste. The staining and glazing should only be done on the supra gingival part of the crown. For the crystallization firing we use a long program because of the thickness of the ceramic.
This is the classical solution with improved esthetics and more design options compared to the monolithic, screw retained crown.
After selecting the 'Abutment with Crown' option in the administration there is a split button among the design tools. The shoulder width should before reduced in the settings to 500 microns. After splitting the mesostructure can be optimized mostly by the Scale Tool. You can scale radial and occlusal.
Additional to the form of a classical crown the sub gingival area must be designed.
The Baseline describes the transition between the sub- and the supra gingival area of the abutment crown. Ist works a little bit like a preparation margin. Normally the form and position of the baseline is calculated by the software. Unfortunately the proposals are mostly not good and it's difficult to change them. The best way is, to simply ignore the form of this line. If there is a nice emergence profile, the option Gingiva Mask can be used. Then the form of the subgingival form of the abutment crown will be adapted to the emergence profile. The subgingival area should be smooth with a certain degree of gingival pressure. For the milling of stew retained crowns A-14 or A-15 abutment blocks can be selected.
The scanning of a TiBase situation is different from 'normal' scans.
The oder of the scanning catalogues should not be changed. First Active jaw, without scanbody, then antagonist and lateral scan. At least after positioning of the TiBase or scanpost the scanbody folder. During the acquisition process the scanbody must be clean and dry. Do not change folders and also do not use the cut tool.
There are some things we have to consider before we can start scanning. There are the selection of TiBase or ScanPost and the referring Scanbody.
The optical Impression in the Ti-Base workflow can be done either with the TiBase itself, but the even better solution is the use of a ScanPost. The right Scanbody must be selected and we have to check it's proper fit. The position of the later sprue can only be determined with the position of the notch on the TiBase/Scanpost. This should be 90 degree clockwise to the sprue-position.
The process of case definition for implant abutments is different from 'normal' restorations.
Two design-types are available: Screw retained Crown and Abutment With Crown. The design type can be changed later during the design phase - if necessary. Abutment blocks can be selected from Dentsply Sirona, Ivoclar and VITA. The type of the implant can be selected for the determination of the TiBase. At least the decision between scanning from TiBase or Scanpost have to be made.
TiBase connected CEREC® superstructures are based on a special connector type and referring ceramic blocks with a pre-milled inner structure.
The lower part of the TiBases are designed to connect with the inner geometry of a lot of different implant types. The upper part have a standardized form wich fits into special, pre-milled ceramics blocks. These Abutment Block are available from Zirconium Dioxide, Lithium Disilicate, Hybrid-Ceramics and PMMA. There are two main design types - one in the classical way of a meso structure and a covering crown. The other so called Hybrid-Abutment-Crown is a screw retained, monolithic abutment.
After the crystallization process the crown and the Ti-Base must be glued together. Perfect surface polishing is a success factor for abutment solutions.
After intense cleaning of the inner area of the crown the surface must be be etched and silanized (Monobond Etch & Prime, Ivoclar) The surface of the Ti-Base must be sandblasted and coated with a primer (Monobond plus, Ivoclar). Finally the sugingival surface of the crown should be polished with a special silicone polisher, that ensures the sufficient degree of roughness for a perfect bio-integration.
All steps of the post processing of the milled crown before the crystallization process
After cutting the sprue the surface should be smoothened with special, diamond containing stones. For the try-in the Ti-Base can be fixed in the block with the help of a light body silicone impression material. The try-in can be a little bit difficult, because there might be a difference between axis of the implant and the direction of insertion of the crown. The adjustment of the inter proximal areas should be done very careful with the help of thin articulation foil. Staining and glazing is equal to that one on normal crowns, with one exception: The sub gingival ares should NOT be stained and glazed. For the firing the abutment crown should be placed of a special, very thin firing pin with the support of Object Fix Flow firing paste. For the firing a standard program must be used. Because of the thickness of these crown do not use speed sintering.
3D print, wash process, and light-cure with the Primeprint 3D printer and Primeprint PPU (post-processing unit). Primeprint collaborates with software for automated print and post-processing, and extensive material management.
