Bill Marais strikes again
Prepping a full upper arch next week and just wanted to post this amazing waxup I got from Bill.... He always amazes me. It is expensive at $85/unit... but totally worth it!
Preop:
Bill digitally waxes up in Exocad and prints it in an Acrylic puck... then after mill does hand touching and adjustments:
He then duplicates in white stone in case you would like to show to patient
Includes a great stent to transfer to the mouth if needed or for provisionals.... and a prep guide:
He also will do it completely digital and send you the .stl if you would like to print yourself for $50/unit. I do it both ways and will discuss the advantages and disadvantages this week in Vegas at the Mentor Meeting and my Sat Anterior lecture.
Nice!
Exocad; Is that available to dentists in the US?
As powerful as SW 4.5.1 is, I would think creating mockups would be possible. Do you see any type of "digital waxup" abilities in the pipeline for CEREC?
Thanks for showing this Mike. One of the things that I have difficulty with is the stent (or putty version) not having a soft tissue stop. Does he include the palate behind the central incisors to give some kind of idea that the stent has a positive stop to prevent placing the guides in the wrong place. Labs seem to miss the point on this so easily when it comes to the "real world." Anyone have any tips on how to deal with that aspect (other than to have them "bite down" into the stent, which works for the clear but not for a putty mold of the temps).
Thanks in advance all.
Looking forward to hearing this on Wednesday.
You can purchase exocad, it is about 5000, then you have to add on the modules that you want. There is a demo version for about 300 or so.
Bill does amazing work
love those line angles...i love that he uses a subtractive wax technique, too many labs want to use an additive only technique and they send back a wax up with shit detail and no anatomy.
ernie i just fill the prep guide with temp material, it gives you the visual confirmation you are looking for.
On 9/11/2017 at 1:14 pm, Jos Dijkstra said... ernie i just fill the prep guide with temp material, it gives you the visual confirmation you are looking for.
Not sure what you mean Jos. If it is putty (unable to see through it), how do you know it is in the proper position without a tissue stop? Mind tend to come out too long more often than too short, which is at least fixable. If a clear stent, I like to bite and visually confirm the incisal edges using a ruler. Can you explain with more detail so I understand what you mean? Thanks.
Then putty sent has enough soft tissue detail that I have no issues with stops. In this case the molars are not waxed so I have a reference point... but I have used these same ones with all teeth prepped and have had no issues.
On 9/11/2017 at 1:49 pm, Mike Skramstad said... Then putty sent has enough soft tissue detail that I have no issues with stops. In this case the molars are not waxed so I have a reference point... but I have used these same ones with all teeth prepped and have had no issues.
Thanks Mike.
On 9/11/2017 at 2:09 pm, Ernie Johnson said...On 9/11/2017 at 1:49 pm, Mike Skramstad said... Then putty sent has enough soft tissue detail that I have no issues with stops. In this case the molars are not waxed so I have a reference point... but I have used these same ones with all teeth prepped and have had no issues.Thanks Mike.
Ernie, you can ask him to give several matrixes, when he is done with anteriors to take one while posteriors were not touched yet and that way you can control stops. Another way to control the prep and bite ask him to give a transfer bite. Gregory
This case isn't even prepped yet. I will for sure post when it's done. I have others I will present in Vegas
On 9/11/2017 at 5:10 pm, David Edelson said...Marias has some mad skills. Exactly why we should support our lab family as well.
Absolutely! I don't think anyone here has suggested otherwise. Bill is great.
Definitely will be there Saturday Mike.
Biggest question is: does the fully digital give you the detail you want? Or does it require him doing a combination?
I will wait til Saturday for my other questions. Beautiful work
When you do all digital, there are some minor detail issues you have to deal with. First because you need to 3D print. Even at 25 micron z axis, there is some detail lost... plus, Bill adds some hand detail after he mills which increases detail.
Eventually we can hopefully import the stl of the Biocopy... but there are issues there as well... what if it doesn't stitch?
Lots of things to think about and lots of ways to do things. Exciting times.
Ernie, Get the wax-up done and make your own matrix using Crystal by Clinicians Choice. You can see through it to ck the seat and you can even speed up the cure with a light if you are using Luxatemp.
Ernie
My lab send me a putty covering the palate which I use as stop. It gives me good support and the shelve of the provisional is in it so when I reline it is stable with the putty
Flavio
On 9/11/2017 at 6:40 pm, John Lee said... Mike, where is Bill's lab?
Disa Dental Studios
Portland Oregon
On 9/11/2017 at 8:03 pm, Flavio Rasetto said... Ernie My lab send me a putty covering the palate which I use as stop. It gives me good support and the shelve of the provisional is in it so when I reline it is stable with the putty Flavio
Agree...and that is what I ask for on my lab slip and then the palate gets removed. I'll just turn into a (bigger) A-hole and scream bloody murder about it the next time it happens. Thanks for the input everyone!
Just an update on this case. I know many of you were at my Lecture Saturday (or at the Mentor Meeting) and heard me talk about the 3rd way to do a waxup.
I prepped it yesterday first thing in the am.... Now today here is where i'm at. I printed a solid model last night and did all the finishing today. All restorations were milled in EF mode.
I did have a few issues on this case that slipped by, but overall...no problems.
Don't want to speak for Mike......and the milling unit is very good.....buuuuuut
Those contours and texture are all the human touch (I'm guessing
). Mike great work with your talents. Again, the mill gets you 80% there, but that is some impressive contouring and artistic work. Cannot wait to see the final results!!
Tom
