New techniques are being developed all the time for the Itero machine:
- There are some dental labs that are using iTero scans to manufacture partial denture frameworks. You will have to purchase the OrthoCAD $5000 software package intended for orthodontic/Invisalign models, but it may be worth it to have excellent fitting frameworks every time.
- Obstructive Sleep Apnea models can also be scanned on OrthoCAD software. This means the dental assisting staff can have the scans already done for the doctor to approve before sending them on to the lab for appliance manufacturing.
Tricks of the Trade:
- Building crowns under an existing removable partial denture rests and clasps. This has always given me trouble. If you get one to fit well then you are just lucky. There are dental labs that can now make CAD/CAM eMax crowns under existing RPD frameworks with iTero scans. If you have a tooth that fits the rest(s) and clasp(s) well that you are replacing, then get a pre-prep scan and send it to the lab as a separate study model. Then scan your prep like usual and they will merge the two scans together to make a nicely fitting crown. If the tooth is not in good shape, then mock up the proper anatomy in composite first and then scan.
- If you have a full mouth restoration case that you have been working up with provisionals and are satisfied with the esthetics and function, then you can scan the provisional and the lab can merge the final preps together with your provisionals to make your final product.
- If there is a large edentulous space that you cannot focus your scanner camera on because it is too far away, then use bite registration material to close up the gap.
- Beware of the older software versions (v.4.0 and older) for the iTero. The interpolation mode may look pretty on your machine, but may have huge missing areas of data when it finally makes it to the dental lab. This has held up cases all over the country and drives dental labs crazy! Nobody wants to call back in patients for new scans after you told them your fancy machine was the best impression known to mankind. Newer versions (v.4.5) are virtually trouble free.
- iTero will give you the OrthoCAD software for free if you are a licensed Invisalign provider, but if you want to use it for other reasons (partial frameworks or OSA appliances), then it costs $5000! Outrageous!
Be sure to read the blog on Cadent iTero: Trouble in Paradise