The system consists of the printer and a post processing unit (ppu). These components are not small, so You should calculate, that You have enough space for the footprint. Both units need a wired network connection. You should have two access point for this. The most important part is the Primeprint box, a transport container that ensures a clean and safe application without direct contact to the resin. Inside the printer is located the material unit, that contains the material cartridge. for each material You need a separate material unit. The PPU contains beside the the transport box two two washing containers to pre-wash and finally wash the printed object in isopropanol. Please notice, that You need two of these containers for every material that You use - that means You need a lot of space to store them all. Additionally the PPU needs a gas tube with nitrogen to prevent the formation of an oxygen inhibition layer during light curing.
Not seldom users are reporting about cracks and fissures at the door of the milling chamber of the MC XL milling unit. This is a severe problem, because water can penetrate and destroy the electronics.
The change the door of the milling chamber at the MC XL for a non expert is possible, but not easy. A lot of parts of the cover must be removed and the mechanism of the doors joint is not easy. The whole procedure takes roundabout 30 minutes.
After the click on the Scanbody-head now the virtual position is displayed, on wich the software has matched the form.
The scan body is needed to define the implant position. In clicking on the top of the small pyramid at the scan bodies head. The software matches in this moment a virtual form with the real form of the scan body. The result of this procedure is now graphically displayed. In everything is right, both objects must be in the same place. In our video it is visible, that errors can occur. To prevent failures, respect the following rules: 1. Ever use a new scan body. 2. If a damage of the form of the scan body is detected, don't use this one. 3. During scanning the scanbody should be dry and clean.
After every 120 milled Zirconia restorations the filter bag must be changed. After 3 - 4 changes of the filter bag, also the HEPA-Filter must be changed.
The necessity of changing the filter bag is displayed at the touch screen menu of the Primemill. For this work please urgently wear a face mask and gloves. The Zirconia dust is harmful. At first the front cover must be removed by loosen the two knurled nuts. Then the filter bag is visible and can be removed. If You want to change additional the HEPA-Filter, the perforated shield must be removed by releasing the two screws at it. After replacing the filters the front shield can be closed. Don't forget to reset the data at the Primemill display.
The from CEREC or inLab CAD imported data will be matched in the inLab 22 CAM to a production device and to a material.
CAM-data can be directly opened. After this 5 steps are necessary: 1 - Definition of a production device 2 - Selektion of a case (or more cases - collecting) 3 - Definition of a new or selection of an existing workpiece 4 - Definition of the production details (position / connectors) 5 - Starting the production process
After making the design either in CEREC or inLab Software the data must be exported that they can be later opened in the CAM.
Some things should be done already in the design software (like CEREC): Select a sufficient material and the the milling machine, that later should be used. Here is actual Prmemill is the center of interest. In the production could be selected th type of milling and the mill-position, but this can be done better later in the CAM software. So - the most important step is to select either 'Export to CAM' or 'Export to Folder'.
With a small kit of 4 instruments (Zirconia Processing Kit by CMC / Meisinger) it is possible to optimize the surface of milled Zirconia restorations.
Zirconia is after milling very weak and very fragile. The surface is very sentive against pollution. You should urgently use gloves and wear a face mask. At first the restoration must be removed from the block. The sprues can be cutted by a tungsten carbide bur. Then the areas of the sprues must be smoothed. The best solution is the use of a rough silicone polisher. Together with the Meisinger Company we created a small set of instruments for this. Other areas and especially the margins should be smoothed by a conical formed polisher. Finally there is a disk from the same material wich can be used for the inter proximal areas.
The Open Rubber Dam its very easy and fast to apply and can be used for simple clinic procedures, for scanning and for situations, when the normal rubber dam is impossible to place.Use a medium rubber shield and a big frame. Make only two holes - normally at the position of the first molars. Place clamps 12A and 13A. Make a straight cut between the clamps and push the rubber to the labial side. Invert it to retract the lips and the soft tissues.
After scanning the form of the jaws the splint must be designed with a special software. We as CEREC® users are using the inLab Splint App.
The Construction Software belongs to the 3D Printer and is needed to check and place the object for printing.
