All on x

1. Pre-surgical Waxup

Pontic Waxup
Dentate Arch
 INTRODUCTION

Never Look Back.

Go all in from day one. Master the best. Never look back. This is the most powerful, scalable, and future-proof work ow in digital We encourage clinicians to embrace in-house design—not to replace lab
dentistry. exocad is the industry gold standard—globally adopted, technicians, but to elevate collaboration. When you understand design,
At The MOD Institute, this philosophy drives everything we do. We packed with online education, and backed by a vibrant community. you understand what’s possible—and you gain a profound respect for
believe every dental o ce deserves the knowledge and tools to From single crowns to complex full-arch rehabs, it evolves with you. the artistry of lab technicians.
bring design and printing in-house—unlocking unprecedented
e ciency, breaking barriers, and empowering same-day dentistry exocad Ultimate + a high-performance 3D printer = $25K. Better yet, exocad’s DentalShare and WebView tools allow for real-time
for all. collaboration with expert technicians around the world. You can handle
This is a full-blown same-day dentistry setup—no compromises. You’ll in-house what makes sense, and easily outsource what doesn’t—
The work ows taught in this master guide aren’t just helpful— be designing, printing, curing, and delivering high-quality restorations in creating a seamless hybrid work ow that enhances both e ciency and
they’re practice-transforming. They’ll reignite your passion for a matter of hours. Everything from single units and dentures to same- quality.
dentistry and open doors to deliver care that’s faster, more day All-on-X provisionals—done in-o ce, on your terms.
a ordable, and more accessible than ever before.
The best part? As your skills grow, your tools grow with you. exocad’s
Happy Designing,
Let’s be real: you only have time in your career to master one modular system means the design principles you learn today apply
design software. So why waste it on clunky, outdated platforms seamlessly to more advanced work ows tomorrow. It’s not just learning
that don’t grow with you? These “free” or budget options may seem software—it’s building a foundation for every future restoration you’ll
appealing, but they come at the highest cost—your time and your do.
future. They stall growth, drain productivity, and lock you into
limitations. One of the worst decisions you can make is investing This guide is your blueprint. It walks you through the most common,
hundreds of hours into tools that cap your potential. high-impact cases you’ll encounter and provides your team with a clear, Dr. Wally Renne & The MOD Team
repeatable roadmap to success.
Instead, go all in on the best: exocad + 3D Printing.

Copyright © 2025 The MOD Institute

Published by WRMDSV I LLC, in the United States of America. First Publication April, 2025 Front cover image by Dr. Wally Renne. Supporting images by Dr. Michael DeFee and Dr.
Queiroz. Names, places, products and events are the sole opinion of the author.
All rights reserved. All rights reserved. This book or any portion thereof may not be reproduced 320 Broad St. #210
or used in any manner whatsoever without the express written permission of the publisher Charleston, SC 29401
except for the use of brief quotations in a book review. USA
www.themodinstitute.com
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exocad MASTER GUIDE

ONLINE LEARNING

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39 LESSONS | 24 CE CREDITS | 33 RESOURCES

T he essential series for clinician-led exocad design. From crowns to bite guards to bridges, implants
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Table of Contents
1. exocad Foundations 2. exocad Smile
01 AI Crown Design 1 Design & Veneers
02 Inlays & Onlays 68 01 Direct Print Mockup with AI 1
03 AI Implant Crown Designs 113 02 Direct Print Mockup without AI 165
04 Adhesion Bridge Design 160 03 Conversion to Final Veneers 308
05 Immediate Adhesion Bridge Design 214 04 Conversion to Mockup Model 336
06 AI Guard Design 272
07 Monolithic Partial Design 351
08 Split File Partial Design 436

exocad MASTER GUIDE

Table of Contents
3. exocad Full Mouth 4. exocad All on X
Restorations 01 Dentate Single Arch Waxup 1

01 Ultra Fast Temps 5 02 Anatomic Waxup 101

02 Case Duplication Techniques 47 03 Pontic Waxup Day Of 179

03 Face Scan Mounting 155 04 Conversion: Edentulous Arch 269

04 CBCT Mounting 191

05 Pre-Surgical Waxup: Dual Arch 352
06 Universal Method: Day of Surgery 465
07 Using a Scanned Denture 605
08 Bar Design: Convert to Split File 696
09 iCam Day of Surgery 806

exocad MASTER GUIDE

Table of Contents
5. exocad Dentures
01 Denture Settings 1
02 Copy Denture 19
03 Renewed Copy Denture 100
04 Merge IOS to Denture and Photos 183
05 Use Face Scans 291
06 MOD Denture Record System 392
07 Digital Denture Rebase 483
08 Immediate Denture: Natural Teeth 515
09 Immediate Denture: Library Teeth 593

exocad MASTER GUIDE

 All on x

1. Pre-surgical Waxup

1

Pontic Waxup
Dentate Arch

< TABLE OF CONTENTS exocad MASTER GUIDE

Table of Contents
01 AI Crown Design 1
02 Inlays and Onlays 68
03 AI Implant Crown Designs 113
04 Adhesion Bridge Design 160
05 Immediate Adhesion Bridge Design 214
06 AI Guard Design 272
07 Monolithic Partial Design 351
08 Split File Partial Design 436

< TABLE OF CONTENTS exocad MASTER GUIDE

 FO U N DAT I O N S

AI Crown Design

1 | exocad FOUNDATIONS < TABLE OF CONTENTS

 1 . Open Dental DB
AI features are only
available in some regions
and on exocad 3.2-9 or
later.

2 | exocad FOUNDATIONS
 2 . Click “Default Client”
Select Here.

3 | exocad FOUNDATIONS
 3 . Click “Default Client”
Select “Default Client” in
the drop down menu.

4 | exocad FOUNDATIONS
 4 . Enter Patient Name
Enter the patient’s name
in the type field.

5 | exocad FOUNDATIONS
 5 . Click Settings
Click this icon to access
the settings.

6 | exocad FOUNDATIONS
 6 . Click Here
Select settings in the drop
down menu.

7 | exocad FOUNDATIONS
 7 . Click “Cloud”
Select the cloud tab.

8 | exocad FOUNDATIONS
 8 . Turn On AI Crown
Toggle this setting to the
on position.

9 | exocad FOUNDATIONS
 9 . Save
Save the settings that you
have adjusted.

10 | e x o c a d F O U N D A T I O N S
10 . Select the Tooth
Select the tooth that you are
creating the crown for.

11 | e x o c a d F O U N D A T I O N S
 11 . Click “Anatomic Crown”
Select the “Atomic Crown”
option.

12 | e x o c a d F O U N D A T I O N S
12 . Select “3D Print”
Click on the “3D Print” box
option.

13 | e x o c a d F O U N D A T I O N S
13 . Set the AI Settings
This only needs to be done
once. The settings will be
remembered and tied the
client.

14 | e x o c a d F O U N D A T I O N S
14 . Crown Margin Settings
Horizontal crown margin
0.1mm.

Angled crown margin 0.1mm.

15 | e x o c a d F O U N D A T I O N S
15 . AI Distance
AI Distance to antagonist
0.2mm

16 | e x o c a d F O U N D A T I O N S
16 . AI Distance
Distance to Neighbor should
be set to 0mm

17 | e x o c a d F O U N D A T I O N S
17 . AI Settings
0.9 Crown Details.

18 | e x o c a d F O U N D A T I O N S
18 . Cement Gap
Set the beginning of cement
gap 0.3mm.

19 | e x o c a d F O U N D A T I O N S
19 . Final Look
Make sure that your settings
match these:

20 | e x o c a d F O U N D A T I O N S
20 . Click “OK”
Click “OK” to move to the
next step.

21 | e x o c a d F O U N D A T I O N S
21 . Click “Save”
Click “Save” here.

22 | e x o c a d F O U N D A T I O N S
22 . Click “Design”
Click the “Design” button
here.

23 | e x o c a d F O U N D A T I O N S
23 . Load Scans
The software will indicate
what arch it wants first by the
text box in the upper left
corner of the screen.

24 | e x o c a d F O U N D A T I O N S
24 . Check Settings: Click “Tools”
Let’s check your settings for
design before doing anything.
This only needs to one
checked once. Click tools.

25 | e x o c a d F O U N D A T I O N S
25 . Click “Settings”
Click settings here.

26 | e x o c a d F O U N D A T I O N S
26 . Turn Simple Design On
Toggle this setting to on.

27 | e x o c a d F O U N D A T I O N S
27 . Design Workflows
Make sure that your settings
match these:

28 | e x o c a d F O U N D A T I O N S
28 . System Confirguration
Click “System Configuration”

29 | e x o c a d F O U N D A T I O N S
29 . HD
Select your favorite library.

30 | e x o c a d F O U N D A T I O N S
30 . Add-On Modules
Click on the “Add-on
Modules” tab.

31 | e x o c a d F O U N D A T I O N S
31 . Auto Articulation
I like Skull Articulator. Make
sure to select use auto
articulator.

32 | e x o c a d F O U N D A T I O N S
32 . TruSmile
Select “TruSmile on Start”.

33 | e x o c a d F O U N D A T I O N S
33 . Settings
Make your settings match
these:

34 | e x o c a d F O U N D A T I O N S
34 . Cloud
Click on the “Cloud” tab.

35 | e x o c a d F O U N D A T I O N S
35 . Enable Cloud Features
Make your settings match
these:

36 | e x o c a d F O U N D A T I O N S
36 . Enable Cloud Features
Make your settings match
these:

37 | e x o c a d F O U N D A T I O N S
37 . Save
Save your settings.

38 | e x o c a d F O U N D A T I O N S
38 . You Have to Restart
For all your new settings to
work, you need to restart the
software. Just exit and then
go back to design.

39 | e x o c a d F O U N D A T I O N S
39 . Don’t Save
Select “Do not save”.

40 | e x o c a d F O U N D A T I O N S
40 . Back to Design
Select the “Design” tab.

41 | e x o c a d F O U N D A T I O N S
41 . Reload Models
Reload the models now.

42 | e x o c a d F O U N D A T I O N S
42 . Orientation
Right click to rotate model.
Look staring down long axis
of the crown prep as if the
crown is being delivered on
the tooth.

43 | e x o c a d F O U N D A T I O N S
43 . Click “Next”
Click the “Next” button.

44 | e x o c a d F O U N D A T I O N S
44 . Confirm Parameters
Confirm the parameters.

45 | e x o c a d F O U N D A T I O N S
45 . Settings
These are the settings that I
use for printing.

46 | e x o c a d F O U N D A T I O N S
46 . Click “Request Cloud Calculation”
Click the “Request Cloud
Calculation Solution.

47 | e x o c a d F O U N D A T I O N S
47 . Wait 90 Seconds
Wait for the calculated time.

48 | e x o c a d F O U N D A T I O N S
48 . Click Here
Select the rating for the
crowns.

49 | e x o c a d F O U N D A T I O N S
49 . Click “Happy” and Continue
Select “I am happy with the
result- continue with fast
workflow”.

50 | e x o c a d F O U N D A T I O N S
50 . Hit “Next”
Select the “Next” button.

51 | e x o c a d F O U N D A T I O N S
51 . Click Margin
Depending on the retraction
level this can be one click or
may require up top 8 clicks.

52 | e x o c a d F O U N D A T I O N S
52 . Click Margin
I tend to select the 4 line
angles.

53 | e x o c a d F O U N D A T I O N S
53 . Click Margin
I tend to select 4 line angles.

54 | e x o c a d F O U N D A T I O N S
54 . Click Margin
I tend to select the 4 line
angles.

55 | e x o c a d F O U N D A T I O N S
55 . Click Open Areas
Click the areas that it missed.

56 | e x o c a d F O U N D A T I O N S
56 . Click “Correct/Draw”
Click “Correct/Draw”.

57 | e x o c a d F O U N D A T I O N S
57 . Drag Margin
Fine-tune by dragging the
margin line.

58 | e x o c a d F O U N D A T I O N S
58 . Turn Off Color
Turning off the color can be
helpful.

59 | e x o c a d F O U N D A T I O N S
59 . Finalize Margin
Fine-tune.

60 | e x o c a d F O U N D A T I O N S
60 . Finalize Margin
Fine-tune.

61 | e x o c a d F O U N D A T I O N S
61 . Click “Next”
Click the “Next” button.

62 | e x o c a d F O U N D A T I O N S
62 . Click “Next”
Software will auto calculate
best path of insertion. You
can change it if needed by
rotating model and hitting set
from view.

63 | e x o c a d F O U N D A T I O N S
63 . Watch Auto-Articulation
If you hit “A” on the keyboard
for antagonist you can toggle
on and off the opposing arch
and you should see dynamic
movement.

64 | e x o c a d F O U N D A T I O N S
64 . Watch Auto-Articulation
If you hit “A” on the keyboard
for antagonist you can toggle
on and off the opposing arch
and you should see dynamic
movement.

65 | e x o c a d F O U N D A T I O N S
65 . Check Colors
The software automatically
adapts occlusion and
Proximal contacts. Occlusion
should be blue, proximal teal.
Use tools if need to edit.
Then hit “next”.

66 | e x o c a d F O U N D A T I O N S
66 . You Are Done
You have completed your AI
Crown Design.

67 | e x o c a d F O U N D A T I O N S
 FO U N DAT I O N S

Inlays and Onlays

68 | e x o c a d F O U N D A T I O N S < TABLE OF CONTENTS

 1 . Select Client
Select your client from the
drop-down menu. I usually
select “default”.

69 | e x o c a d F O U N D A T I O N S
 2 . Add Patient Name
Type in the patient name in
the text field.

70 | e x o c a d F O U N D A T I O N S
 3 . Click Tooth
Click the tooth you will be
working on.

71 | e x o c a d F O U N D A T I O N S
 4 . Click “Inlay/Onlay”
Click the “Inlay/ Onlay”
button.

72 | e x o c a d F O U N D A T I O N S
 5 . Click “3D Print”
Click the “3D Print” button.

73 | e x o c a d F O U N D A T I O N S
 6 . Change Gap to 0.1 mm
Change the gap to 0.1 mm.

74 | e x o c a d F O U N D A T I O N S
 7 . Change to 1.7 mm
Border taper is how soon the
minimum thickness occurs
from the margin line and if
left default you often get that
unsightly material hump at
the margin.

75 | e x o c a d F O U N D A T I O N S
 8 . Beginning of Gap: 0.2 mm
This represents the area on
the margin that will be
closed. The smaller the
number here the easier the
onlay is to seat.

76 | e x o c a d F O U N D A T I O N S
 9 . Click “OK”
Click “OK”.

77 | e x o c a d F O U N D A T I O N S
10 . Click “Save”
Click “Save”.

78 | e x o c a d F O U N D A T I O N S
 11 . Click “Design”
Click “Design”.

79 | e x o c a d F O U N D A T I O N S
12 . Load Scans
Load the scans.

80 | e x o c a d F O U N D A T I O N S
13 . Rotate Orientation
Rotate the orientation.

81 | e x o c a d F O U N D A T I O N S
14 . Select Margin
You must click at least 4
spots on the margin. I usually
click more than 4. Pick line
angles and corners.

82 | e x o c a d F O U N D A T I O N S
15 . Margin
You must click at least 4
spots on the margin. I usually
click more than 4. Pick line
angles and corners.

83 | e x o c a d F O U N D A T I O N S
16 . Keep Selecting Margin
Keep selecting the margin.

84 | e x o c a d F O U N D A T I O N S
17 . Keep Selecting Margin
You must click at least 4
spots on the margin. I usually
click more than 4. Pick line
angles and corners.

85 | e x o c a d F O U N D A T I O N S
18 . Fine-Tune
Once 4 are clicked it will
attempt a margin line. You
can keep adding more to help
it. If you have a dot you don’t
like simply left-click and hold
then also right-click to
delete.

86 | e x o c a d F O U N D A T I O N S
19 . Correct
To perfect the margin hit
correct/draw.

87 | e x o c a d F O U N D A T I O N S
20 . Correct
Click the green margin line or
ball to drag and perfect the
margin.

88 | e x o c a d F O U N D A T I O N S
21 . Next
Click “Next”.

89 | e x o c a d F O U N D A T I O N S
22 . Insertion
The software attempts to
detect an insertion direction.
Often it needs to be fixed.
Rotate the model and look for
colors that indicate
undercuts.

90 | e x o c a d F O U N D A T I O N S
23 . Click Here
Here we can see the intense
undercuts shown by the
colors in the automatic
insertion direction. This
needs to be minimized.

91 | e x o c a d F O U N D A T I O N S
24 . Rotate
Rotate the entire model to a
better path of insertion. As if
the restoration was going to
drop out of the screen and
fall into the prep. That is the
angle you want.

92 | e x o c a d F O U N D A T I O N S
25 . Set From View
After rotating to the ideal
path of insertion hit set from
view.

93 | e x o c a d F O U N D A T I O N S
26 . Verify
At the new insertion direction
make sure no colors are on a
margin. The software will
block out undercuts up to
1mm except at a margin. If
you have undercuts on a
margin try another angle or
reprep the tooth.

94 | e x o c a d F O U N D A T I O N S
27 . Next
Hit “Next”.

95 | e x o c a d F O U N D A T I O N S
28 . Adjacent Teeth
The software automatically
identifies the adjacent teeth.
Sometimes when scanning
with a rubber dam exocad
will confuse the mesial and
distal. This can be corrected
easily by hitting this button.

96 | e x o c a d F O U N D A T I O N S
29 . Place Tooth
The software automatically
places a tooth where it thinks
it belongs.

97 | e x o c a d F O U N D A T I O N S
30 . Fine-Tune
Many tools exist to perfect
this. Click the tooth to move
it, control and click rotate,
shift to scale.

98 | e x o c a d F O U N D A T I O N S
31 . Morph
You can morph a cusp of area
by selecting this icon

99 | e x o c a d F O U N D A T I O N S
32 . Morph
Click and drag cusps and
marginal ridges if needed.

100 | e x o c a d F O U N D A T I O N S
33 . Morph
Click and drag cusps and
marginal ridges if needed

101 | e x o c a d F O U N D A T I O N S
34 . Next
Click “Next”.

102 | e x o c a d F O U N D A T I O N S
35 . Smooth
One of the few tools I use in
this stage is Free-Smooth. I
use it at the emergence of the
inter proximal gingival
embrasure.

103 | e x o c a d F O U N D A T I O N S
36 . Get Out of Free-Form
Get out of free-form.

104 | e x o c a d F O U N D A T I O N S
37 . Check Contacts
Hit “S” on the keyboard to
remove the scan. Check
proximal contacts. They
should be teal if you have the
color map set to “contact
areas” not “interference
contacts”. You may need to
smooth them, add or remove
material as needed. You can
hit “Cut all intersections”
again to refine.

105 | e x o c a d F O U N D A T I O N S
38 . Remove Bad Contacts
The occlusal contacts should
be true blue. If you have a
bad location of a contact use
the remove tool by selecting
free- add/remove and holding
shift to remove. Make your
brush small so you do not
deform your onlay.

106 | e x o c a d F O U N D A T I O N S
39 . Remove Bad Contacts
Here I have a contract on an
incline plane I need to
remove. I only want contacts
on horizontal flat surfaces. I
hold shift on the keyboard
and click to remove.

107 | e x o c a d F O U N D A T I O N S
40 . Hit “Next”
Hit “Next”.

108 | e x o c a d F O U N D A T I O N S
41 . Export
Export now.

109 | e x o c a d F O U N D A T I O N S
42 . Save Scene As
Hit “Save Scene As”.

110 | e x o c a d F O U N D A T I O N S
43 . Save the STL
Save the STL.

111 | e x o c a d F O U N D A T I O N S
44 . Visible Objects Only: Default Orientation
Visible objects only: Default
Orientation.

You are now done.

112 | e x o c a d F O U N D A T I O N S
 FO U N DAT I O N S

AI-Assisted Implant Crown

113 | e x o c a d F O U N D A T I O N S < TABLE OF CONTENTS

 1 . Open Dental DB
Open Dental DB to begin.

114 | e x o c a d F O U N D A T I O N S
 2 . Select the Client
Select “Default” under
client selection.

115 | e x o c a d F O U N D A T I O N S
 3 . Type Patient Name
Type in the patient name.

116 | e x o c a d F O U N D A T I O N S
 4 . Select the Implant Site
Select the tooth number
for your implant site.

117 | e x o c a d F O U N D A T I O N S
 5 . Anatomic Crown
Select the “Anatomic
Crown” button.

118 | e x o c a d F O U N D A T I O N S
 6 . 3D Print
Select “3D Print”.

119 | e x o c a d F O U N D A T I O N S
 7 . Screw Retained
Click the “screw-retained”
button.

120 | e x o c a d F O U N D A T I O N S
 8 . Scan Body Scan
If you have a soft tissue
scan and a scan body scan
you will select scan body
scan. If you only have a
scan body scan and no
soft tissue scan you will
select “Scan Body in Main
Scan”. Once selected hit
OK at the bottom right
corner of the screen.

121 | e x o c a d F O U N D A T I O N S
 9 . Click “Save”
Click the “Save” Button

122 | e x o c a d F O U N D A T I O N S
10 . Click “Design”
Click the “Design” button.

123 | e x o c a d F O U N D A T I O N S
 11 . Load Your Files
Please note that the software
asks you for very specific
files in a certain order. The
type of the file it wants is
indicated in the top left hand
corner text box.

You will need a

1) Soft tissue scan

2) Scanbody scan

3) Antagonist

124 | e x o c a d F O U N D A T I O N S
12 . Orientation
Right-click to rotate the
model so that you are looking
straight down the occlusal
plane as shown. Then hit
“next”.

125 | e x o c a d F O U N D A T I O N S
13 . Click “Request Cloud Calculation”
Click the “Request Cloud
Calculation” button.

126 | e x o c a d F O U N D A T I O N S
14 . Wait 90 Seconds
Wait for the calculated
upload time.

127 | e x o c a d F O U N D A T I O N S
15 . Click the Check Mark
If happy with the initial
proposal hit the check box.

128 | e x o c a d F O U N D A T I O N S
16 . Click “Next”
Click the “Next” Button.

129 | e x o c a d F O U N D A T I O N S
17 . Find the Brand of Your Scan Body
Find and select the brand of
your Scan Body.

130 | e x o c a d F O U N D A T I O N S
18 . Find the Brand of Your Scan Body
The scan body you choose to
scan with is very important.
Some are locked down and
don’t let you do creative
workflows. Research this
carefully before selecting a
scan body to purchase and
scan with. I like TruAbutment.

131 | e x o c a d F O U N D A T I O N S
19 . Select Ti-Base Type
Select the Ti-Base Type from
the drop-down menu.

132 | e x o c a d F O U N D A T I O N S
20 . Select the Cement Gap
Select the cement gap from
the drop-down menu.

133 | e x o c a d F O U N D A T I O N S
21 . Select Scan Body Exposure
Look at how much tissue is
covering the apical portion of
your scan body.

134 | e x o c a d F O U N D A T I O N S
22 . Select Scan Body Exposure
Drag the little slider to
virtually slice the scan body
to mimic the amount exposed
in the intraoral scan. Please
note just a best guess
estimate is fine.

135 | e x o c a d F O U N D A T I O N S
23 . Select Scan Body Exposure
Drag the little slider to
virtually slice the scan body
to mimic the amount exposed
in the intraoral scan. Please
note just a best guess
estimate is fine.

136 | e x o c a d F O U N D A T I O N S
24 . Match the Scan Body
You should see a red dot on
the virtual scan body in the
lower left windo. Left-click
the intraoral scan of the scan
body in the same spot.

137 | e x o c a d F O U N D A T I O N S
25 . Check Accuracy
You should have a color map
of the colors of the accuracy
of the merge. If you don’t it is
a problem with your settings.
You can hold control on the
keyboard and recalculate and
you can see the colors. Blue
and green are really good.
Avoid a lot of pink at the flat
top of the scan body. If you
see this, trim the virtual scan
body and try again.

138 | e x o c a d F O U N D A T I O N S
26 . Hit “Next”
Hit the “Next” Button.

139 | e x o c a d F O U N D A T I O N S
27 . Define the Emergence Profile
This is an optional step I
often skip and hit next. It is a
step where you can draw the
subcritical contour line on the
gingiva. This may be helpful
to copy a perfectly healed
and sculpted tissue site. Even
though I have a nice tissue
sculpting here I still opted to
skip this step.

140 | e x o c a d F O U N D A T I O N S
28 . Abutment Bottom
This is an optional step where
you can sculpt the subcritical
contour, change the shape,
and alter the emergence
profile. I skipped this step in
favor of free forming in the
next tab. You may want to
explore this step and become
familiar with it.

141 | e x o c a d F O U N D A T I O N S
29 . Free-Forming
This step I have my software
set to automatically mount
the case and do dynamic
articulation in addition it
automatically cuts static
occlusion and proximal
contacts to be perfect.

142 | e x o c a d F O U N D A T I O N S
30 . Free-Smooth
Select the “Smooth/Free”
button.

143 | e x o c a d F O U N D A T I O N S
31 . Smooth Subcritical Contours
Hide the scan by selecting the
eye icon on the top left object
browser. Then smooth and
sculpt your gingival contours.

144 | e x o c a d F O U N D A T I O N S
32 . Click Tissue Pressure
Turn on “show distances” if it
is off.

145 | e x o c a d F O U N D A T I O N S
33 . Change Type
Hi the small chevron shown
here.

146 | e x o c a d F O U N D A T I O N S
34 . Distance to Scan Data
Change to “Distance to Scan
Data”.

147 | e x o c a d F O U N D A T I O N S
35 . Change Scale
Slide the left ball all the way
to the left.

148 | e x o c a d F O U N D A T I O N S
36 . Click Nearest Point Distance
Check the “Nearest Point
Distance” box.

149 | e x o c a d F O U N D A T I O N S
37 . Click Here
Click here on the slider.

150 | e x o c a d F O U N D A T I O N S
38 . Change Max Color Scale to 0.6mm
Change the max color scale
to 0.6mm as shown here.

151 | e x o c a d F O U N D A T I O N S
39 . Sculpt Pressure
Add your “add/remove” and
“smooth/flatten” tools to add
or relieve tissue pressure.
Remeber that hitting SHIFT
on the keyboard togges
between the tool features.
Try to maintain a smooth,
cleanable surface.

152 | e x o c a d F O U N D A T I O N S
40 . Check Contact Areas
Change the scale back to
show contact areas.

153 | e x o c a d F O U N D A T I O N S
41 . Check Proximal Contact
Proximal contact should be
teal. Use add remove and
smooth flatten to adjust size
and strength.

154 | e x o c a d F O U N D A T I O N S
42 . Remove Interferences
If this pops up, hit the
“Remove Interferences”
option.

155 | e x o c a d F O U N D A T I O N S
43 . Click “Next”
Click the “Next” button.

156 | e x o c a d F O U N D A T I O N S
44 . Screw Channel
There is nothing to do here
except for hit “next”.

157 | e x o c a d F O U N D A T I O N S
45 . Export
Turn on only the finished
restoration file and right click
the screen, save scene as,
STL, visible objects only.
Default orientation.

158 | e x o c a d F O U N D A T I O N S
46 . All Done!
You have completed your AI
Assisted Implant Crown.

159 | e x o c a d F O U N D A T I O N S
 FO U N DAT I O N S

Adhesion Bridges

160 | e x o c a d F O U N D A T I O N S < TABLE OF CONTENTS

 1 . Open Dental DB
Click on “Dental DB”.

161 | e x o c a d F O U N D A T I O N S
 2 . Default Client
Select “Default Client”.

162 | e x o c a d F O U N D A T I O N S
 3 . Enter Name
Enter the patient name here.

163 | e x o c a d F O U N D A T I O N S
 4 . Click Tooth
Click the tooth of your
restoration.

164 | e x o c a d F O U N D A T I O N S
 5 . Click “Anatomic Pontic”
Click the “Anatomic Pontic”
button.

165 | e x o c a d F O U N D A T I O N S
 6 . Click “3D Print”
Select “3D Print”.

166 | e x o c a d F O U N D A T I O N S
 7 . Copy Mirror if Applicable
Click the “Copy or mirror”
button if applicable.

167 | e x o c a d F O U N D A T I O N S
 8 . Click “Virtual Gingiva”
We use virtual gingiva as the
wings of the prosthetic.

168 | e x o c a d F O U N D A T I O N S
 9 . Click “OK”
Click the “OK” button.

169 | e x o c a d F O U N D A T I O N S
10 . Click “Save”
Click the “Save” button.

170 | e x o c a d F O U N D A T I O N S
 11 . Click “Design”
Click the “Design” button.

171 | e x o c a d F O U N D A T I O N S
12 . Load Files
Load the files.

172 | e x o c a d F O U N D A T I O N S
13 . Rotate and Hit “Next”
Rotate to the occlusal view
and hit “next”. It is important
to have a good top-down
orientation.

173 | e x o c a d F O U N D A T I O N S
14 . Click “Mirror” and “Direct Copy”
This option will automatically
pop up if you selected copy
mirror in the dental DB
prescription. It is always
available in expert mode by
right clicking the model if
you forgot to select it.

174 | e x o c a d F O U N D A T I O N S
15 . Click Center of the Tooth
For anteriors click the center
of the tooth you want to
mirror.

175 | e x o c a d F O U N D A T I O N S
16 . Click the Space
Movee the mouse over the
endentulous space and click
the ridge.

176 | e x o c a d F O U N D A T I O N S
17 . Fine-Tune the Tooth Position
Left click to move the tooth,
control and click to rotate
and shift click to resize.

177 | e x o c a d F O U N D A T I O N S
18 . Click “Next”
Once the tooth is in the
correct position click next

178 | e x o c a d F O U N D A T I O N S
19 . Free-Form
Free-form step.

179 | e x o c a d F O U N D A T I O N S
20 . Click “Cut all intersections”
You should not have to do
much here except cut all
interactions. If you don’t lie
the position of the tooth you
should have spent more time
in the previous step.

180 | e x o c a d F O U N D A T I O N S
21 . Click “Next”
Click the “Next” button.

181 | e x o c a d F O U N D A T I O N S
22 . Select Insertion
Rotate the model to the path
of insertion of the Maryland
bridge. Usually a slight
lingual-rotation.

