Join Our June Q&A Roundup: Questions from Medit user group

Welcome to our June Q&A Roundup! This month, our main focus is on improving communication in digital dentistry, particularly between dentists, clinic staff, and dental technicians. Dr. Keun-Young Jang and Ji-hye Kim (Jane), a talented staff member from his clinic, addressed common questions and issues from the Medit Facebook User Group, providing detailed answers to enhance your clinical practices.


Q1. What causes the implant crown to be out of occlusion?

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The first question this month concerns communication with the technician when making implant prosthetics. Dr. Nguyen from our Medit User Group community shared an issue he encountered with an implant crown that was significantly out of occlusion despite appearing fine during the scanning process. Here’s a detailed analysis and discussion on potential causes and solutions.


Possible Causes of Error

1. PEEK Material Scanbody:

PEEK scanbody can cause errors depending on the tightening torque. If tightened with a force greater than 20 Ncm, the scanbody might dig deeper, causing vertical errors. However, research indicates that such errors are around 100 µm, far less than the 1mm error in Dr. Nguyen’s case.

2. Matching and Merging Errors:

Scanbody Exposure: Insufficient exposure of the scanbody during scanning can cause alignment errors. Selecting the right scanbody with adequate exposure is important.

Method of Matching: The method used for matching (whether three points or one point) affects accuracy.

However, these errors typically do not account for the 1mm discrepancy observed in Dr. Nguyen’s case.


Actual Culprit in Dr. Nguyen’s Case

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Interestingly, the questioner himself revealed the actual culprit. An error occurred during the process of matching and merging, but it was due to user input error. This mistake falls under both the clinic and lab stages, emphasizing the importance of communication between the clinic and the lab to catch and address errors promptly.


Making Implant Prosthesis Using Scanbody

Here’s a detailed breakdown of each step to help avoid occlusal errors:

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Clinic Side

Step 1: Connect the Scanbody and Take an X-ray

  • Ensure the scanbody is correctly connected to the implant, securing it firmly but not overtightening.
  • Take an X-ray to verify no misfit between the scanbody and the implant.

Step 2: Scan the Scanbody

  • Choose the appropriate scanbody size and perform the scan meticulously to avoid any deformation.
  • Use the Medit software to register the scanbody specifications in advance for simultaneous matching during the scan.

Step 3: Send an Online Order to the Dental Lab

  • Fill out the online order form with precise details, including scanbody size and type. Attach necessary files such as X-rays and photographs to provide additional context to the lab.

Lab Side

Step 4: Review Scan Data and Confirm Information

  • The lab technician reviews the scan data to ensure it is complete and accurate. Any discrepancies or issues should be flagged immediately.
  • Match and merge the scanbody data carefully. Errors in this process can lead to significant occlusal discrepancies.
  • If any issues are detected during the matching process, the technician should communicate with the dentist promptly to resolve them before proceeding.

By following these steps meticulously and maintaining open lines of communication, you can significantly reduce the chances of occlusal errors in implant crowns.



Q2. Why does the Modeless crown not fit at all? How to overcome this?

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The second question deals with communication issues when making modeless crowns. Despite good scan data, prosthetics can sometimes end up being high in occlusion, leading to frustration and inefficiency. Identifying the cause through communication and striving for continuous quality improvement is essential.


Challenges and Solutions in Digital Dentistry

At Dr. Jang’s clinic, both in-house and outsourced labs are utilized. When he first introduced modeless crowns in 2019, he faced significant challenges, resulting in  frequent misfits with prosthetics. To overcome these challenges, Dr. Jang implemented a structured adaptation period.


One-Month Adaptation Period

Dr. Jang decided on a one-month adaptation period with the following strategies:

  1. Two Prosthetics for Each Case: Two prosthetics were made for each case in different styles. The better-fitting prosthesis was delivered to the patient, and feedback was provided to the lab.
  2. Thorough Documentation: Detailed evaluation criteria were documented in an Excel file, categorizing contact, margin, occlusion, shade, and fitting. These records were promptly sent to the lab after each delivery.

After a month, the prostheses started fitting well, thanks to thorough feedback.


Key Lessons Learned

From this adaptation period, Dr. Jang learned that:

  1. Mutual Communication is Essential: Expecting modeless crowns to fit well without communication is unrealistic.
  2. Active Communication Systems: Establishing a system that enables active communication is necessary.
  3. Utilizing Digital Tools: Simple A/B methods are effective, but leveraging smart digital tools can streamline the process and reduce the workload.