FUNCTIONS OF A CONSTRUCTION SOFTWARE ARE:
- CHECKING THE QUALITY OF THE DATA FOR PRINTABILITY - IF NECESSARY REPAIR
- POSITIONING OF THE PRINT-OBJECT ON THE PRINTER-PLATFORM
- ARRANGEMENT AND POSITIONING OF SO CALLED SUPPORTS
- SLICING - DIVIDING THE OBJECT IN HORIZONTAL LAYERS
- ADAPTING THE PRINTING PARAMETERS TO THE TYPE OF THE USED RESIN
The scanning should be done with the CONNECT software in consideration of some special things.
The Dental Leaf-Gauge consists of 56 elastic leaves with the thickness of 0.1 mm. It can be used like a jig and is a very interesting tool for the lateral scan.
Normally the AC Primescan is working without problems. Unfortunately we have a lot of reports about broken camera cables. And if this occurs, there is urgent help necessary.
After the direct printing process the surface of the splint must be smoothened and polished.
The JPEG-Export function generates a set of intraoral photos.
If one upper central is damaged and the other one looks good, this one can be used for the design. With the 'Copy&Mirror' design a tooth can be replaced with the mirrored form of the contralateral one. After the preparation margin an additional 'Copy-Line' must be drawn to select the area wich has to be copied.
Biogeneric Copy is used to copy known surfaces in a new restoration. Therefore a fourth catalogue is generated. Normally this scanning is made first. A green checkmark indicates, that the overlay between prep- and bioscopy scan was successful.
From the orderdigitalsolutions website we con download the Core-File. This file in in the DXD-format and can be opened by the CEREC® software. After opening via Import the correct material must be selected. the workflow in complete the same to a normal crown. the obtained models are monochromatic, bit the now integrated form of the abutment is in a very high precision, so the the margin can be found easily by the software. After a few and simple design steps the crown can be milled.
After finishing the details of Your order, it is important to watch Your mails. There will be a message, if the design is finished. With the link it is possible to directly access the website. Because it is very important to assess every aspect of the design, the Editor for this should be installed on Your machine. If the design is ok, its can be approved, if not, there is a field to describe, what must be changed. After the approval the data were sent directly for production - no further changes are possible! At least the data of the core file can be downloaded.
Only a few information is submitted from CONNECT to Atlantis. That's why we have to make some specifications for the design of the abutment there. A restoration type and a material must be selected. It is important to define the Crown Type as 'Core-File'. Emergence width, Emergence shape, Margin position and Margin design will complete the information for the final form of our abutment.
The main part of the Aqusition-screen is take by the camera-window and the preview area of the calculated model. From the sub-menu you can start the scanner. There are two options: 2D (photos) and 3D (scan). Also here are shown the catalogs. Weh ave at least 3 - upper and lower jaw and bite. Only one tool is accessible at the left side - the cut tool, to remove unnecessary areas of the scan.
In this video the transferring of the recorded case to Atlantis is described. The upload of the recorded data of the case is done in the last step of the Connect software. To ensure the complete workflow a few prerequisites must be fulfilled: The user must have an account at Connect Case Center. Atlantis Implants must be selected as a Favorite Lab. Then it must be linked to portals. At least an valid account at the Atlantis website orderdigitalsolutions.com is necessary.
In our new Category 'Implantology' we started with the CEREC® and Atlantis Workflow.
At first the appropriate milling machine can be selected. Otherwise the design-data can be exported to the CAM software. The occlusal milling offset can be set for the MC XL directly and for the Primemill in the Configuration Menu. Depending on the materials fast / fine / extrafine grinding can be selected. A fitting block size is suggested by the software and can be modified. Either the milling with overkill or in the veneer mode can be selected. At least initiates the pressing of the Start button the milling process.
In the Shape Tool we have the options of circular or anatomical changes. It is possible to do this in a two- or for-directional way. More common ist the two-directional move, because it is easier to control. In the circular mode an orange sphere is displayed for the area, the changes will be carried out. We can change the size with a slider or directly on the trackpad. In the anatomical mode the region for the changes where selected depending on the position of the cursor. So it is possible to select the whole tooth or a single cusp and so on.
