CEREC Doctors

If you are not using the virtual articulator on every case- you are crazy!


Discuss amongst yourselves!


I turn it on in administration, and then I keep forgetting to use it when I get to design.  I am adjusting occlusion before I remember that I did not check my occlusal compass. When I do remember it is AWESOME!


It works very amazingly well.


computation is much faster than when initially introduced

especially nice for implant crowns

never had a bad result since the initial encouragement to re try using it in the current version of the software

never use it for the initial proposal

I concur with the OP

God Bless

matt


I've been pleasantly surprised by the virtual articulator! I haven't tracked it but definitely feels like I've dropped my post op adjustments


Basically need to scan "at least" to the midline for best proposals... Include a few more teeth to maximize articulator function at the cost of a whopping few seconds... What's the barrier? ....Agree with less adjustments...

Mark


Do you guys leave it on for the initial proposal? I think the last time this topic came up it was recommended by somebody to scan to the contralateral canine but activate it only after the initial proposal. While learning/starting out I have found that it saves time to scan more teeth because you set up the model axis way faster. The virtual articulation is just a plus.


I have been doing this for a while, when we remember to use it. Occasionally I get something that does not make sense to adjust and disregard. I think that imaging to the contralateral canine, plus a bit and having a good insertion axis are key. The biggest challenge is that the larger models take longer to process. Hopefully this is minimized in 4.5


On 6/12/2017 at 10:38 pm, Marc Thomas said...

I have been doing this for a while, when we remember to use it. Occasionally I get something that does not make sense to adjust and disregard. I think that imaging to the contralateral canine, plus a bit and having a good insertion axis are key. The biggest challenge is that the larger models take longer to process. Hopefully this is minimized in 4.5

What is supposed to occur in 4.5 is that incoming data is precalculated as you scan.  The software starts to calculate the jaw relationship once the buccal bite is taken before you even click to the next phase. 


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With some of the earlier Omnicam models will the preprocessing affect the ability to scan because of RAM issues?


On 6/13/2017 at 6:30 am, Trent Redfearn said...

With some of the earlier Omnicam models will the preprocessing affect the ability to scan because of RAM issues

No.. it should not.


On 6/12/2017 at 9:53 pm, Christopher Bauer said... Do you guys leave it on for the initial proposal? I think the last time this topic came up it was recommended by somebody to scan to the contralateral canine but activate it only after the initial proposal. While learning/starting out I have found that it saves time to scan more teeth because you set up the model axis way faster. The virtual articulation is just a plus.

For non-complex cases, non-implant cases, usually don't do a lot with it after the proposal----leave it checked on for initial proposal, and a lot of the work is done it seems to me.

Mark

 


On 6/13/2017 at 8:23 am, Mark Stockwell said...
On 6/12/2017 at 9:53 pm, Christopher Bauer said... Do you guys leave it on for the initial proposal? I think the last time this topic came up it was recommended by somebody to scan to the contralateral canine but activate it only after the initial proposal. While learning/starting out I have found that it saves time to scan more teeth because you set up the model axis way faster. The virtual articulation is just a plus.

For non-complex cases, non-implant cases, usually don't do a lot with it after the proposal----leave it checked on for initial proposal, and a lot of the work is done it seems to me.

Mark

 

I personally have it turned off to precalculate. Not that it doesnt work- its just a pet peeve of mine that anytime the machine tries to do everything, it sometimes just gives poor propsals.  This is why Im such a fan of the Biojaw, now the Pre-position tool, in that it allows me to really dial in the restoration.  I guess I should have more faith in the software as its gotten so darn good but its just a bad habit over the years.


I agree.  I generally leave it off for initial proposal because I like to see what interference it is potentially there and evaluate this.... then adjust


On 6/12/2017 at 9:19 pm, Mark Stockwell said... Basically need to scan "at least" to the midline for best proposals... Include a few more teeth to maximize articulator function at the cost of a whopping few seconds... What's the barrier? ....Agree with less adjustments... Mark

My only caveat is that scanning to the opposite canine is difficult to impossible with an isolite in place,  hard enough to get to the midline, though I usually try to do that but I'd have to take the isolite out and then go back to get to the opposite canine and would likely get cheeks, lips in the scan so I just go to the midline and hope this is enough,  not sure I'm getting the full benefit but i always check it after design and often have to make a slight adjustment to the cusps.


I think we need a clinical study to validate this but midline seems to be enough to capture the data.

 


Love it... I don't have a pet peeve, just a creature of habit, and I don't seem to have an issue of poor proposals-- at least not related to articulator, but I won't swear to it... for me, if I don't capture past the midline, I can't really "see"  the model axis as well.... I guess that is a pet peeve confused

Mark


No doubt the more information, the better the end result.  But the question is at what point does it become the law of diminishing returns meaning the work required to get the additional data is not worth the incremental increase in accuracy.


Other than what you, Mike and Mark have said about model axis and up to seven teeth in arch, I don't know....

Doing trainings, I find that imaging is like material thickness recommendations--- if you say 1.3 for e.Max, you get 1mm.... if you say at least to the midline, a lot of times you barely get there, and watching new users set up the model axis is off because I/they just can't really see it properly--- and their proposals aren't ideal and blame the software. I don't disagree with anything you've said.. I admit I'm more addicted to getting to the other canine, and find it takes a few more seconds.... probably the "admitting to a problem" is the first step     big grin

Mark          


I think there is definitely a case to be made for some sort of study on this.  How much is too much, how much is too little and what is just right for each different clinical scenario.

While we strive to be complete in our care, we also want to be efficient.  These are just questions that come to mind that I would love answered.


Wow, I take a few months off from cerec docs website and come back today to see talk of a 4.5 software (i think I'm on 4.2)and a virtual articulator...

i used to blame my second visit post op patients sensitivities to bonding issues or the resin, but now that I rmgi cement zirconia non-stop, and still have to have adjustment visits on most molar cases, it's time to consider other issues.

i also always thought that if I leave a cerec molar out of occlusion, than surely I won't need to adjust it for sensitivity later? But apparently the tooth can shift into the wrong occlusion and lead to sensitivities anyway!?!

i also realize that doing a biocopy without scanning the opposing arch also does not ensure no interference sensitivities even though shape the same as preop photo?!?

 

 


On 6/27/2017 at 3:19 am, Jeff Levy said...

Wow, I take a few months off from cerec docs website and come back today to see talk of a 4.5 software (i think I'm on 4.2)and a virtual articulator...

i used to blame my second visit post op patients sensitivities to bonding issues or the resin, but now that I rmgi cement zirconia non-stop, and still have to have adjustment visits on most molar cases, it's time to consider other issues.

i also always thought that if I leave a cerec molar out of occlusion, than surely I won't need to adjust it for sensitivity later? But apparently the tooth can shift into the wrong occlusion and lead to sensitivities anyway!?!​Because it MUST erupt into occlusion, but now it will be a random one that you are NOT in control of. Instead design restoration with holding contacts.

i also realize that doing a biocopy without scanning the opposing arch also does not ensure no interference sensitivities even though shape the same as preop photo?!? ​Consider that the copied tooth may have, probably has, interferences existing. Slight variation in milling, especially with emax, may emphasis these.

 

 

 


Another case today. Used the virtual articulator. Zero post op adjustments.  None. Nada. Zilch.  Use that articulator folks!


I have a patient with no stable bite at all. Used virtual articulator, but we need to make CEREC articulator to work in CR and habitual bite. If we can take the bite at CR and habitual bite and program CEREC to make restorations with the smooth transition from CR to habitual bite would be great. it happens not to often of course. Gregory