Checkpoints for Modeless Crowns: Dentist, Staff, Dental Technician

Checkpoints for Modelless Crowns

Effective communication involves clear checkpoints for each party involved in the process.

  1. Dentist:
    • Ensure optimal crown preparation.
    • Instruct staff to scan only when the best scanning environment is achieved.
  2. Staff:
    • Evaluate the scanning environment before starting. If not suitable, request help from the dentist.
    • Discuss scan results with the dentist and complete the scanning process.
  3. Dental Technician:
    • Promptly assess the scan data upon receiving the online request. If not appropriate, provide immediate feedback to the clinic.
    • Design the prosthesis in compliance with the request and confirm the design with the dentist.


Checkpoints in the Modeless Process

Checkpoints in the Modelless Process

  1. Before Starting Design: Confirm Margin Line (Medit Margin Line Creation)
    • Check the scan data in the lab and set the margin position immediately. Technicians should confirm the margin position on the same day of treatment for accuracy.
  2. During Design Process: Design Discussion & Check Internal Fit (ExoCAD Mobile & Medit Crown Fit)
    • After confirming margins, the crown design process begins. Confirm the final design to request adjustments and ensure the dentist’s opinion is reflected.
  3. After Delivery: Overall Evaluation
    • Evaluate the prosthesis on the day of delivery. Record any discrepancies and communicate them immediately to the technician. Immediate feedback helps correct issues for future cases.


Tips for Achieving a Well-Fitting Modeless Crown

Internal Fit Check (Medit Crown Fit)

Use software to check the internal value in advance. Scan the inner surface of the crown and match it with the scan data to visualize and correct discrepancies. Medit Crown Fit software provides a color-coded report indicating issues, helping to quickly identify causes such as incorrect preparation, inaccurate scans, or technician errors. After a few cases, the technician can set the exact internal fit value that matches the dentist’s preparation style.


By following these methods and ensuring clear communication, dentists can collaborate effectively with lab technicians to produce accurate prosthetics. If a modeless crown does not fit initially, work with the current lab to improve quality through the introduced communication methods before considering switching labs. This approach will lead to receiving satisfactory modeless crowns in a shorter time.



Q3. Can Medit Link be used to efficiently communicate with lab technicians?

The final question addresses how to effectively communicate with lab technicians through Medit Link. Sam from the Medit User Group inquired about sending photos and receiving replies via Medit Link and suggested the creation of a real-time communication portal.


Offline vs. Online Communication

Offline Vs Online Communication in Clinic

In Dr. Jang’s clinic, prosthetics are produced both in-house and outsourced. For in-house labs, the laboratory order form is written and delivered manually, ensuring direct communication with technicians. However, this method has drawbacks, such as lost cards and time-consuming sorting. Conversely, outsourced work often lacks open lines of communication for sufficient exchanges between the dentist and technician.


Digital Communication

Digital Communication

Based on Sam’s question, we discussed three essential aspects of communication in a digital environment:

  1. Online Lab Orders:
    • Good communication starts with a well-prepared lab request form, ideally including all necessary information, the dentist’s opinions, and detailed requirements.
    • Dr. Jang’s clinic uses a standardized lab request form, attached to Medit Link. Details like tooth number and accessory information are entered, ensuring accuracy and reducing mistakes. Specific preferences, such as whether to replace or create a custom abutment, are noted.
  2. Exchanging Opinions:
    • While messenger chats are commonly used, they have limitations, such as the lack of video communication.
    • Medit Link’s Case Talk platform allows real-time conversations with technicians while viewing scan data. Dr. Jang often uses ExoCAD’s remote meeting features, sharing screens for detailed discussions and allowing direct modifications to the design.
  3. Portal-like Platform:
    • Although it does not exist yet, Medit plans to create such a platform, incorporating structured communication at fixed checkpoints.
    • Proposed System by Dr. Jang : A Trello-like platform would allow users to see progress stages and leave comments, facilitating easier communication within busy schedules. This would help overcome the reluctance to communicate at necessary stages, ensuring continuous updates and feedback.


Establishing a comprehensive communication system can significantly improve the quality of prosthetics produced, whether in-house or outsourced. By utilizing Medit Link and other digital tools, dentists can streamline communication with lab technicians, enhancing efficiency and accuracy.



The June Q&A session provided an in-depth look at enhancing communication in digital dentistry. From addressing the causes of implant crown occlusal errors to overcoming fit issues with modeless crowns and utilizing Medit Link for efficient lab communication, the session offered valuable, actionable insights.


Join us next month as we tackle more questions and challenges from our Medit User Group, continuing to improve our clinical practices together!


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