In the main screen of the CEREC® Software it is possible to do a lot a things. Most important is the access to the patient database. The definition of a patient is ever the first step in each CEREC® restoration. But there are more things to do from the main screen. From the System Bar it is possible to open / save / export data files of cases of CEREC® restorations. It gives access to system operations like Settings and License Manager.
If You want the full overview about the actual current status of the GC Initial LiSi Blocks, You should urgently watch this nearly 100 minutes webinar.
There was a long and quiet period here at this website. The reason was that I was very ill. Thanks to all the good wishes for me. Slowly the power is returning an we can proceed to build this, what we've promised at the beginning of this year.
Surface characteristics are a key thing for esthetic anterior restorations. With a few drawings of a pencil you can create a roadmap. Grooves and perikymatia, which have to be removed and the ridges, wich should be prominent. The work can be done with diamond instruments. The first step of polishing is to ensure a very high gloss of the ridges for a good light reflection. This is the reason we especially use at first the green twister. The rest is simple. Going down from red to the yellowish twister will lead to a high gloss but preserve our surface design details. The last step can be a super-polishing with brushes.
GC Lustre Pastes ONE offer an impressive possibility to improve the esthetics of milled, monochromatic Initial LiSi restorations. The process should be done systematically. It starts with the first step - application of the Gaze Paste Lustre Neutral Fluo. Step 2 is lowering the brightness in the incised area to achieve the effect of translucency with Light Grey and Light Blue. In step 3 the Halo Effect can be created with Vanilla. Then in step 4 the body will be shaded with Body A and B. Step 5: Mixing the upper and lower areas leads to a transition zone. A Mamelon Effect can be created in form of 3 typical cones with Orange. In the next step we can create some 'Irregularities' with Opal Effect. In step 9 the Halo effect can be improved with Twilight. In step 10 a Clean Up is finishing the process.
CEREC® ist (more or less) a closed system. Dentsply Sirona do not allow to use the designs made in the CEREC® software in third party applications. In times of 3D printing there is a urgent need for this. There is a way, using the inLab software. At first we export the design in form of a DXD file. This is possible to open in inLab. From there at least we can export Restoration-STL.
GC Initial LiSi Blocks contains from fully crystallized Lithium Disilicate. That means no additional firing is necessary. In This video are described the chemical/physical characteristics and the ways of integration into the CEREC® system.
Setting the model axis is a optional step, because it's done by the software automatically. Nothing at all improvements of the positioning of the model axis lead to more precise proposals of the contact points, the occlusion and the general form. The must must be oriented in 3 views. The horseshoe is the occlusal view on the model. The most important point is the incised point. It must be located between the two centrals. The we have an anterior, a premolar and a molar segment. The lateral view should respect the curve of SPEE, the anterior view the curve of WILSON.
The o-ring is located beyond the sleeve of the camera and serves for sealing up the inner side from pollution. From time to time we should check and replace it, when it's damaged or lost (like in our case. The oder number for new ones is 6680974 Sealing Ring 26x1. Remove at first the sleeve. Replace a new o-ring in siding it to one point of the o-ring groove, then use your thumb and your index finger to push the ring into the groove.
In the third part we'll describe how to extract a tooth virtually on a digital model.Especially for the design of surgical guides for implants it is necessary to remove teeth, if they will be extracted in the moment of the implantation process. We are describing here two possible ways: The use of the replace tool alone and the combination of the cut and then replace tool. With the second option it is possible to get better and more predictable results.
This procedures should be urgenntly applied to avoid infections of the patients and ths clinic staff. The wipe disinfectionn should be done at the screen, the touchpad, the handle, the scanner and the scanner rest. Only approved disinfectatnts should be used.
Shade peg is a firing paste like Object Fix (Ivoclar Vivadent) with the main difference, the is is not light grey. It comes in 10 different colors wich are corresponding to the Shade Guide colors. After selecting the underground color at your preparation with the help of the Shade Guide, You can select the same color from Shade Peg. The You can fix the restoration on it and use the supports we know from e.max technology. Now you can apply your shades and stains and see directly the effect.
May this year become a good year for us all. The last two ones were hard enough. Here is our new website, wich is more or less empty in this moment. It was a big work to reach this point and now let's see, how it looks, when this year is over.