182 | e x o c a d F O U N D A T I O N S
23 . Select Insertion
Select Insertion.

183 | e x o c a d F O U N D A T I O N S
24 . Click
Click “Insertion direction
from view”.

184 | e x o c a d F O U N D A T I O N S
25 . Click “Next”
Click the “Next” button.

185 | e x o c a d F O U N D A T I O N S
26 . Draw Wings
Here we draw the wings.
Default 1mm thick for the
wings is perfect.

186 | e x o c a d F O U N D A T I O N S
27 . Draw Wings
Click “A” on the keyboard to
turn on antagonist.

187 | e x o c a d F O U N D A T I O N S
28 . Draw Wings
Continue to draw wings.

188 | e x o c a d F O U N D A T I O N S
29 . Draw Wings
Continue to draw wings.

189 | e x o c a d F O U N D A T I O N S
30 . Draw Guide Planes
Turn off the tooth by hitting
“F” on the keyboard. Then
draw your guidelines.

190 | e x o c a d F O U N D A T I O N S
31 . Draw Guide Planes
Usually perfectly mid
proximal for the guideline.
You can extend more facial
for better retention but will
sacrifice some esthetics.

191 | e x o c a d F O U N D A T I O N S
32 . Draw Tissue Area
Draw the tissue area.

192 | e x o c a d F O U N D A T I O N S
33 . Tissue Area
Typically, center of the ridge.

193 | e x o c a d F O U N D A T I O N S
34 . Second Guide Plane
For 3D Printed adhesion
bridges, I like 2 wings.

For porcelain, metal and

zirconia, I do 1 wing.

194 | e x o c a d F O U N D A T I O N S
35 . Close the Margin
Double click on first ball to
seal the margin.

195 | e x o c a d F O U N D A T I O N S
36 . Tissue is Done
The tissue is now complete.

196 | e x o c a d F O U N D A T I O N S
37 . Turn on Tooth
Click “F” on the keyboard to
turn the tooth back on.

197 | e x o c a d F O U N D A T I O N S
38 . Click “Next”
Please note if you wanted to
move the margin just drag a
green ball and hit apply to
change it.

198 | e x o c a d F O U N D A T I O N S
39 . Click “Next”
I do nothing here. Hit “Next”.

199 | e x o c a d F O U N D A T I O N S
40 . Almost Done
We have to make this
cleanable and smooth.

200 | e x o c a d F O U N D A T I O N S
41 . Click ‘Free-Form”
Click the “Free-Form”
button.

201 | e x o c a d F O U N D A T I O N S
42 . Click “Next”
Click the “Next” button.

202 | e x o c a d F O U N D A T I O N S
43 . Click “Free”
Click the “Free” tab.

203 | e x o c a d F O U N D A T I O N S
44 . Click “Smooth/Flatten”
Click the “Smooth/Flatten”
button.

204 | e x o c a d F O U N D A T I O N S
45 . Smooth Pontic
Ovate are the best. Make sure
that there are no cavities. DO
NOT tocuh the wings or the
proximal contact. You will
mess the fit up.

205 | e x o c a d F O U N D A T I O N S
46 . Open Floss Space
Open a channel for floss
threaders. Use small brush.

206 | e x o c a d F O U N D A T I O N S
47 . Click Pane
Click pane.

207 | e x o c a d F O U N D A T I O N S
48 . Open a Small Channel
Open a small channel.

208 | e x o c a d F O U N D A T I O N S
49 . Open a Small Channel
Open a small channel.

209 | e x o c a d F O U N D A T I O N S
50 . Open a Small Channel
Open a small channel.

210 | e x o c a d F O U N D A T I O N S
51 . Click Tissue Pressure
You can also click distance to
scan data and hit nearest
point distance to see the
exact tissue pressure.

211 | e x o c a d F O U N D A T I O N S
52 . Click “Next”
Hit the “Next” button.

212 | e x o c a d F O U N D A T I O N S
53 . You Are Done
You have completed your
Adhesion Bridge.

213 | e x o c a d F O U N D A T I O N S
 FO U N DAT I O N S

Immediate Adhesion Bridges

214 | e x o c a d F O U N D A T I O N S < TABLE OF CONTENTS

 1 . Click “Default Client”
Select “default client from the
drop down menu”.

215 | e x o c a d F O U N D A T I O N S
 2 . Enter Name
Enter the patient name.

216 | e x o c a d F O U N D A T I O N S
 3 . Click Tooth
Click the tooth you will be
extracting and needing a
adhesion bridge for.

217 | e x o c a d F O U N D A T I O N S
 4 . Click “Anatomic Pontic”
Select “Anatomic Pontic”.

218 | e x o c a d F O U N D A T I O N S
 5 . Click “3D Print”
Select the “3D Print” options.

219 | e x o c a d F O U N D A T I O N S
 6 . Click “Virtual Gingiva”
Select the “Virtual Gingiva”
option.

220 | e x o c a d F O U N D A T I O N S
 7 . Click “Virtual Extraction”
Click “virtual gingiva” for the
wings

Click “yes” under virtual

extraction so we can extract
in wizard mode.

Then, click “ok”

221 | e x o c a d F O U N D A T I O N S
 8 . Click “Save”
Click the “Save” button.

222 | e x o c a d F O U N D A T I O N S
 9 . Click “Design”
Click the “Design” button.

223 | e x o c a d F O U N D A T I O N S
10 . Load Files
Load your files now.

224 | e x o c a d F O U N D A T I O N S
 11 . Rotate the Model
Rotate the model to the
occlusal view and hit “next”.

225 | e x o c a d F O U N D A T I O N S
12 . Click Tooth
Click the tooth you want to
extract. For anteriors I like to
click straight facial.

226 | e x o c a d F O U N D A T I O N S
13 . Evaluate the Socket
Evaluate the socket.

227 | e x o c a d F O U N D A T I O N S
14 . Adjust Socket Angle
Click the ball at the top of the
arrow and move the arrow to
the angle of the long axis of
the tooth. This sets the
extraction socket angle.

228 | e x o c a d F O U N D A T I O N S
15 . Check Socket Depth
You can alter the depth of the
socket by dragging the slider.

229 | e x o c a d F O U N D A T I O N S
16 . Move Slider
Move the slider.

230 | e x o c a d F O U N D A T I O N S
17 . 1-2 mm is Ideal
1 -2 mm is ideal.

231 | e x o c a d F O U N D A T I O N S
18 . Click “Next”
Click the “Next” button.

232 | e x o c a d F O U N D A T I O N S
19 . Free-Form
Free-forming step.

233 | e x o c a d F O U N D A T I O N S
20 . Click “Cut All”
Cut all intersections will
adjust the proximal, occlusion
and pontic pressure to ideal.

234 | e x o c a d F O U N D A T I O N S
21 . Click “Next”
Click the “Next” button.

235 | e x o c a d F O U N D A T I O N S
22 . Rotate to Path of Insertion
Rote slight lingual view.

236 | e x o c a d F O U N D A T I O N S
23 . Click “Set Insertion Direction”
Click “Set Insertion Direction
from View”.

237 | e x o c a d F O U N D A T I O N S
24 . Click “Next”
Click the “Next” button.

238 | e x o c a d F O U N D A T I O N S
25 . Draw Margin
Hit “A” for antagonist. Click
to start drawing your wing
margins.

239 | e x o c a d F O U N D A T I O N S
26 . Draw Wings
Draw wings.

240 | e x o c a d F O U N D A T I O N S
27 . Draw Wings
Continue to draw the wings.

241 | e x o c a d F O U N D A T I O N S
28 . Draw Wings
Continue to draw the wings.

242 | e x o c a d F O U N D A T I O N S
29 . Draw Margin
Draw the margin.

243 | e x o c a d F O U N D A T I O N S
30 . Guide Planes
Remove the antagonist hit “A”
on the keyboard.

Remove the tooth hit “F” on

the keyboard.

244 | e x o c a d F O U N D A T I O N S
31 . Mid-Proximal
Guide plane should extend
Mid-Proximal.

245 | e x o c a d F O U N D A T I O N S
32 . Draw Tissue
Continue to draw the tissue.

246 | e x o c a d F O U N D A T I O N S
33 . Seal Margin
Double click the first dot to
close the margin.

247 | e x o c a d F O U N D A T I O N S
34 . Evaluate
If you need to move a margin
just drag the dot and hit
apply in the left window.

248 | e x o c a d F O U N D A T I O N S
35 . Click “Next”
Click the “Next” button.

249 | e x o c a d F O U N D A T I O N S
36 . Click “Next”
I do not modify the tissue.
You will be tempted to thin
the wings. Do not.

250 | e x o c a d F O U N D A T I O N S
37 . Click “Free-Form”
Click the “Free-form” button.

251 | e x o c a d F O U N D A T I O N S
38 . Click “Free-Form”
Click the “Free-form” button.

252 | e x o c a d F O U N D A T I O N S
39 . Click “Next”
Click the “next” button.

253 | e x o c a d F O U N D A T I O N S
40 . Carefully Adjust Occlusion
Use the remove tool with a
small brush. Hold shift and
adjust occlusion to true blue.

254 | e x o c a d F O U N D A T I O N S
41 . Be Careful
Do not distort wings just
adjust occlusion off needed.
True blue with show contact
areas as the color scale.

255 | e x o c a d F O U N D A T I O N S
42 . Occlusion
Occlusion evaluation step.

256 | e x o c a d F O U N D A T I O N S
43 . Occlusion
I decided to remove almost
all contacts.

257 | e x o c a d F O U N D A T I O N S
44 . Smooth
Open areas for floss
threaders using the smooth
tool and small brushes.

258 | e x o c a d F O U N D A T I O N S
45 . Make Cleanable
Make Cleanable

259 | e x o c a d F O U N D A T I O N S
46 . Smooth Pontic
Smooth Pontic.

260 | e x o c a d F O U N D A T I O N S
47 . No Concavities
No concavities.

261 | e x o c a d F O U N D A T I O N S
48 . Check Tissue Pressure
Check the tissue pressure.

262 | e x o c a d F O U N D A T I O N S
49 . Click “Distance to Scan Data”
Click the “Distance to Scan
Data” button.

263 | e x o c a d F O U N D A T I O N S
50 . Click “Nearest Point”
Click the “Nearest Point”
button.

264 | e x o c a d F O U N D A T I O N S
51 . Change the Scale to 0.1 - 0.5
Change the scale to reflect
this range.

265 | e x o c a d F O U N D A T I O N S
52 . Evaluate Pressure
Evaluate the pressure here.

266 | e x o c a d F O U N D A T I O N S
53 . Click to Adjust Pressure
Click the “Add/Remove”
button to adjust pressure.

267 | e x o c a d F O U N D A T I O N S
54 . Adjust Pressure
Be careful here. You have to
consider the soccer depth
created. For example if you
picked a 2mm socket then
here you want no more than
0.1 pressure. If you selected
a shallow socket depth here
you can add more pressure
for tissue training.

268 | e x o c a d F O U N D A T I O N S
55 . Click “Next”
Click the “Next” button.

269 | e x o c a d F O U N D A T I O N S
56 . Click “Save”
Click the “Save” button.

270 | e x o c a d F O U N D A T I O N S
57 . All Done!
You have completed your
immediate adhesion bridge.

271 | e x o c a d F O U N D A T I O N S
 FO U N DAT I O N S

AI-Assisted Guard Design

272 | e x o c a d F O U N D A T I O N S < TABLE OF CONTENTS

 1 . Select Client
Select client from the
drop-down menu.

273 | e x o c a d F O U N D A T I O N S
 2 . Add Patient Name
Type in your patient name
here.

274 | e x o c a d F O U N D A T I O N S
 3 . Click Any Tooth in the Arch
Click any tooth in the
arch.

275 | e x o c a d F O U N D A T I O N S
 4 . Click “Bite Splint”
Click the “Bite Splint”
option.

276 | e x o c a d F O U N D A T I O N S
 5 . 3D Print
Select “3D Print”.

277 | e x o c a d F O U N D A T I O N S
 6 . Check Settings
Please note the ideal
thickness for a 3D printed
guard is 2.5mm in the
posterior. It is best to scan
the patient with an open
bite using a jig such as a
MOD jig, leaf gauge or
other device. This way you
do not have to arbitrarily
open the pin on the virtual
articulator.

278 | e x o c a d F O U N D A T I O N S
 7 . Click “OK”
Click the “OK” button.

279 | e x o c a d F O U N D A T I O N S
 8 . Single Arch
Click “Single Arch
Appliance”.

280 | e x o c a d F O U N D A T I O N S
 9 . Save
Hit the “Save” button.

281 | e x o c a d F O U N D A T I O N S
10 . Design
Hit the “Design” button.

282 | e x o c a d F O U N D A T I O N S
 11 . Load Scans
Load your scans now.

283 | e x o c a d F O U N D A T I O N S
12 . Orientation
Begin rotating for proper
orientation.

284 | e x o c a d F O U N D A T I O N S
13 . Orientation
Rotate so you are looking
straight down the arch from
the occlusal view. I like to see
some facial surfaces of the
centrals.

285 | e x o c a d F O U N D A T I O N S
14 . Next
Click the “Next” button.

286 | e x o c a d F O U N D A T I O N S
15 . AI Segmentation
AI will automatically segment
the teeth in the arch. Check
for errors here. It is not
uncommon to have errors.
You may need to click a tooth
in the pictogram and then
click the tooth in the scan for
recalculation.

287 | e x o c a d F O U N D A T I O N S
16 . Fine-Tune
You can click a tooth on the
left hand side pictogram and
fine tune segmentation by
clicking the central groove of
a posterior tooth or the
straight facial of an anterior
tooth. Make sure the tooth
you click in the scan is
highlighted orange on the
pictogram.

288 | e x o c a d F O U N D A T I O N S
17 . Click “Next”
I don’t worry much about the
arrow angulations for a bite
guard. Ideally, they are
aligned with the long axis of
the tooth. You can click the
ball on the arrow and drag to
recalculate the root angle.

289 | e x o c a d F O U N D A T I O N S
18 . Default Settings
These settings are perfect for
a printed guard. Key split soft
or night guard flex are best.

290 | e x o c a d F O U N D A T I O N S
19 . Next
Hit the “Next” button.

291 | e x o c a d F O U N D A T I O N S
20 . Optional Articulator
You can start the articulator
here if needed. Most people
do not need this in design but
I will show it for completion.
If you did not scan the patient
with an open bite you must
enter the articulator and
open the pin. Not an ideal
way of doing things.

292 | e x o c a d F O U N D A T I O N S
21 . Click Automatically
Click the “automatically” tab.

293 | e x o c a d F O U N D A T I O N S
22 . Click the Mesial Incisal of 24
It’s ok if your arches are not
mounted correctly. Ignor the
disorder and start clicking
your points to help position
this in the articulator.

294 | e x o c a d F O U N D A T I O N S
23 . Click Cusp Tip of the Left Molar
Click here.

295 | e x o c a d F O U N D A T I O N S
24 . Click the Cusp Tip of the Right Molar
Click the cusp tip of the right
molar.

296 | e x o c a d F O U N D A T I O N S
25 . Click “Perform Alignment”
Click the “Perform
Alignment” button.

297 | e x o c a d F O U N D A T I O N S
26 . Click “OK” Here
Click the “OK” button.

298 | e x o c a d F O U N D A T I O N S
27 . Leave the Gap
Please note we scan our
patient open using a MOD
Jig, leaf gauge or Lucia jig.
The teeth come into exocad
already open. This is the best
way. If you do it this hit leave
the gap.

299 | e x o c a d F O U N D A T I O N S
28 . Leave the Gap
Click “It’s OK that way, leave
gap”.

300 | e x o c a d F O U N D A T I O N S
29 . Start Movements
Please note if you did not
scan the patient with an open
bite using a jig, open the pin
here by sliding the “opening
the bite” to 5mm before you
hit start movements.

301 | e x o c a d F O U N D A T I O N S
30 . Click “OK”
Click the “OK” button.

302 | e x o c a d F O U N D A T I O N S
31 . Click “Next”
Click the “Next” button.

303 | e x o c a d F O U N D A T I O N S
32 . AI Margins
AI will automatically detect
the margins and make a guard
based on the settings
selected in the beginning.

304 | e x o c a d F O U N D A T I O N S
33 . Hit “Next”
You can move the AI margin
and hit Apply or hit “Next” if
it got it.

305 | e x o c a d F O U N D A T I O N S
34 . Flatten
Go to Free-Smooth/Flatten

306 | e x o c a d F O U N D A T I O N S
35 . Free: Smooth / Flatten
Click the Smooth/Flatten
button.

307 | e x o c a d F O U N D A T I O N S
36 . Size Maximum
Set the size to maximum.

308 | e x o c a d F O U N D A T I O N S
37 . Strength Maximum
Set the strength to maximum.

309 | e x o c a d F O U N D A T I O N S
38 . Hold SHIFT to Flatten
Hold the SHIFT button to
flatten.

310 | e x o c a d F O U N D A T I O N S
39 . Keep Flattening
Hold SHIFT and then left-
click to flatten the posterior
areas.

311 | e x o c a d F O U N D A T I O N S
40 . Keep Flattening
Continue to flatten.

312 | e x o c a d F O U N D A T I O N S
41 . Smooth Anterior
You may need to add to the
anterior, then smooth.

313 | e x o c a d F O U N D A T I O N S
42 . Add
Click the Add/Remove Tool.

314 | e x o c a d F O U N D A T I O N S
43 . Add Where Contacts are Lacking
Continue to add where no
contacts are.

315 | e x o c a d F O U N D A T I O N S
44 . Smooth
Click the “Smooth/Flatten”
button.

316 | e x o c a d F O U N D A T I O N S
45 . Continue to Smooth
Continue to smooth.

317 | e x o c a d F O U N D A T I O N S
46 . Adapt Static Occlusion
Click “Adapt” and then
“Static Occlusion.

0mm is ideal.

318 | e x o c a d F O U N D A T I O N S
47 . Static Occlusion
Static occlusion should all be
equal now. If indents are too
large, smooth them and adapt
again.

319 | e x o c a d F O U N D A T I O N S
48 . Click Dynamic
In the View distances tab on
the top of the screen hit the
dynamic button. If you can’t
see this you did not use
articulator or need to hit the
chevron to show more
options.

320 | e x o c a d F O U N D A T I O N S
49 . Cut Dynamic
Under adapt, in “Dynamic
Occlusion” hit the chevron.

321 | e x o c a d F O U N D A T I O N S
50 . Exclude Selected Parts
Check the “Exclude Selected
Parts” box.

322 | e x o c a d F O U N D A T I O N S
51 . Preserve MIP Marks
Click pinpoint areas from the
MIP contacts that you want to
preserve.

323 | e x o c a d F O U N D A T I O N S
52 . Preserve MIP Marks
Continue to preserve MIP
marks.

324 | e x o c a d F O U N D A T I O N S
53 . Perserve MIP Marks
Continue to preserve MIP
marks.

325 | e x o c a d F O U N D A T I O N S
54 . Preserve MIP Marks
Continue to preserve MIP
marks.

326 | e x o c a d F O U N D A T I O N S
55 . Preserve MIP Marks
Continue to preserve MIP
marks.

327 | e x o c a d F O U N D A T I O N S
56 . Preserve MIP Marks
Continue to preserve MIP
marks.

328 | e x o c a d F O U N D A T I O N S
57 . Preserve MIP Marks
Continue to preserve MIP
marks.

329 | e x o c a d F O U N D A T I O N S
58 . Cut Dynamic
Now you can cut the dynamic
occlusion.

330 | e x o c a d F O U N D A T I O N S
59 . Check Dynamic
Check the dynamic occlusion.

331 | e x o c a d F O U N D A T I O N S
60 . Turn Off Dynamic
Unselect the dynamic button.

332 | e x o c a d F O U N D A T I O N S
61 . Slide Mandible Protrusive
Drag the mandible protrusive
with the slider.

333 | e x o c a d F O U N D A T I O N S
62 . Slide Laterotrusion
Slide laterotrusion.

334 | e x o c a d F O U N D A T I O N S
63 . Look at Movements
As you slide you can see the
movements.

335 | e x o c a d F O U N D A T I O N S
64 . Ramps
You can remove interferences
or build up anterior or cuspid
ramps.

336 | e x o c a d F O U N D A T I O N S
65 . Ramps
You can remove interferences
or build up anterior or cuspid
ramps.

337 | e x o c a d F O U N D A T I O N S
66 . Ramps
You can remove interferences
or build up anterior or cuspid
ramps.

338 | e x o c a d F O U N D A T I O N S
67 . Ramps
If you want cuspid ramps you
need to build them in. Most
AI guards do not have cuspid
ramps so this step is extra.

339 | e x o c a d F O U N D A T I O N S
68 . Recalculate Articulator
You must recalculate
articulator movements to see
how the new ramps impact
guidance.

340 | e x o c a d F O U N D A T I O N S
69 . Choose Influencing Teeth
You must now tell exocad that
you want the new cuspid
ramps to impact the
excessive calculations.

341 | e x o c a d F O U N D A T I O N S
70 . OK
Hit the “OK” button.

342 | e x o c a d F O U N D A T I O N S
71 . Restart Articulator Movement
Click the “Restart articulator
movment simulation!” Button.

343 | e x o c a d F O U N D A T I O N S
72 . Check New Movement
Drag the slide to see how the
cupids ramps impacted
lateral movements and
posterior disclussion.

344 | e x o c a d F O U N D A T I O N S
73 . Check Dynamic Movements
Drag the slider and see new
guidance. Please note the
dynamic color maps is off.
now we can see cuspid rise
and no other contacts.

345 | e x o c a d F O U N D A T I O N S
74 . Check Dynamic Movements
Check Dynamic Movements.

346 | e x o c a d F O U N D A T I O N S
75 . Check Dynamic Movements
Check the dynamic
movements.

347 | e x o c a d F O U N D A T I O N S
76 . Check Dynamic Movements
Check the dynamic
movements.

348 | e x o c a d F O U N D A T I O N S
77 . Next to Finalize
Hit the “Next” button to
finalize.

349 | e x o c a d F O U N D A T I O N S
78 . All Done!
You have completed your
guard design.

350 | e x o c a d F O U N D A T I O N S
 REMOVABLES

Monolithic Partial

351 | e x o c a d F O U N D A T I O N S < TABLE OF CONTENTS

 1 . Select Client
Select the client.

352 | e x o c a d F O U N D A T I O N S
 2 . Enter Patient Name
Enter Patient Name.

353 | e x o c a d F O U N D A T I O N S
 3 . Click Missing Tooth
Click the tooth that is
missing.

354 | e x o c a d F O U N D A T I O N S
 4 . Click Anatomic Pontic
Click Anatomic Pontic.

355 | e x o c a d F O U N D A T I O N S
 5 . 3D Print
Select “3D Print”.

356 | e x o c a d F O U N D A T I O N S
 6 . Copy Mirror if Desired
Select “Copy Mirror” if
desired.

357 | e x o c a d F O U N D A T I O N S
 7 . Virtual Gingiva
Select “Virtual Gingiva”.

358 | e x o c a d F O U N D A T I O N S
 8 . OK
Hit the “OK” button.

359 | e x o c a d F O U N D A T I O N S
 9 . Save
Copy this to all missing teeth
if you have multiple missing
teeth.

Hit “Save”.

360 | e x o c a d F O U N D A T I O N S
10 . Design
Hit “Design”.

361 | e x o c a d F O U N D A T I O N S
 11 . Load Scans
Load your scans

362 | e x o c a d F O U N D A T I O N S
12 . Orientate Model
Orientate your model.

363 | e x o c a d F O U N D A T I O N S
13 . Orientate Model
Right click and rotate the
model to be looking perfectly
down the occlusal view and
hit next

364 | e x o c a d F O U N D A T I O N S
14 . Mirror
In the mirror tool I like to
rotate the model to look
straight facial if it is an
anterior tooth.

365 | e x o c a d F O U N D A T I O N S
15 . Click Center Facial of Tooth
Click the tooth that you want
to mirror.

366 | e x o c a d F O U N D A T I O N S
16 . Position Tooth
Drag the mouse to the
edentulous space and left lick
to place tooth.

367 | e x o c a d F O U N D A T I O N S
17 . Move and Rotate
Click the tooth to move it.
Hold control on your
keyboard to rotate. Hold Shift
to scale.

368 | e x o c a d F O U N D A T I O N S
18 . Check All Angles
Rotate the model to look at
the position form all angles

369 | e x o c a d F O U N D A T I O N S
19 . Fine-Tune Position
Hold shift and drag the
mouse to scale. Hold control
and left click to rotate. Click
and drag to move the
position.

370 | e x o c a d F O U N D A T I O N S
20 . Next
Hit “Next”.

371 | e x o c a d F O U N D A T I O N S
21 . Cut All Intersections
You should not spend a lot of
time here in Free-From. If
you do you rushed previous
steps. I have my software
automatically cut all
intersections so I can just hit
next here.

372 | e x o c a d F O U N D A T I O N S
22 . Set Insertion Direction
This is the most important
part to determine fit of the
partial. Rotate the model to
look straight down the
edentulous space and hit “set
insertion direction from
view.”

373 | e x o c a d F O U N D A T I O N S
23 . Rotate Model
Rotate the model.

374 | e x o c a d F O U N D A T I O N S
24 . Set From View
Hit the “Insertion from view”
button.

375 | e x o c a d F O U N D A T I O N S
25 . Apply
Hit the Apply button.

376 | e x o c a d F O U N D A T I O N S
26 . Free-Form
Click on the “FREE-
FORMING” tab.

377 | e x o c a d F O U N D A T I O N S
27 . Add/Remove
Hit the Add/Remove button.

378 | e x o c a d F O U N D A T I O N S
28 . Melt Block Out Wax
Where the clasp tips will
engage melt back the block-
out wax by holding shift and
left clicking. How much you
remove depends on flexibility
of claps. For retainer material
and flex materials melt back
to the original tooth. The
software will not let you melt
more than the original model.

379 | e x o c a d F O U N D A T I O N S
29 . Melt Block Out Wax
The pink color is letting me
know I have intense undercut
engagement off the color
scale. I am using a slightly
flexible material here so I will
engage a lot of undercuts but
only in the clasp tip area.

380 | e x o c a d F O U N D A T I O N S
30 . Engage Secondary Retention
Engage secondary retention.

381 | e x o c a d F O U N D A T I O N S
31 . Engage Secondary Retention
I am engaging secondary
retention on the linguals.
Never more than 200 microns
(red) of undercut engagement
for secondary retention.

382 | e x o c a d F O U N D A T I O N S
32 . Engage Secondary Retention
I am engaging secondary
retention on the linguals.
Never more than 200 microns
(red) of undercut engagement
for secondary retention.

383 | e x o c a d F O U N D A T I O N S
33 . Engage Secondary Retention
Engage secondary retention.

384 | e x o c a d F O U N D A T I O N S
34 . Hit “Next”

385 | e x o c a d F O U N D A T I O N S
35 . Draw Major Connector
Draw the major connector.

386 | e x o c a d F O U N D A T I O N S
36 . Draw Major Connector
Draw the major connector.

387 | e x o c a d F O U N D A T I O N S
37 . Draw Major Connector
Draw the major connector.

388 | e x o c a d F O U N D A T I O N S
38 . Draw Major Connector
Draw the major connector.

389 | e x o c a d F O U N D A T I O N S
39 . Draw Major Connector
Draw the major connector.

390 | e x o c a d F O U N D A T I O N S
40 . Draw Major Connector
Draw the major connector.

391 | e x o c a d F O U N D A T I O N S
41 . Draw Major Connector
Hit “A” to turn on antagonist
if needed while making the
borders. I recommend lingual
plating for printed
prosthetics.

392 | e x o c a d F O U N D A T I O N S
42 . Draw Major Connector
Continue.

393 | e x o c a d F O U N D A T I O N S
43 . Draw Major Connector
Continue.

394 | e x o c a d F O U N D A T I O N S
44 . Draw Major Connector
Continue.

395 | e x o c a d F O U N D A T I O N S
45 . Guide Plane
Remove the tooth by hitting
“F” on the keyboard.

396 | e x o c a d F O U N D A T I O N S
46 . Guide Plane
Guide plane should drop
vertically to the tissue about
mid proximal.

397 | e x o c a d F O U N D A T I O N S
47 . Continue Minor Connector and Clasp
Continue the minor connector
and clasp.

398 | e x o c a d F O U N D A T I O N S
48 . Clasps
Start drawing your clasp.
Printed claps need to be
beefy. Like shark fins. 5mm
wide where it connects to the
guide plane.

399 | e x o c a d F O U N D A T I O N S
49 . Clasps
Thick clasps are better for
the printed prosthetics.

400 | e x o c a d F O U N D A T I O N S
50 . Second Guide Plane
Continue with the second
guide plane.

401 | e x o c a d F O U N D A T I O N S
51 . Second Guide Plane
Continue with the second
guide plane.

402 | e x o c a d F O U N D A T I O N S
52 . Second Guide Plane
Continue with the second
guide plane.

403 | e x o c a d F O U N D A T I O N S
53 . Second Guide Plane
Continue with the second
guide plane.

404 | e x o c a d F O U N D A T I O N S
54 . Finalize
Finalize.

405 | e x o c a d F O U N D A T I O N S
55 . Finalize
Finalize.

406 | e x o c a d F O U N D A T I O N S
56 . Finalize
Double click on first ball to
lock in the design

407 | e x o c a d F O U N D A T I O N S
57 . Base Thickness
1.5mm for base thickness for
monolithic printed
prosthetics. Hit apply to
change thickness. Please note
your tissue line can be moved
by clicking a green ball and
move it. Hit apply to save
changes.

408 | e x o c a d F O U N D A T I O N S
58 . Next
Hit “Next”.

409 | e x o c a d F O U N D A T I O N S
59 . Free-Form Smooth
Smooth in free-form.

410 | e x o c a d F O U N D A T I O N S
60 . Free-Form Smooth
Smooth in free-form.

411 | e x o c a d F O U N D A T I O N S
61 . Free-Form Smooth
Smooth in free-form.

412 | e x o c a d F O U N D A T I O N S
62 . Free
Select the free tab.

413 | e x o c a d F O U N D A T I O N S
63 . Smooth
Select the Smooth/Flatten
tool.

414 | e x o c a d F O U N D A T I O N S
64 . Smooth Clasp Tip
Smooth the Clasp Tip.

415 | e x o c a d F O U N D A T I O N S
65 . Smooth Clasp Tip
Smooth the Clasp Tip.

416 | e x o c a d F O U N D A T I O N S
66 . Smooth Clasp Tip
Smooth the Clasp Tip.

417 | e x o c a d F O U N D A T I O N S
67 . Smooth Palatal Border
Smooth the Palatal Border.

418 | e x o c a d F O U N D A T I O N S
68 . Smooth Palatal Border
Smooth the Palatal Border.

419 | e x o c a d F O U N D A T I O N S
69 . Next
Hit the “Next” button.

420 | e x o c a d F O U N D A T I O N S
70 . Done
You have completed your
monolithic partial design.

421 | e x o c a d F O U N D A T I O N S
71 . Add Name
Add the patient name.

422 | e x o c a d F O U N D A T I O N S
72 . Click Free-Form
Click the Free-Form button.

423 | e x o c a d F O U N D A T I O N S
73 . Next
Click “Next”.

424 | e x o c a d F O U N D A T I O N S
74 . Click Attachments
Click.

425 | e x o c a d F O U N D A T I O N S
75 . Click Subtract
Click

426 | e x o c a d F O U N D A T I O N S
76 . Click Library
Click.

427 | e x o c a d F O U N D A T I O N S
77 . Scroll to Text
Select the “text” option from
the drop-down menu.

428 | e x o c a d F O U N D A T I O N S
78 . Click the Text Box
Click here.

429 | e x o c a d F O U N D A T I O N S
79 . Name
Write in patient name.

430 | e x o c a d F O U N D A T I O N S
80 . Click Partial and Move Name
Click on the partial.

You can hold Control to

rotate and click to move

431 | e x o c a d F O U N D A T I O N S
81 . Click Apply
Click Apply to finalize.

432 | e x o c a d F O U N D A T I O N S
82 . Hit “Next”
Hit the next button.

433 | e x o c a d F O U N D A T I O N S
83 . Hit “Save”
Hit YES

434 | e x o c a d F O U N D A T I O N S
84 . All Done!
Your design is officially
complete.

435 | e x o c a d F O U N D A T I O N S
 REMOVABLES

Split File Partial

436 | e x o c a d F O U N D A T I O N S < TABLE OF CONTENTS

 1 . Select Client
Select the client.

437 | e x o c a d F O U N D A T I O N S
 2 . Select Client
Select the client.

438 | e x o c a d F O U N D A T I O N S
 3 . Enter Patient Name
Enter Patient Name.

439 | e x o c a d F O U N D A T I O N S
 4 . Click Missing Tooth
Click the tooth that is
missing.

440 | e x o c a d F O U N D A T I O N S
 5 . Partial Denture
Select “Partial Denture”.

441 | e x o c a d F O U N D A T I O N S
 6 . Flexible Denture
Select “flexible denture”,
then hit “OK”.

442 | e x o c a d F O U N D A T I O N S
 7 . Click the Opposing Arch
Click the Opposing Arch.

443 | e x o c a d F O U N D A T I O N S
 8 . Click “Antagonist”
Click Antagonist.

444 | e x o c a d F O U N D A T I O N S
 9 . Click “OK”
Click “OK”.

445 | e x o c a d F O U N D A T I O N S
10 . Click “Save”
Click “Save”.

446 | e x o c a d F O U N D A T I O N S
 11 . Click “Design”
Click “Design”.

447 | e x o c a d F O U N D A T I O N S
12 . Load Scans
Load your scans.

448 | e x o c a d F O U N D A T I O N S
13 . Orientation
Right click and rotate model
to be looking down the
edentulous space form the
occlusal view.

Then hit “Next”.

449 | e x o c a d F O U N D A T I O N S
14 . Path of Insertion
Path of Insertion.

450 | e x o c a d F O U N D A T I O N S
15 . Rotate
Rotate the model to the
desired path of insertion of
the partial denture. Typically
looking on the center of the
ridge with equal visualization
of the guide plane areas.

451 | e x o c a d F O U N D A T I O N S
16 . Click “Insertion Direction” and “Apply”
Hit “Set insertion direction
from view” and then “Apply”.

452 | e x o c a d F O U N D A T I O N S
17 . Free-Forming
Select the Free-forming tab.

453 | e x o c a d F O U N D A T I O N S
18 . Clasp Retention
Hold shift and left click to
remove wax in the clasp tip
area. How much removed
depends on the material used
for printing.

454 | e x o c a d F O U N D A T I O N S
19 . Clasp Retention
Hold shift and left click to
remove wax in the clasp tip
area. How much removed
depends on the material used
for printing.

455 | e x o c a d F O U N D A T I O N S
20 . Clasp Retention
Hold shift and left click to
remove wax in the clasp tip
area. How much removed
depends on the material used
for printing.

456 | e x o c a d F O U N D A T I O N S
21 . Secondary Retention
Hold shift and remove wax for
secondary retention. Do not
exceed 200 microns (red) for
secondary retention.

457 | e x o c a d F O U N D A T I O N S
22 . Secondary Retention
Hold shift and remove wax for
secondary retention. Do not
exceed 200 microns (red) for
secondary retention.

458 | e x o c a d F O U N D A T I O N S
23 . Secondary Retention
Hold shift and remove wax for
secondary retention. Do not
exceed 200 microns (red) for
secondary retention.

459 | e x o c a d F O U N D A T I O N S
24 . Next
Hit next.

460 | e x o c a d F O U N D A T I O N S
25 . Tooth Placement
Tooth Placement.

461 | e x o c a d F O U N D A T I O N S
26 . Enter Expert Mode
Enter expert mode.

462 | e x o c a d F O U N D A T I O N S
27 . Right-Click
Right-click the model.

463 | e x o c a d F O U N D A T I O N S
28 . Copy Mirror
Select “Copy Mirror”

464 | e x o c a d F O U N D A T I O N S
29 . Click Tooth
For anteriors I like to rotate
the model to straight facial.
Click the center of the tooth
you want to mirror.

465 | e x o c a d F O U N D A T I O N S
30 . Place Tooth
Move the mouse to the
edentulous space and left
click.

466 | e x o c a d F O U N D A T I O N S
31 . Fine-Tune Position
Now, click the tooth and
move it. Control to rotate.
Shift and click to scale.

467 | e x o c a d F O U N D A T I O N S
32 . Multiple Angles
Look from all angles to
ensure the tooth is exactly
where you want it.

468 | e x o c a d F O U N D A T I O N S
33 . Click “OK”
Click “OK”.

469 | e x o c a d F O U N D A T I O N S
34 . Back to Wizard
Go back to wizard mode.

470 | e x o c a d F O U N D A T I O N S
35 . Free-Form
My settings will automatically
cut all intrusions here. If
yours do not hit “cut all
intersections” I try not to do
too much in Free-Form. Hit
next

471 | e x o c a d F O U N D A T I O N S
36 . Draw Tissue
Draw tissue.

472 | e x o c a d F O U N D A T I O N S
37 . Draw Tissue
Draw tissue.

473 | e x o c a d F O U N D A T I O N S
38 . Draw Tissue
Hit “A” for antagonist to see
opposing dentition when
marking major connector. I
recommend lingual plating
when possible.

474 | e x o c a d F O U N D A T I O N S
39 . Draw Tissue
Draw Tissue.

475 | e x o c a d F O U N D A T I O N S
40 . Draw Tissue
Draw Tissue.

476 | e x o c a d F O U N D A T I O N S
41 . Guide Plane
Mid proximal drop a vertical
line to the tissue for the guide
plane.

477 | e x o c a d F O U N D A T I O N S
42 . Clasp
The clasp needs to be thick,
more like a shark fin shape.
It should be 5mm wide where
it connects to the guide
plane.

478 | e x o c a d F O U N D A T I O N S
43 . Clasp
The clasp needs to be thick,
more like a shark fin shape.
It should be 5mm wide where
it connects to the guide
plane.

479 | e x o c a d F O U N D A T I O N S
44 . Guide Plane
Continue.

480 | e x o c a d F O U N D A T I O N S
45 . Lingual Plating
Continue.

481 | e x o c a d F O U N D A T I O N S
46 . Lingual Plating
Continue.

482 | e x o c a d F O U N D A T I O N S
47 . Finalize
Double click the starting ball
for finalizing the tissue

483 | e x o c a d F O U N D A T I O N S
48 . Fine-Tune
Edit the margin line by
clicking anywhere and
dragging. Make sure
thickness is 2.5mm. Hit
apply.

484 | e x o c a d F O U N D A T I O N S
49 . Click “Next”
Next.

485 | e x o c a d F O U N D A T I O N S
50 . Free-Form Smooth
Hit the Free tab.

486 | e x o c a d F O U N D A T I O N S
51 . Free-Form Smooth
Select “Smooth/Flatten”

487 | e x o c a d F O U N D A T I O N S
52 . Smooth Clasp Tip
Smooth Clasp Tip.

488 | e x o c a d F O U N D A T I O N S
53 . Smooth Clasp Tip
Smooth Clasp Tip.

489 | e x o c a d F O U N D A T I O N S
54 . Smooth Clasp Tip
Smooth Clasp Tip.

490 | e x o c a d F O U N D A T I O N S
55 . Smooth Lingual Border
Smooth lingual border.

491 | e x o c a d F O U N D A T I O N S
56 . Smooth Lingual Border
Smooth lingual border.

492 | e x o c a d F O U N D A T I O N S
57 . Next
Hit Next.

493 | e x o c a d F O U N D A T I O N S
58 . Pocket Thickness
Set to 1mm under tooth
thickness.

494 | e x o c a d F O U N D A T I O N S
59 . Tooth Pocket Gap
Set Pocket Gap to .2mm

495 | e x o c a d F O U N D A T I O N S
60 . Next
Hit Next.

496 | e x o c a d F O U N D A T I O N S
61 . Done
You have finished your
design.

497 | e x o c a d F O U N D A T I O N S
62 . Add Name
Click Free-form restorations.

498 | e x o c a d F O U N D A T I O N S
63 . Next
Hit Next.

499 | e x o c a d F O U N D A T I O N S
64 . Merged Gingiva
Merged gingiva.

500 | e x o c a d F O U N D A T I O N S
65 . Attachment
Select Attachment tab.

501 | e x o c a d F O U N D A T I O N S
66 . Subtract
Hit Subtract

502 | e x o c a d F O U N D A T I O N S
67 . Library
Select “Text” under library
options.

503 | e x o c a d F O U N D A T I O N S
68 . Click Text Box
Add the name to the text box.

504 | e x o c a d F O U N D A T I O N S
69 . Move the Name
Drag the name or control
rotate .

505 | e x o c a d F O U N D A T I O N S
70 . Alter Size
For printing you want them
larger than you think.

Hit “APPLY” when done.

506 | e x o c a d F O U N D A T I O N S
71 . Next
Hit “Next”

507 | e x o c a d F O U N D A T I O N S
72 . Save
Select “Save”

508 | e x o c a d F O U N D A T I O N S
73 . Export Parts
The parts are automatically
saved in the project folder. Or
you can export them here.
Turn off the finished
restoration to view only tissue

509 | e x o c a d F O U N D A T I O N S
74 . Each Part Needs to be Turned On
Turn on each part one at a
time.

510 | e x o c a d F O U N D A T I O N S
75 . Export
Right click screen, Save scene
as.

511 | e x o c a d F O U N D A T I O N S
76 . STL
Select STL and location.

512 | e x o c a d F O U N D A T I O N S
77 . STL
Plan STL.

513 | e x o c a d F O U N D A T I O N S
78 . Visible Objects Only
When prompted “Save visible
objects only”, hit”YES”.

514 | e x o c a d F O U N D A T I O N S
79 . Default Orientation
Select “Default Orientation”.

You are done!

515 | e x o c a d F O U N D A T I O N S
 All on x

1. Pre-surgical Waxup

1

Pontic Waxup
Dentate Arch

< TABLE OF CONTENTS exocad MASTER GUIDE

Table of Contents
01 Direct Print Mockup with AI 1
02 Direct Print Mockup without AI 165
03 Conversion to Final Veneers 308
04 Conversion to Mockup Model 336

< TABLE OF CONTENTS exocad MASTER GUIDE

 SMILE DESIGN

Direct Print Mockup

WITH AI

1 | exocad SMILE DESIGN & VENEERS < TABLE OF CONTENTS

 1 . AI Smile Design
Smile Design with AI.

2 | exocad SMILE DESIGN & VENEERS

 2 . Dental DB
Begin by opening Dental
DB.

3 | exocad SMILE DESIGN & VENEERS

 3 . Click “New Treatment”
Click the “New” button.

4 | exocad SMILE DESIGN & VENEERS

 4 . Click “Default Client”
Select the default client.

5 | exocad SMILE DESIGN & VENEERS

 5 . Add Name
Add the patient name here.

6 | exocad SMILE DESIGN & VENEERS

 6 . Distal-Most Tooth
Click the distal-most
tooth.

7 | exocad SMILE DESIGN & VENEERS

 7 . Click “Mockup”
Click the “Mockup”
button.

8 | exocad SMILE DESIGN & VENEERS

 8 . Click “3D Print”
Select the “3D Print”
option.

9 | exocad SMILE DESIGN & VENEERS

 9 . Click “OK”
Set minimum thickness to
0.2-0.3mm depending on
printer.

10 | e x o c a d S M I L E D E S I G N & V E N E E R S
10 . Click Contralateral Tooth
Hold shift and click the distal
most contralateral tooth in
the smile design.

11 | e x o c a d S M I L E D E S I G N & V E N E E R S
 11 . Remove Connectors
Remove the connectors as
shown here.

12 | e x o c a d S M I L E D E S I G N & V E N E E R S
12 . Keep Removing Connectors
Continue to remove the
connectors.

13 | e x o c a d S M I L E D E S I G N & V E N E E R S
13 . Click “Save”
Click the “Save” button.

14 | e x o c a d S M I L E D E S I G N & V E N E E R S
 14 . Click “Design”
Click the “Design” button.

15 | e x o c a d S M I L E D E S I G N & V E N E E R S
 15 . Load Files
Load files now.

16 | e x o c a d S M I L E D E S I G N & V E N E E R S
16 . Rotate
Rotate the scan.

17 | e x o c a d S M I L E D E S I G N & V E N E E R S
 17 . Top Down View
Rotate the model looking
looking down on the occlusal
and hit “NEXT”.

18 | e x o c a d S M I L E D E S I G N & V E N E E R S
18 . Start Segmentation
Start segmentation.

19 | e x o c a d S M I L E D E S I G N & V E N E E R S
19 . Click “Start Segmentation”
Click the “Start
Segmentation” button.

20 | e x o c a d S M I L E D E S I G N & V E N E E R S
20 . Wait for AI
If you have clean crips scans
the AI will auto segment the
arch.

21 | e x o c a d S M I L E D E S I G N & V E N E E R S
 21 . Segment the Remaining Teeth
Segment all the remaining
teeth by clicking on the blank
tooth then in the pictogram.

22 | e x o c a d S M I L E D E S I G N & V E N E E R S
22 . Click Central Groove
Click the scan of the tooth
you selected in the
pictogram. Posterior teeth
click central groove.

23 | e x o c a d S M I L E D E S I G N & V E N E E R S
23 . Keep Segmenting
Continue to segment the
teeth.

24 | e x o c a d S M I L E D E S I G N & V E N E E R S
24 . Keep Segmenting
Continue to segment the
teeth.

25 | e x o c a d S M I L E D E S I G N & V E N E E R S
25 . Alter Tooth Angulations
Click the ball at the tip of the
arrow to move the arrow to
the long axis of the tooth.
Make sure not to accidentally
click the tooth itself because
it will start segmentation.

26 | e x o c a d S M I L E D E S I G N & V E N E E R S
26 . Continue Altering Arrows
Continue altering the arrows.

27 | e x o c a d S M I L E D E S I G N & V E N E E R S
27 . Fine-Tune the Arrows
All arrows should be coming
out the center of the central
groove of posteriors and out
the center of the incisal edge
anteriors.

28 | e x o c a d S M I L E D E S I G N & V E N E E R S
28 . Use Natural Teeth
If you desire to use the
patients natural teeth for the
smile design you have to
select “Use also as restorative
model” Here I am opting
NOT to do that.

29 | e x o c a d S M I L E D E S I G N & V E N E E R S
29 . Click “Next”
Click the “Next” button.

30 | e x o c a d S M I L E D E S I G N & V E N E E R S
30 . AI Segmentation of Lower
Begin AI Segmentation of the
Lower.

31 | e x o c a d S M I L E D E S I G N & V E N E E R S
31 . AI Segmentation of Lower
Continue the AI segmentation
of the lower.

32 | e x o c a d S M I L E D E S I G N & V E N E E R S
32 . AI Segmentation of Lower
Continue the AI segmentation
of the lower.

33 | e x o c a d S M I L E D E S I G N & V E N E E R S
33 . AI Segmentation of Lower
Continue the AI segmentation
of the lower.

34 | e x o c a d S M I L E D E S I G N & V E N E E R S
34 . Evaluate Accuracy
Evaluate the accuracy of the
lower segmentation.

35 | e x o c a d S M I L E D E S I G N & V E N E E R S
35 . Continue Segmentation
Click the teeth not segmented
in the pictogram and work
your way around the arch.

36 | e x o c a d S M I L E D E S I G N & V E N E E R S
36 . Click Center of Tooth Selected
Click center of the tooth
selected.

37 | e x o c a d S M I L E D E S I G N & V E N E E R S
37 . Finish the Arch
Finish the arch.

38 | e x o c a d S M I L E D E S I G N & V E N E E R S
38 . Correction
If any tooth needs correcting
click the tooth make it orange
then got to correction. Click
to paint yellow. Hold shift to
remove yellow.

39 | e x o c a d S M I L E D E S I G N & V E N E E R S
39 . Correction
Continue correction.

40 | e x o c a d S M I L E D E S I G N & V E N E E R S
40 . Click “Apply”
Click the “apply” button.

41 | e x o c a d S M I L E D E S I G N & V E N E E R S
 41 . Alter Arrow Angles
Click the ball at the top of the
arrow and rotate to the long
axis of the tooth.

42 | e x o c a d S M I L E D E S I G N & V E N E E R S
42 . Correct Angles
Correct the angles.

43 | e x o c a d S M I L E D E S I G N & V E N E E R S
43 . Click “Next”
Click the “Next” button.

44 | e x o c a d S M I L E D E S I G N & V E N E E R S
44 . Click “Start Smile Creator”
Click the “Start Smile
Creator” button.

45 | e x o c a d S M I L E D E S I G N & V E N E E R S
45 . Click “Load Retracted Image”
Click the “load retracted
image” button.

46 | e x o c a d S M I L E D E S I G N & V E N E E R S
46 . Navigate to Retracted Photo
Locate the retracted photo.

47 | e x o c a d S M I L E D E S I G N & V E N E E R S
47 . AI Auto Alignment
AI will automatically align the
intraoral scan to the photo.

48 | e x o c a d S M I L E D E S I G N & V E N E E R S
48 . Click “Next”
Click the “Next” button.

49 | e x o c a d S M I L E D E S I G N & V E N E E R S
49 . Click “Load a Smile Image”
Click the “load a smile image”
button.

50 | e x o c a d S M I L E D E S I G N & V E N E E R S
50 . Navigate to Smile Photo
Locate the smile photo.

51 | e x o c a d S M I L E D E S I G N & V E N E E R S
 51 . AI Auto Alignment
AI will automatically align
smile photo to the retracted.
If you have bad photos at
different angles they will
never align.

52 | e x o c a d S M I L E D E S I G N & V E N E E R S
52 . Click “Next”
Click the “Next” button.

53 | e x o c a d S M I L E D E S I G N & V E N E E R S
53 . Adjust the Lip Line
Begin to adjust the lip line.

54 | e x o c a d S M I L E D E S I G N & V E N E E R S
54 . Click “Next”
Click the “Next” button.

55 | e x o c a d S M I L E D E S I G N & V E N E E R S
55 . Click the Dot and Move to the Pupil
The dot should be perfectly
in the center of the pupil.

56 | e x o c a d S M I L E D E S I G N & V E N E E R S
56 . Click “Next”
Click the “Next” button.

57 | e x o c a d S M I L E D E S I G N & V E N E E R S
57 . Move Proportion Gauge
Click the proportion gauge in
the center and drag it.

58 | e x o c a d S M I L E D E S I G N & V E N E E R S
58 . Move Proportion Gauge
Move the proportion gauge.

59 | e x o c a d S M I L E D E S I G N & V E N E E R S
59 . Move the Midline
Move facial midline to be
coincident with maxillary
midline unless desiring to
prepare the teeth and move
midline.

60 | e x o c a d S M I L E D E S I G N & V E N E E R S
60 . Move the Gingival Line to Midline
Move the Gingival Line to
Midline.

61 | e x o c a d S M I L E D E S I G N & V E N E E R S
61 . Move the Gingival Line to Midline
Move the Gingival Line to
Midline.

62 | e x o c a d S M I L E D E S I G N & V E N E E R S
62 . Move the Smile Arc to Midline
Move the Smile Arc to the
Midline.

63 | e x o c a d S M I L E D E S I G N & V E N E E R S
63 . Move the Smile Arc to Midline
Move the Smile Arc to the
Midline.

64 | e x o c a d S M I L E D E S I G N & V E N E E R S
64 . Move Proportion Gauge to Midline
Click and drag proportion
gauge to midline. The vertical
bar is lined up to midline. The
horizontal bar on the desired
incisal edge location of the
waxup 8 and 9.

65 | e x o c a d S M I L E D E S I G N & V E N E E R S
65 . Move the Proportion Gauge
Click and drag proportion
gauge to midline. The vertical
bar is lined up to midline. The
horizontal bar on the desired
incisal edge location of the
waxup 8 and 9.

66 | e x o c a d S M I L E D E S I G N & V E N E E R S
66 . Change the Ratio
Change the ratio to
100-65-50

67 | e x o c a d S M I L E D E S I G N & V E N E E R S
67 . Click “Ratio”
Click the correct ratio.

68 | e x o c a d S M I L E D E S I G N & V E N E E R S
68 . Drag Cuspid Position
Drag Cuspid Position.

69 | e x o c a d S M I L E D E S I G N & V E N E E R S
69 . Check
Check the midline

Check the incisal edge

position

Check the cuspid position

Central width should be in

the 8mm range

70 | e x o c a d S M I L E D E S I G N & V E N E E R S
70 . Click “Next”
Click the “next” button.

71 | e x o c a d S M I L E D E S I G N & V E N E E R S
 71 . Turn On Preoperative Teeth
Click the far icon to in each
window to turn on
preoperative teeth.

72 | e x o c a d S M I L E D E S I G N & V E N E E R S
72 . Turn On Preoperative Teeth
Click the far icon to in each
window to turn on
preoperative teeth.

73 | e x o c a d S M I L E D E S I G N & V E N E E R S
73 . Click “All Distinguished”
To help see the contrast
between the wax and natural
teeth right click the tru smile
icon and hit all distinguished.

74 | e x o c a d S M I L E D E S I G N & V E N E E R S
74 . Focus Here
You want to focus here first.

75 | e x o c a d S M I L E D E S I G N & V E N E E R S
75 . Rotate Palatal
Usually you have to rotate the
entire arch palatal. Make sure
the square box is around ALL
your waxup teeth . If you
don’t have a box click and
drag a big square around the
teeth.

76 | e x o c a d S M I L E D E S I G N & V E N E E R S
76 . Check Parallelism
The cusp tips premolar to
cuspid should parallel nature.

77 | e x o c a d S M I L E D E S I G N & V E N E E R S
77 . Position Incisal Edges
Now click the midline in the
silhouette area and drag the
entire box of teeth apical to
the incisal edge position of
the proportion gauge.

78 | e x o c a d S M I L E D E S I G N & V E N E E R S
78 . Change Aesthetic
To get back to silhouettes
click outline then preview and
back to outline to refresh the
screen.

79 | e x o c a d S M I L E D E S I G N & V E N E E R S
79 . Verify Incisal Edge
Make sure incisal edge
position is on the horizontal
line of proportion gauge.

80 | e x o c a d S M I L E D E S I G N & V E N E E R S
80 . Adjust Gingival Zenith
Click the blue dot and drag
the cervical to match 8 and 9
natural teeth. (Unless you
want to simulate surgical
crown lengthening) .

81 | e x o c a d S M I L E D E S I G N & V E N E E R S
81 . Click “Measurements”
Click the “measurement”
button.

82 | e x o c a d S M I L E D E S I G N & V E N E E R S
82 . Click the Center of Tooth 9
Click the center of tooth 9.
Look at the measurement on
the silhouette. Should be
somewhere in the 10mm
range long and 8 mm range
wide.

83 | e x o c a d S M I L E D E S I G N & V E N E E R S
83 . Anterior Posterior Position
Focus here and move the
entire arch anteriorly until
you are near the natural
incisal edge position and see
wax on the facial surfaces.

84 | e x o c a d S M I L E D E S I G N & V E N E E R S
84 . Anterior Posterior Position
For an additive veneer case
you want to see mostly wax
on the front of the teeth.

85 | e x o c a d S M I L E D E S I G N & V E N E E R S
85 . Individual Teeth Movement
Now you will click individual
teeth and move them. This is
different compared to my
normal workflow because the
AI workflow is different.

86 | e x o c a d S M I L E D E S I G N & V E N E E R S
86 . Individual Teeth Movement
Begin adjusting the individual
teeth.

87 | e x o c a d S M I L E D E S I G N & V E N E E R S
87 . Individual Teeth Movement
Begin adjusting the individual
teeth.

88 | e x o c a d S M I L E D E S I G N & V E N E E R S
88 . Individual Teeth Movement
Click and drag each tooth so
you see wax on the facial.

89 | e x o c a d S M I L E D E S I G N & V E N E E R S
89 . Individual Teeth Movement
Individual teeth movement.

90 | e x o c a d S M I L E D E S I G N & V E N E E R S
90 . Individual Teeth Movement
Keep working around the
smile moving each tooth to
have a thin coating of wax on
the facial.

91 | e x o c a d S M I L E D E S I G N & V E N E E R S
91 . Symmetrical Movements
Click mirror movements when
you want to have both teeth
move at the same rate.

92 | e x o c a d S M I L E D E S I G N & V E N E E R S
92 . Click “Mirror Movements”
Click the “mirror movements”
button.

93 | e x o c a d S M I L E D E S I G N & V E N E E R S
93 . Symmetrical Movement
Single tooth movement will
now automatically mirror
movements to the
contralateral side. Toggle
mirror on and off and fine
tune tooth positions.

94 | e x o c a d S M I L E D E S I G N & V E N E E R S
94 . Free-Form
Click the “Free-Form”
button.

95 | e x o c a d S M I L E D E S I G N & V E N E E R S
95 . Free-Form
Click the “Anatomic” button.

96 | e x o c a d S M I L E D E S I G N & V E N E E R S
96 . Visualize Thickness
Click the “Visualize
Thickness” button.

97 | e x o c a d S M I L E D E S I G N & V E N E E R S
97 . Select Thickness
Some modern printers can
print ultra thin shells at 200
microns. All printers can do
300 microns.

98 | e x o c a d S M I L E D E S I G N & V E N E E R S
98 . Select Tooth Parts
Select tooth parts and start
morphing small areas of the
mockup.

99 | e x o c a d S M I L E D E S I G N & V E N E E R S
99 . Click Areas to Morph and Drag
Be carful with this tool. You
can make things look bad real
fast. As a general rule small
movements like fine tuning
proximal contact locations.

100 | e x o c a d S M I L E D E S I G N & V E N E E R S
100 . Click “Free”
Click the “Free” tab.

101 | e x o c a d S M I L E D E S I G N & V E N E E R S
101 . Maximum Size Add Tool
Slide the scale to maximum.

102 | e x o c a d S M I L E D E S I G N & V E N E E R S
102 . Add Thickness
Anywhere pink is toot thin
and will not print. Using large
brush size to add ensures the
tooth will stay anatomically
correct. move the whole
tooth.

103 | e x o c a d S M I L E D E S I G N & V E N E E R S
103 . Add Thickness
You may often find clicking
the silhouettes to add
thickness works better.

104 | e x o c a d S M I L E D E S I G N & V E N E E R S
104 . Eliminate Pink
Eliminate the pink areas that
you see.

105 | e x o c a d S M I L E D E S I G N & V E N E E R S
105 . Keep Adding
Continue to add.

106 | e x o c a d S M I L E D E S I G N & V E N E E R S
106 . No Pink
Eliminate the visible pink
areas.

107 | e x o c a d S M I L E D E S I G N & V E N E E R S
107 . Click “OK”
Click the “OK” button.

108 | e x o c a d S M I L E D E S I G N & V E N E E R S
108 . Click “Next”
Click the “Next” button.

109 | e x o c a d S M I L E D E S I G N & V E N E E R S
109 . Click “Photorealistic Preview”
Wait for the photorealistic
calculations.

110 | e x o c a d S M I L E D E S I G N & V E N E E R S
110 . Adjust Slider
Move the slider around to
see.

111 | e x o c a d S M I L E D E S I G N & V E N E E R S
111 . Click “Next”
Click the “Next” button.

112 | e x o c a d S M I L E D E S I G N & V E N E E R S
112 . Click “Done”
Click the “Done” button.

113 | e x o c a d S M I L E D E S I G N & V E N E E R S
113 . Click “Advanced”
Click the “Advanced” tab.

114 | e x o c a d S M I L E D E S I G N & V E N E E R S
114 . Click This Button
Click the button shown here.

115 | e x o c a d S M I L E D E S I G N & V E N E E R S
115 . Fine-Tune
Begin to fine-tune your
design.

116 | e x o c a d S M I L E D E S I G N & V E N E E R S
116 . Click “Wax Spatula”
Click the wax spatula button.

117 | e x o c a d S M I L E D E S I G N & V E N E E R S
117 . Fine-Tune
Continue to fine-tune your
design.

118 | e x o c a d S M I L E D E S I G N & V E N E E R S
118 . Click and Drag
Small movements are best
with the wax spatula.

119 | e x o c a d S M I L E D E S I G N & V E N E E R S
119 . Click “Smile Window”
Click the “Smile Window”
button.

120 | e x o c a d S M I L E D E S I G N & V E N E E R S
120 . Verify Aesthetics
Check the aesthetics of your
design.

121 | e x o c a d S M I L E D E S I G N & V E N E E R S
121 . Verify Aesthetics
Check the aesthetics of your
design.

122 | e x o c a d S M I L E D E S I G N & V E N E E R S
122 . Click “Next”
Click the “next” button.

123 | e x o c a d S M I L E D E S I G N & V E N E E R S
123 . Rotate the Path of Insertion
Rotate the path of insertion.

124 | e x o c a d S M I L E D E S I G N & V E N E E R S
124 . Roate to Facial
Almost straight facial but still
want to see incase edges.

125 | e x o c a d S M I L E D E S I G N & V E N E E R S
125 . Click “Set Insertion Direction”
Click the “Set Insertion
Direction” button.

126 | e x o c a d S M I L E D E S I G N & V E N E E R S
126 . Apply
Click “Apply”.

127 | e x o c a d S M I L E D E S I G N & V E N E E R S
127 . Click “Free-Forming”
Click the “Free-Forming” tab.

128 | e x o c a d S M I L E D E S I G N & V E N E E R S
128 . Click “Add/Remove”
Click the “Add-Remove” tool.

129 | e x o c a d S M I L E D E S I G N & V E N E E R S
129 . Click “Shift”
Hold SHIFT and melt some of
the blackout wax for a more
intimate fit of the mockup

130 | e x o c a d S M I L E D E S I G N & V E N E E R S
130 . Remove Around the Arch
Remove Around the Arch.

131 | e x o c a d S M I L E D E S I G N & V E N E E R S
131 . Before the Removal
This is before the removal.

132 | e x o c a d S M I L E D E S I G N & V E N E E R S
132 . Click “Expert”
The mockup is now done.
However if you want to cut
the mockup to fit the arch you
need to go to expert mode.

133 | e x o c a d S M I L E D E S I G N & V E N E E R S
133 . Click “Free-Form”
Click the model and then the
popup window will show all
the steps. Hit Freeform.

134 | e x o c a d S M I L E D E S I G N & V E N E E R S
134 . Click “Visualize Thickness”
Click the “Visualize
Thickness” button.

135 | e x o c a d S M I L E D E S I G N & V E N E E R S
135 . Drag the Thickness
Change the thickness slider
to 0.3 to 0.2 depending on
your printer.

136 | e x o c a d S M I L E D E S I G N & V E N E E R S
136 . Click “Add/Remove”
Click “Add/Remove”.

137 | e x o c a d S M I L E D E S I G N & V E N E E R S
137 . Change Size to Max
Drag the slider to the
maximum size.

138 | e x o c a d S M I L E D E S I G N & V E N E E R S
138 . Remove the Pink Areas
Like you did before, add
thickness to the areas that
show the pink color.

139 | e x o c a d S M I L E D E S I G N & V E N E E R S
139 . Add Thickness
Like you did before, add
thickness to the areas that
show the pink color.

140 | e x o c a d S M I L E D E S I G N & V E N E E R S
140 . Add Thickness
Like you did before, add
thickness to the areas that
show the pink color.

141 | e x o c a d S M I L E D E S I G N & V E N E E R S
141 . Add Thickness
Like you did before, add
thickness to the areas that
show the pink color.

142 | e x o c a d S M I L E D E S I G N & V E N E E R S
142 . Remove Lingual Flash
Hold SHIFT and click to
remove lingual flash.

143 | e x o c a d S M I L E D E S I G N & V E N E E R S
143 . Remove Lingual Flash
Hold SHIFT and click to
remove lingual flash.

144 | e x o c a d S M I L E D E S I G N & V E N E E R S
144 . Uncheck“Visualize Mockup”
Uncheck the box.

145 | e x o c a d S M I L E D E S I G N & V E N E E R S
145 . Click “Free”
Click the “Free” tab.

146 | e x o c a d S M I L E D E S I G N & V E N E E R S
146 . Click “Add/Remove”
Click “Add/Remove”

147 | e x o c a d S M I L E D E S I G N & V E N E E R S
147 . Adjust Dynamic Contacts
My software is set up for
automatic dynamic
articulation. Check back
earlier in this guide for how
to do this in settings. I am
now going to use remove tool
to equalize contacts. I like to
select green for dynamic.

148 | e x o c a d S M I L E D E S I G N & V E N E E R S
148 . Equalize Dynamic
Equalize Dynamic.

149 | e x o c a d S M I L E D E S I G N & V E N E E R S
149 . Equalize Dynamic
Equalize Dynamic.

150 | e x o c a d S M I L E D E S I G N & V E N E E R S
150 . Equalize Dynamic
Equalize Dynamic.

151 | e x o c a d S M I L E D E S I G N & V E N E E R S
151 . Click “Adapt”
Click the “Adapt” button.

152 | e x o c a d S M I L E D E S I G N & V E N E E R S
152 . Click “Approximal”
Click the “Approximal”
button.

153 | e x o c a d S M I L E D E S I G N & V E N E E R S
153 . Click “Adapt Design to Jaw Scan”
This is the very last thing you
do. Once hot no further
modificatios should be done
because then they will not fit.

154 | e x o c a d S M I L E D E S I G N & V E N E E R S
154 . Evaluate the Shells
Now you no longer have
pontics, but have veneers.

155 | e x o c a d S M I L E D E S I G N & V E N E E R S
155 . Verify Cut Veneers
Verify the cut veneers.

156 | e x o c a d S M I L E D E S I G N & V E N E E R S
156 . Click “OK”
Click “OK”.

157 | e x o c a d S M I L E D E S I G N & V E N E E R S
157 . All Done!
You are done with design.

158 | e x o c a d S M I L E D E S I G N & V E N E E R S
158 . Export
Make sure only your final
parts are visible. Right click
the screen in empty space
and hit save scene as.

159 | e x o c a d S M I L E D E S I G N & V E N E E R S
159 . Change to STL
Change file type to STL and
pick location.

160 | e x o c a d S M I L E D E S I G N & V E N E E R S
160 . Click “Save”
Click the “save” button.

161 | e x o c a d S M I L E D E S I G N & V E N E E R S
161 . Click “Yes”
Click the “Yes” button.

162 | e x o c a d S M I L E D E S I G N & V E N E E R S
162 . Click “Default”
Click the default option and
you are done.

163 | e x o c a d S M I L E D E S I G N & V E N E E R S
163 . Click “Default”
Use default coordinate
system.

164 | e x o c a d S M I L E D E S I G N & V E N E E R S
 SMILE DESIGN

Direct Print Mockup

WITHOUT AI

165 | e x o c a d S M I L E D E S I G N & V E N E E R S < TABLE OF CONTENTS

 1 . Case Set Up
Select “Default” client.

166 | e x o c a d S M I L E D E S I G N & V E N E E R S
 2 . Case Set Up
Type the patient name.

167 | e x o c a d S M I L E D E S I G N & V E N E E R S
 3 . Case Set Up
Select distal-most tooth
you want to design.

168 | e x o c a d S M I L E D E S I G N & V E N E E R S
 4 . Case Set Up
Select Mockup, then hit
“3D Print”.

Minimum thickness 0.3mm

is safe on most printers.
Some printers can do
0.2mm.

Hit OK on the bottom right.

169 | e x o c a d S M I L E D E S I G N & V E N E E R S
 5 . Case Set Up
Hold SHIFT on the
keyboard and don’t let go.

170 | e x o c a d S M I L E D E S I G N & V E N E E R S
 6 . Case Set Up
Left mouse click
contralateral premolar
while still holding SHIFT.

171 | e x o c a d S M I L E D E S I G N & V E N E E R S
 7 . Case Set Up
Click each bubble to
remove the connector.

172 | e x o c a d S M I L E D E S I G N & V E N E E R S
 8 . Case Set Up
Click each bubble to
remove the connector.

173 | e x o c a d S M I L E D E S I G N & V E N E E R S
 9 . Case Set Up
Hit “Save”.

174 | e x o c a d S M I L E D E S I G N & V E N E E R S
10 . Case Set Up
Hit “Design”.

175 | e x o c a d S M I L E D E S I G N & V E N E E R S
 11 . Case Set Up
Hit “Design”.

176 | e x o c a d S M I L E D E S I G N & V E N E E R S
12 . Case Set Up
Find the files.

177 | e x o c a d S M I L E D E S I G N & V E N E E R S
13 . Case Set Up
Load upper scan first.

178 | e x o c a d S M I L E D E S I G N & V E N E E R S
14 . Case Set Up
Load lower scan next.

179 | e x o c a d S M I L E D E S I G N & V E N E E R S
15 . Orientation
Right click to rotate the
model so the occlusal
surfaces are facing you and
you can see a little of the
facial of the anterior.

180 | e x o c a d S M I L E D E S I G N & V E N E E R S
16 . Orientation
Hit “Next”.

181 | e x o c a d S M I L E D E S I G N & V E N E E R S
17 . Smile Creator
Hit “Start Smile Creator”.

182 | e x o c a d S M I L E D E S I G N & V E N E E R S
18 . Smile Creator
Roll the mouse ball to zoom
in on photo and left click CEJ
of 6.

183 | e x o c a d S M I L E D E S I G N & V E N E E R S
19 . Smile Creator
Next, click cusp tip of 11
(note if ball is not loading you
may have accidentally clicked
someplace else on image.
Zoom out and search for
them. If you do not like the
exact location left click the
ball and drag it ).

184 | e x o c a d S M I L E D E S I G N & V E N E E R S
20 . Smile Creator
Click.

185 | e x o c a d S M I L E D E S I G N & V E N E E R S
21 . Smile Creator
Now click same exact spots
on the 3D scan. start with
tooth 6 CEJ and move onto
tooth 11 cusp tip. Make sure
yellow and green match on
the model and photo.

186 | e x o c a d S M I L E D E S I G N & V E N E E R S
22 . Smile Creator
Hit “next”.

187 | e x o c a d S M I L E D E S I G N & V E N E E R S
23 . Smile Creator
Start to better align the two
models. First, right click the
midline and hold. Drag the
mouse to rotate the model to
make it closer of a match. I
try to split the difference on
left and right.

188 | e x o c a d S M I L E D E S I G N & V E N E E R S
24 . Smile Creator
Next, left click the center of
the balls and drag it small
amounts to futher tweak the
match.

189 | e x o c a d S M I L E D E S I G N & V E N E E R S
25 . Smile Creator
Next, left click the center of
the contralateral ball and
drag it small amounts to
futher tweak the match.

190 | e x o c a d S M I L E D E S I G N & V E N E E R S
26 . Smile Creator
Repeat on both sides.

191 | e x o c a d S M I L E D E S I G N & V E N E E R S
27 . Smile Creator
Once satisfied, hit “next”. No
ghosting should be detected
(even on the molars).

192 | e x o c a d S M I L E D E S I G N & V E N E E R S
28 . Smile Creator
Load a smile image now.

193 | e x o c a d S M I L E D E S I G N & V E N E E R S
29 . Smile Creator
Search for the smile image.

194 | e x o c a d S M I L E D E S I G N & V E N E E R S
30 . Smile Creator
Wait 5 seconds, the software
will use AI to align the smile
and retracted. If photos are
well made from same angle
this will be a perfect match.
You can tell you have a
perfect match if the maxillary
teeth do not look blurry.

195 | e x o c a d S M I L E D E S I G N & V E N E E R S
31 . Smile Creator
The maxilla should be clear
at least cuspid to cuspid. you
can move the balls to adjust
but this does not typically
help if the photos are taken at
a bad angle.

196 | e x o c a d S M I L E D E S I G N & V E N E E R S
32 . Smile Creator
Hit “Next”.

197 | e x o c a d S M I L E D E S I G N & V E N E E R S
33 . Smile Creator
Mark the lips.

198 | e x o c a d S M I L E D E S I G N & V E N E E R S
34 . Smile Creator
You can add as a control
point by clicking the line.

199 | e x o c a d S M I L E D E S I G N & V E N E E R S
35 . Smile Creator
Hit “Next”.

200 | e x o c a d S M I L E D E S I G N & V E N E E R S
36 . Smile Creator
Mark the center of the pupil.

201 | e x o c a d S M I L E D E S I G N & V E N E E R S
37 . Smile Creator
Mark the center of the pupil.

202 | e x o c a d S M I L E D E S I G N & V E N E E R S
38 . Smile Creator
Hit “Next”.

203 | e x o c a d S M I L E D E S I G N & V E N E E R S
39 . Smile Creator
Click and move the blue line
to the patients right.

204 | e x o c a d S M I L E D E S I G N & V E N E E R S
40 . Smile Creator
Click and move the
proportion gauge line to the
patients left.

205 | e x o c a d S M I L E D E S I G N & V E N E E R S
41 . Smile Creator
For no prep cases move the
facial midline to be perfectly
in the center of the maxillary
natural midline .

206 | e x o c a d S M I L E D E S I G N & V E N E E R S
42 . Smile Creator
Delete the blue line by left-
clicking the ball, holding and
then also right-clicking.

207 | e x o c a d S M I L E D E S I G N & V E N E E R S
43 . Smile Creator
Left-click center of the
proportion gauge and move it
to the midline.

208 | e x o c a d S M I L E D E S I G N & V E N E E R S
44 . Smile Creator
Get the vertical bar in line
with the midline.

209 | e x o c a d S M I L E D E S I G N & V E N E E R S
45 . Smile Creator
Change to a 100-65-50 ratio.

210 | e x o c a d S M I L E D E S I G N & V E N E E R S
46 . Smile Creator
Correct the cant by clicking
here and making the number
0 degrees.

211 | e x o c a d S M I L E D E S I G N & V E N E E R S
47 . Smile Creator
Shrink the gauge by clicking
here and align the distal of
the cuspid bar to the distal of
the cuspid in the photo.

212 | e x o c a d S M I L E D E S I G N & V E N E E R S
48 . Smile Creator
Pick one cuspid if you can’t
get both.

213 | e x o c a d S M I L E D E S I G N & V E N E E R S
49 . Smile Creator
Hit “Next”.

214 | e x o c a d S M I L E D E S I G N & V E N E E R S
50 . Smile Creator
After selecting the library you
want the next step is rotating
the arch such that the cusp
tips are parallel to natural
arch. We are in the bottom
right corner of the screen.

215 | e x o c a d S M I L E D E S I G N & V E N E E R S
51 . Smile Creator
Next, make sure the entire
arch has a box around it and
click the center of 8 and 9
and move the entire arch
apical to line up the CEJ.

216 | e x o c a d S M I L E D E S I G N & V E N E E R S
52 . Smile Creator
Notice that the CEJ is lined
up. And incisal edges are on
the horizontal line from the
proportion gauge. If not you
can drag the baby blue ball
located where the pink circles
are in the image.

217 | e x o c a d S M I L E D E S I G N & V E N E E R S
53 . Smile Creator
Now click “measurement”.

218 | e x o c a d S M I L E D E S I G N & V E N E E R S
54 . Smile Creator
Click number 9. The central
should be 10 -11mm long.

