February 19, 2012

Cadent iTero: Trouble in Paradise

I admit it, I’m spoiled.  I have been using the Cadent iTero digital impression system for over two years and love it!  That is until it stopped working!

Our beloved iTero first started to have problems almost exactly 2 years from the date of purchase with a dying battery back-up.  Beep, beep, beep.  We had to completely shut it down between operatories to use it throughout the day, which was manageable.  The Henry Schein technician came to our office after a couple of days and replaced the battery backup over lunch.  It worked great after that for about 2 weeks until one morning it would not start up at all.  We unplugged the unit and let the circuitry calm down several times until it finally fired up.  Good thing because we had a full day of crown and bridge.  It worked alright for about another week and then it was dead for good.  Nothing we could think of or do would resurrect our little work horse.  I called the service number and got someone with a very heavy south Asian accent.  He had me pull off panels and press buttons that were in no way the problem because quite frankly, I don’t think he understood what I was saying.  After all of the worthless help he provided  he said he was going to schedule a technician to fix it the very next day.  Shoot!  We had another day of crown and bridge cases and no iTero!  We pulled out our old polyvinyl siloxane impression materials and made it through the day as if we were working with stone knives and bear skins.  I must have tried to turn on that darn machine at least 10 times that day in desperation.

Day 1

The next morning we were looking forward to having our machine repaired, but instead received the news that the Henry Schein service technician called in sick.  This time we had implant cases scheduled that needed to be restored and I wanted to use scanning jigs to make custom abutments and crowns.  I hate to reschedule anything, but I did it anyway and the schedule quickly filled up with, you guessed it, broken teeth needing crowns.  Shoot!

Day 2

The technician showed up early.  He was a local guy from Henry Schein, not the guy from Tampa who got sick yesterday.  He brought the wrong batteries so he had to leave and get a different one.  So much for our crown cases in the morning.  After he came back he worked for a while and said he was going to have to order more parts and someone will be back tomorrow.  Shoot!

Day 3

The same tech showed up at 10:30am and was immediately hard at work.  He changed out the power button and then the main power supply which did the trick. We are now up and running, hopefully for another 2 years of trouble free scanning!

Beware of Software Update:

We still are using the original software that came with the iTero 2 years ago.  They have a newer version but I’ve talked with my labs and they are NOT recommending you update to the newer 4.0 version because it is in many ways a step backwards.  If you haven’t heard already known, Cadent sold to Invisalign and there have been a few hiccups:

  • I usually scan my cases and then internet them to Tel Aviv.  In Israel, they receive the raw data, clean up the artifact, define the margins and pin index the case.  Then it is sent over the internet to New Jersey where the models are milled with a computer milling machine.  If you are using scanning jigs, New Jersey is skipped and instead the data is sent straight to the labs in either Canada or California where they design and manufacture both the custom abutments and crowns.  The case usually takes about 2 ½ weeks to complete.  One of our cases was held up because they were having trouble with the crown margins.  When I looked at the case on the Itero, this is what I saw to the right.  They were trying to put crown margins on the scanning jigs.  At first it made me laugh out loud, but after second thought I realized they were having a serious problem with their conversion from Cadent to Invisalign.
  • I understand the operations have been switched around to save money.  Instead of the models being sent to Tel Aviv, Israel, they are now being sent to Costa Rica.  Then instead of being milled in New Jersey, they are being milled in the murder capital of the world Juarez, Mexico.
  • With the newer software upgrade, iTero is having problems that are driving the dental labs crazy!  Interpolated scans are missing data.   This means the scans that the doctors see on their iTero machine is not the same as what the dental lab tech is seeing.  Therefore, when it gets to the dental lab, huge areas of data that have been filled in to look pretty for the doctors eyes during the scans are missing.  This causes lab cases to be put on hold while the lab tech calls the doctor to get new scans and generally disrupts the flow of cases to and from the dental labs. At this point I would NOT recommend you upgrade until Cadent/Invisalign addresses the missing data issues.
Read about iTero trick of the trade on the following blogs: