[ClinicCAD v0.9.5] Designing in Medit ClinicCAD

There are two modules for designing restorations in Medit ClinicCAD - Prepared Data and Pre-Op Data. You will choose one based on your available scans and target restoration when assigning scan data after opening the app.

• In the prepared data module, the restoration is created based on the scan data of the already prepared tooth using the teeth libraries. But if needed, you can also import pre-op data for referencing tooth anatomy while designing the outer surface. In this module, you can design all types of restorations.
• In the pre-op data module, you can only design eggshell-type crowns and bridges based on the preoperational scan data. Note that this mode will be disabled if other types of restorations are registered in the Medit Link form.

Choose a module that suits your case and assign your available scan data to start.

 

Data Alignment

After assigning scan data, you will enter the Data Alignment feature. It's essential to align the scan data with the occlusal plane before you begin working to ensure the accuracy of the subsequent automated processes.

In most cases, the alignment will be performed automatically. Check the data position in Multi-View and make any necessary adjustments by moving the data with a mouse.

If the alignment has failed or is unsatisfactory, click "Detach Data" below and realign it again with "Align by 3 Points" or "Align by 4 Points.”

• If you're working with a half arch data, use "Half Arch Alignment.” With it, you will be aligning data and plane based on the corresponding points selected on both.

When data is aligned, click "Done" to start designing.

You can return to data alignment from the first step of the design workflow by clicking the feature icon at the bottom. Note that this will reset all your previous work.

 

Data Editing

Data Editing is a tool that allows users to refine the imported scan data without leaving the program. It is provided in the first step of each module next to the Data Alignment tool.

This tool allows reviewing the imported scan data for any imperfections before creating restorations. With the provided tools, you can trim any excessive gingiva data, modify the data surface, and fill holes if any are present. Learn below how to do each mentioned task.

 

How to trim data

Trimming Tool is automatically activated once you enter.

1. Start by choosing a selection tool that will help you to designate parts of the data you want to remove.

	Smart Teeth Selection	Automatically select all teeth of the arch, leaving out gingiva parts.
	Brush Selection	Select all entities on a freehand-drawn path on the screen. Only the front face is selected. The brush comes in three sizes.
	Smart Single Tooth Selection	Automatically select the area of a single tooth, leaving out gingiva parts. Click and drag the mouse on the tooth.
	Polyline Selection	Select all entities within a polyline shape drawn on the screen.
	Flood Fill Selection	Select the connected area based on the mouse movements.

 

2. If needed, modify the selected area using the following tool options.

	Autofill Selected Area	Automatically fill in entities of the selected area.
	Shrink Selected Area	Reduce the selected area each time you press the button.
	Expand Selected Area	Expand the selected area each time you press the button.
	Invert Selected Area	Invert the selection.

• You can also turn on “Deselection Mode” to modify selection manually or use “Clear All Selection” to automatically deselect everything.
  
  
  

3. To complete the trim, click “Delete Selected Area.”

 

How to fill holes

1. Switch to the “Fill Holes” tool.
2. Locate any missing data areas and adjust the "Maximum Perimeter of a Hole."
If the "Use Neighboring Colors for Filled Holes" option is on, the program will use the matching color palette to fill the area; otherwise, it is filled in grey.

3. Click “Apply” to fill the hole with the new mesh.

 

How to sculpt data

Find the area that needs modifications and, using the tools below, add, remove, smooth or morph its parts.

	Add	Use the mouse to add on part of the data. Hotkey: 1
	Remove	Use the mouse to remove parts of the data. Hotkey: 2
	Smooth	Use the mouse to smooth parts of the data. Hotkey: 3
	Morph	Use the mouse to morph parts of the data. Hotkey: 4
	Groove	Remove material from the restoration with a sharp blade to create grooves. Hotkey: 5

 

Prepared Data Module

Your workflow in this module depends on your target restoration. Check the table below to see what steps you will be working in based on your target.

	Margin & Insertion Path	Tooth Data Arrangement	Final Design
Bridge	O	O	O
Crown	O	O	O
Veneer	O	O	O
Inlay/Onlay	O	O	O
Coping	O	X	O
Cervical Inlay*	O	X	O

*Cervical inlay workflow will be explained separately in the appendix.

 

Margin & Insertion Path

In the first step, you must draw margin lines for all teeth numbers registered in the form and then set the insertion path for each restoration.

1. Start by checking the teeth form at the bottom. If a tooth number has a green check mark, the margin line for this tooth has already been created or was imported from the case.

 

2. Then, click the tooth number that does not have a margin yet and draw it using the “Auto Creation” or “Manual Creation” tool.

”Auto Creation” draws a margin based on one clicked point; “Manual Creation” draws a margin based on multiple points.

• Turn on “Section View” or “Dynamic View Change” to assist you when drawing the margin manually.

 

3. All margins can be edited by adding, moving, or deleting the control points. Click to add a point, right-click it to delete, and drag it to move.

While editing, you can turn on “Curvature Display Mode” to better understand the depth.

 

4. You can work on the insertion path only after margins for all target teeth have been created.

Turn on “Show Insertion Path” and adjust the automatically set path by dragging the insertion path arrow. The grey arrow will indicate the original direction.

Alternatively, you can rotate the 3D data and click “Set Arrow to Your Viewpoint” at the bottom.

5. When done, click “Next” or press the space bar to move to the next step.

 

Tooth Data Arrangement

The purpose of this step is to arrange tooth data for your restorations. When you enter this step, the library data will automatically be placed based on the margins and insertion path you created.

1. There are four default teeth libraries, and you can choose what library to use in the Library toolbox on the right.

 

2. Alternatively, you can duplicate tooth data from your imported scans (prepared or pre-op) to use instead of a library one. For this, turn on “Copy/Mirror” and choose if you want to copy or mirror the scanned tooth. ”Copy” will create an exact replica of a scanned tooth, while “Mirror” will create a symmetrical one.

 

3. Choose a tooth number for which you want to substitute the library data with the scanned one, and then select the tooth that will be copied or mirrored. Selection can be performed using “Smart Single Tooth Selection” or “Brush Selection.” If you need to correct the selected area, use the deselection features.

 

4. Once the data is selected, click “Apply” to complete.

• If you want to return to using the library data, click the “Reset” button next to “Apply.”

5. When you have tooth data arranged for all your target teeth, adjust their placement using Positioning tools. You can move, scale, or rotate the tooth data.

• Choose “Free Move/Scale” to make major modifications with no restrictions. Click the question mark in the toolbox to see the shortcuts for available actions.

• Choose “3D Manipulator” when more precise changes are needed, as this tool performs modifications along a specific axis only.

 

6. You should consider the contact points when moving the tooth data. To assess the contact of the restoration with its antagonists and adjacents, refer to the color bar in the bottom left corner.

 

7. In this step, you can also review the parameters for the restoration’s inner and outer surfaces before they are applied in the next step. By default, your most recently used parameters will be applied. Click “Parameter Settings” in the Side Toolbar to see the details.

• You can manually configure the parameter values or use the recommended preset for your particular printer.

 

8. When done, click “Next.”

 

Final Design

This is the final step of designing your restorations. In this step, you must review and if needed edit the design of the created restorations and check applied parameters before printing.

 

1. Start by reviewing the created restorations. Turn on the analysis tools in the Side Toolbar to see where sculpting of the outer surfaces might be needed.

”Contact Areas with Adjacents” and “Contact Areas with Antagonists” will show the contact points with neighboring teeth through colors.

”Minimum Thickness” will point out areas of the crowns that are too thin in red. Add more material in these areas using sculpting tools.

 

2. Correct any design flaws using “Sculpting.” You can add, remove, smoothen, morph, and carve out material on the restoration’s outer surface.

Choose a sculpting tool, adjust the brush strength and size, and then modify the required areas. Use the “Groove” option to create grooves easily.

 

3. Any substantial sculpting might require additional review of the restoration fit and previously set parameters. Use “Adaptation” to make quick adjustments; you can adapt the restoration to adjacents and antagonists by a set distance.

• If your bridge has a pontic, you can adjust its distance to gingiva using the Adaptation Tools in this step. Choose the “Adapt to Gingiva” feature, set the desired distance, and click “Adapt.”

• If dynamic occlusion data was imported, you can choose whether to adapt to antagonists based on ‘static’ or ‘dynamic’ occlusion.

 

4. If you are working on a bridge, the data of each individual element will be combined into one by adding connectors. Edit the connectors using the “Move” or “Edit” tools.

• When using ”Move,” drag the center point of a connector to readjust the connector’s position and cross-section area automatically.

• When using ”Edit,” margins of the connector on both teeth will appear. You can reshare the connectors by editing those margins. Similar to editing the tooth’s margin line, click to add a point, right-click it to delete, and drag the points to move.

 

5. If you are working on a crown design, you can add screw access holes or handles with “Screw/Handle.”

• Start by choosing what element you want to add and click “Auto Set.” This will automatically place the cylinder for creating an element in the most optimal place - handle on a lingual side and hole in the center. Then, adjust the radius and height of the cylinder below and click “Add.”

• You can also quickly move the cylinder around with a “Move” tool and change its direction by rotating the data and then setting it to your view with “Set Toward You.”

 

6. Lastly, review the inner and outer parameters in “Parameter Settings” before saving your design and sending it to printing. To save your restoration designs, click “Complete” at the bottom right corner.

 

7. If you have a SprintRay 3D printer, you can transfer your restoration design from this step right into the RayWare Cloud. For this, use the “Print with SprintRay” at the bottom and follow the guidance on the screen.

 

Pre-Op Data Module

The general workflow of creating ‘eggshell’ crowns and bridges consists of three steps: Tooth Selection > Margin & Insertion Path > Final Design. The Tooth Data Arrangement step will be provided if you choose to substitute pre-op scan data with the library (more about this step read in the Prepared Data Module chapter).

 

Tooth Selection

This is the first step in designing eggshell-type crowns and restorations. The goal of this step is to select preoperational data corresponding to each tooth registered in the Medit Link form.

 

1. Upon entering the step, the data for the teeth numbers indicated in the form at the bottom will be automatically selected.

 

2. Review the accuracy of the automatic selection to ensure the correct generation of the restorations' outer surfaces in the subsequent steps.

If editing is required, select a target tooth number in the form and make changes using the selection tools.

• You can clear all selection on a specific tooth using “Clear All Selection” and then accurately reselect data with “Smart Single Tooth Selection” by clicking and dragging the mouse over that tooth data.

• Or you can make minor corrections to the selection with “Brush Selection” or “Brush Deselection.”

3. When done, click “Next” or press the space bar to move to the next step.

 

Margin & Insertion Path

The purpose of the second step is to establish the margin lines and set the insertion path for future restorations.

 

1. The margin lines will be created automatically upon entering this step. You must review the generated margin lines and edit them if needed.

• To edit the margin lines, use the “Shrink/Expand” slider at the bottom. You can shrink or expand the margin for all teeth at once or for a specific tooth number by selecting it in the form at the bottom.

• You can also edit the margin line by adding, moving, or deleting the control points. Click to add a point, right-click it to delete, and drag it to move.

2. The insertion path will also be automatically detected. Examine the detected insertion path. If editing is needed, drag the insertion path arrow to adjust its direction. The grey arrow will indicate the originally detected direction.

• Alternatively, you can rotate the 3D data and click “Set Arrow to Your Viewpoint” at the bottom.

 

3. In this step, you can also review the parameters for the restoration’s inner and outer surfaces before they are applied in the next step. By default, your most recently used parameters will be applied. Click “Parameter Settings” in the Side Toolbar to see the details.

• You can manually configure the parameter values or use the recommended preset for your particular printer.

 

4. When done, click “Next.”

 

Final Design

This is the final step of designing your restorations. In this step, you must review and, if needed, edit the design of the created restorations and check applied parameters before printing.

 

1. Start by reviewing the created restorations. Turn on the analysis tools in the Side Toolbar to see where sculpting of the outer surfaces might be needed.

”Contact Areas with Adjacents” and “Contact Areas with Antagonists” will show the contact points with neighboring teeth through colors.

”Minimum Thickness” will point out areas of the crowns that are too thin in red.

Add more material in these areas using sculpting tools.

 

2. Correct any design flaws using “Sculpting.” You can add, remove, smoothen, morph, and carve out material on the restoration’s outer surface.

Choose a sculpting tool, adjust the brush strength and size, and then modify the required areas. Use the “Groove” option to create grooves easily.

 

3. Any substantial sculpting might require additional review of the restoration fit and previously set parameters. Use “Adaptation” to make quick adjustments; you can adapt the restoration to adjacents and antagonists by a set distance.

• If your bridge has a pontic, you can adjust its distance to gingiva using the Adaptation Tools in this step.
  Choose the “Adapt to Gingiva” feature, set the desired distance, and click “Adapt.”

• If dynamic occlusion data was imported, you can choose whether to adapt to antagonists based on ‘static’ or ‘dynamic’ occlusion.

 

4. If you are working on a bridge, the data of each individual element will be combined into one by adding connectors. Edit the connectors using the “Move” or “Edit” tools.

• When using ”Move,” drag the center point of a connector to readjust the connector’s position and cross-section area automatically.

• When using ”Edit,” margins of the connector on both teeth will appear. You can reshare the connectors by editing those margins. Similar to editing the tooth’s margin line, click to add a point, right-click it to delete, and drag the points to move.

 

5. If you are working on a crown design, you can add screw access holes or handles with “Screw/Handle.”

• Start by choosing what element you want to add and click “Auto Set.” This will automatically place the cylinder for creating an element in the most optimal place - handle on a lingual side and hole in the center. Then, adjust the radius and height of the cylinder below and click “Add.”

• You can also quickly move the cylinder around with a “Move” tool and change its direction by rotating the data and then setting it to your view with “Set Toward You.”

 

6. Lastly, review the inner and outer parameters in “Parameter Settings” before saving your design and sending it to printing. To save your restoration designs, click “Complete” at the bottom right corner.

 

7. If you have a SprintRay 3D printer, you can transfer your restoration design from this step right into the RayWare Cloud. For this, use the “Print with SprintRay” at the bottom and follow the guidance on the screen. You must already have a RayWare Cloud account to use this feature.