219 | e x o c a d S M I L E D E S I G N & V E N E E R S
55 . Smile Creator
Next, move the whole arch
facial in this view.

220 | e x o c a d S M I L E D E S I G N & V E N E E R S
56 . Smile Creator
You want to see mostly wax
on the facial of the anterior 4
incisors, but want some small
areas with natural tooth
showing like I have on 9.

221 | e x o c a d S M I L E D E S I G N & V E N E E R S
57 . Smile Creator
Make sure your midline is
correct, you incisal of 8 and 9
are on the horizontal blue
line, tooth 9 is 10-11mm long
and you have mostly wax on
the facial incisors. Hit “Next”.
Please note I do not worry
about cuspids and premolars
in this module.

222 | e x o c a d S M I L E D E S I G N & V E N E E R S
58 . Smile Creator
Pick a color, but note that we
do not use this image.

223 | e x o c a d S M I L E D E S I G N & V E N E E R S
59 . Smile Creator
Hit “Next”.

224 | e x o c a d S M I L E D E S I G N & V E N E E R S
60 . Smile Creator
Hit “done”.

225 | e x o c a d S M I L E D E S I G N & V E N E E R S
61 . Tooth Placement
Hit “Chain Mode”.

226 | e x o c a d S M I L E D E S I G N & V E N E E R S
62 . Tooth Placement
Click red dots, turn the red
premolar dots to green on
both sides.

227 | e x o c a d S M I L E D E S I G N & V E N E E R S
63 . Tooth Placement
Turn dots red above 8 and 9
by clicking them. This will
lock those teeth in position.

228 | e x o c a d S M I L E D E S I G N & V E N E E R S
64 . Tooth Placement
Click the wax tooth on the
premolar site and move it to
desired position.

229 | e x o c a d S M I L E D E S I G N & V E N E E R S
65 . Tooth Placement
Do the same on the other
side.

230 | e x o c a d S M I L E D E S I G N & V E N E E R S
66 . Tooth Placement
Click advanced.

231 | e x o c a d S M I L E D E S I G N & V E N E E R S
67 . Tooth Placement
Click the eye.

232 | e x o c a d S M I L E D E S I G N & V E N E E R S
68 . Tooth Placement
Turn on smile window.

233 | e x o c a d S M I L E D E S I G N & V E N E E R S
69 . Tooth Placement
Turn on the helper line.

234 | e x o c a d S M I L E D E S I G N & V E N E E R S
70 . Tooth Placement
Now, move each tooth
individually.

CTRL to rotate

SHIFT to grow

CTRL and SHIFT to stretch.

235 | e x o c a d S M I L E D E S I G N & V E N E E R S
71 . Tooth Placement
Move each tooth palatal until
you see natural tooth poking
through, then move facial
until it is just gone.

236 | e x o c a d S M I L E D E S I G N & V E N E E R S
72 . Tooth Placement
Move each tooth palatal until
you see natural tooth poking
through then move facial until
it is just gone.

237 | e x o c a d S M I L E D E S I G N & V E N E E R S
73 . Tooth Placement
Move each tooth palatal until
you see natural tooth poking
through, then move facial
until it is just gone.

238 | e x o c a d S M I L E D E S I G N & V E N E E R S
74 . Tooth Placement
Move each tooth palatal until
you see natural tooth poking
through, then move facial
until it is just gone.

239 | e x o c a d S M I L E D E S I G N & V E N E E R S
75 . Tooth Placement
Move each tooth palatal until
you see natural tooth poking
through, then move facial
until it is just gone.

240 | e x o c a d S M I L E D E S I G N & V E N E E R S
76 . Tooth Placement
Keep working around the
smile for each tooth.

241 | e x o c a d S M I L E D E S I G N & V E N E E R S
77 . Tooth Placement
Move each tooth palatal until
you see natural tooth poking
through, then move facial
until it is just gone.

242 | e x o c a d S M I L E D E S I G N & V E N E E R S
78 . Tooth Placement
Make sure to have the
proximal contacts perfectly
inline with natural tooth
embrasure. I like to use CTRL
and SHIFT to stretch.

243 | e x o c a d S M I L E D E S I G N & V E N E E R S
79 . Smile Creator
Make sure to have the
proximal contacts perfectly
inline with natural tooth
embrasure. I like to use CTRL
and SHIFT to stretch.

244 | e x o c a d S M I L E D E S I G N & V E N E E R S
80 . Tooth Placement
Make sure to have the
proximal contacts perfectly
inline with natural tooth
embrasure. I like to use CTRL
and SHIFT to stretch.

245 | e x o c a d S M I L E D E S I G N & V E N E E R S
81 . Tooth Placement
Check how the teeth look in
the smile view.

246 | e x o c a d S M I L E D E S I G N & V E N E E R S
82 . Tooth Placement
To make minor movements,
click this icon.

247 | e x o c a d S M I L E D E S I G N & V E N E E R S
83 . Tooth Placement
Fine tune the cervical.

248 | e x o c a d S M I L E D E S I G N & V E N E E R S
84 . Tooth Placement
Note: if massive amounts of
root is exposed here then you
need to use other previous
eyeball icon tool ctr to rotate
neck of tooth palatal. This is
for small movements only.

249 | e x o c a d S M I L E D E S I G N & V E N E E R S
85 . Tooth Placement
Fine tune proximal embrasure
with this tool. Note: Strength
is not important at this point,
but you must have contact.

250 | e x o c a d S M I L E D E S I G N & V E N E E R S
86 . Tooth Placement
Keep fine tuning.

251 | e x o c a d S M I L E D E S I G N & V E N E E R S
87 . Tooth Placement
This tool can morph cusp tips
as well.

252 | e x o c a d S M I L E D E S I G N & V E N E E R S
88 . Tooth Placement
This tool can morph cusp tips
as well.

253 | e x o c a d S M I L E D E S I G N & V E N E E R S
89 . Tooth Placement
95% of the design is done
before hitting next. Once
happy, hit “next”.

254 | e x o c a d S M I L E D E S I G N & V E N E E R S
90 . Dynamic Articulation
My Software is set to do
automatic dynamic
articulation. This can be set
up in the tools-settings-add
on module

255 | e x o c a d S M I L E D E S I G N & V E N E E R S
91 . Virtual Waxup Bottom
Now, we need to pick the
insertion path of the mockup.
The default is always wrong.

256 | e x o c a d S M I L E D E S I G N & V E N E E R S
92 . Virtual Waxup Bottom
Rotate the model to be almost
facial, but with a little incisal
edge visible and hit “set
insertion from view”.

257 | e x o c a d S M I L E D E S I G N & V E N E E R S
93 . Tooth Placement
Hit “Apply”.

258 | e x o c a d S M I L E D E S I G N & V E N E E R S
94 . Virtual Waxup Bottom
Hit freeform once the blue
model is rendered. The little
text box will become active
once you hit apply down
below.

259 | e x o c a d S M I L E D E S I G N & V E N E E R S
95 . Virtual Waxup Bottom
This model has blockout wax
to help the mockup to seat in
the mouth. Hold shift and
click the wax areas to remove
a little wax to modify fit of
shells for more intimate
adaptation. Be carful not to
remove too much wax or they
might not seat.

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96 . Virtual Waxup Bottom
This is before model
adjustment.

261 | e x o c a d S M I L E D E S I G N & V E N E E R S
97 . Virtual Waxup Bottom
This is after. I removed some
wax. Be careful not to remove
too much or the trial smile
may not fit due to too much
undercut engagement.

262 | e x o c a d S M I L E D E S I G N & V E N E E R S
98. Virtual Waxup Bottom
Hit “Next”.

263 | e x o c a d S M I L E D E S I G N & V E N E E R S
99. Free-Form
Hit “Visualize Thickness”.

264 | e x o c a d S M I L E D E S I G N & V E N E E R S
100. Free-Form
Change to 0.3. If you have a
new printer with a XY
resolution below 40 microns
you can go down to 0.2 or
0.25mm. If you selected this
in the setup then you will see
the slider will go down
further to 0.2mm.

265 | e x o c a d S M I L E D E S I G N & V E N E E R S
101. Free-Form
Click “Add/Remove”.

266 | e x o c a d S M I L E D E S I G N & V E N E E R S
102. Free-Form
Move size to max.

267 | e x o c a d S M I L E D E S I G N & V E N E E R S
103. Free-Form
Remove the pink by clicking
and adding wax. Pink is too
thin and will not print.

Note: The margin will always

remain pink.

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104. Free-Form
Remove the pink by clicking
and adding wax. Pink is too
thin and will not print.

Note: The margin will always

remain pink.

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105. Free-Form
Remove the pink by clicking
and adding wax. Pink is too
thin and will not print.

Note: The margin will always

remain pink.

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106. Free-Form
Continue with each tooth.

271 | e x o c a d S M I L E D E S I G N & V E N E E R S
107. Free-Form
Remove the pink by clicking
and adding wax. Pink is too
thin and will not print.

Note: The margin will always

remain pink.

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108. Free-Form
The only pink left is at the
borders.

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109. Free-Form
Adjust size to medium

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110. Free-Form
Increase strength.

275 | e x o c a d S M I L E D E S I G N & V E N E E R S
111. Free-Form
Remove wax on the lingual by
holding SHIFT + left-click
and hold and rub.

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112. Free-Form
Now click off the visualize
thickness.

277 | e x o c a d S M I L E D E S I G N & V E N E E R S
113. Free-Form
Now, on the top bar, click this
chevron.

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114. Free-Form
Click all the indications to
make them all orange.

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115. Free-Form
Manually adjust dynamic
occlusion to be all one
strength (green) on all of the
teeth by holding SHIFT and
left-clicking to melt the
contact or don’t hold shift to
add.

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116. Free-Form
Manually adjust dynamic
occlusion to be all one
strength (green) on all teeth
by holding SHIFT and left-
clicking.

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117. Free-Form
Manually adjust dynamic
occlusion to be all one
strength (green) on all teeth
by holding SHIFT and left-
clicking.

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118. Free-Form
Manually adjust dynamic
occlusion to be all one
strength (green) on all teeth
by holding SHIFT and left-
clicking.

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119. Free-Form
Manually adjust dynamic
occlusion to be all one
strength (green) on all teeth
by holding SHIFT and left-
clicking.

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120. Free-Form
Turn off dynamic and make
sure show contact areas is
on. Ensure that there is no
contact on veneers in static.

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121. Free-Form
Next, turn your waxup half-
way clear by dragging the
slider here.

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122. Free-Form
Then, click “Anatomic” tooth
parts.

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123. Free-Form
Click on “tooth parts”.

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124. Free-Form
Make sure the CEJ of the
waxup is aligned with natural
sulcus.

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125. Free-Form
Edit each tooth from a
perfectly straight facial view.

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126. Free-Form
You can also tip the roots to
help.

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127. Free-Form
Turn back on the mockup
thickness and make sure it is
on 0.3mm and do a list
minute check.

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128. Free-Form
Add to any areas if they have
accidentally been made too
thin on the last step. To avoid
veneers short of the natural
CEJ you want to make sure
the pink band is in the sulcus
area.

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129. Free-Form
Click on the “free” tab.

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130. Adaptation
Go to free-adapt and click
“approximal”.

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131. Adaptation
Go to free-adapt and click
“static occlusion”.

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132. Adaptation
Now, you will see that it is
shells.

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133. Adaptation
Now, you will see that it is
shells.

Click “Next”.

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134. Final Step: Export
Now, you see merged design
(printable files).

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135. Final Step: Export
Turn on all merged parts.

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136. Final Step: Export
Right-click screen.

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137. Final Step: Export
Save scene as, pick “STL and
Location”.

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138. Final Step: Export
Rename it.

303 | e x o c a d S M I L E D E S I G N & V E N E E R S
139. Final Step: Export
Pick location.

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140. Final Step: Export
Hit ‘Save”.

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141. Final Step: Export
Visible Objects Only: Yes

Default Orientation

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142. Final Step: Export
Hit “Next” and the case will
close.

You can move on to the

conversion to finals.

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 SMILE DESIGN

Conversion to Final Veneers

308 | e x o c a d S M I L E D E S I G N & V E N E E R S < TABLE OF CONTENTS

 1 . Final Step: Export
Be sure that you have
exported your design before
beginning the conversion to
finals. Hit “Next” and the
case will close.

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 2 . Convert to Final Veneers
It can be immediate, weeks or
months later to convert a
mockup to final individual
printed no prep veneers is
fast. Reload the case by going
to “load”.

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 3 . Convert to Final Veneers
Find the patient under “Load”
in DB.

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 4 . Convert to Final Veneers
Load and hit “design”.

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 5 . Convert to Final Veneers
Load BEFORE hard cut. This
is critical when converting
your mockup to veneers.
Please note this only works
with minimum to no prep
veneers.

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 6 . Convert to Final Veneers
Go to expert mode and click
the model. A blue bar should
pop up on the bottom. Find
the trash can and click.

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 7 . Convert to Final Veneers
Go to expert mode and click
the model. A blue bar should
pop up on the bottom. Find
the trashcan and click.

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 8 . Convert to Final Veneers
Delete the virtual waxup
bottom.

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 9 . Convert to Final Veneers
Now, click “virtual waxup
bottom” here.

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10 . Convert to Final Veneers
Set insertion from facial view
with some incisal edge visible
like this.

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 11 . Convert to Final Veneers
Hit “Apply”.

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 12 . Convert to Final Veneers
Hit “Free-forming”.

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 13 . Convert to Final Veneers
Be more aggressive with wax
removal. Hold SHIFT. Now,
we have some individual
veneers, so we can be more
aggressive and remove much
more wax than before when
they were all splinted.

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 14 . Convert to Final Veneers
The model should be crisp.

Note: You can still remove too

much making a veneer that
may not seat. Use common
sense.

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 15 . Convert to Final Veneers
Click “OK”.

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 16 . Convert to Final Veneers
Click on “Wizard”.

324 | e x o c a d S M I L E D E S I G N & V E N E E R S
 17 . Convert to Final Veneers
Go to “free”.

325 | e x o c a d S M I L E D E S I G N & V E N E E R S
 18 . Convert to Final Veneers
Click “Adapt”.

326 | e x o c a d S M I L E D E S I G N & V E N E E R S
 19 . Convert to Final Veneers
Click in this order:

1). Approximal

2). Static Occlusion

3). Lastly, Adapt Design Jaw

Scan Hard Cut. Once you do
this you should not edit the
design at all. So only do this
if happy with the design.

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20 . Convert to Final Veneers
Check your proximal.

328 | e x o c a d S M I L E D E S I G N & V E N E E R S
 21 . Convert to Final Veneers
Click “adjacents”

329 | e x o c a d S M I L E D E S I G N & V E N E E R S
22 . Convert to Final Veneers
Look for the teal blue contact
when show contact areas is
on.

330 | e x o c a d S M I L E D E S I G N & V E N E E R S
23 . Convert to Final Veneers
Hit “Next” and you are done
now.

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24 . Convert to Final Veneers
You will then hit “Next”.

332 | e x o c a d S M I L E D E S I G N & V E N E E R S
25 . Convert to Final Veneers
Hit “next” again. You are
done now.

333 | e x o c a d S M I L E D E S I G N & V E N E E R S
26 . Convert to Final Veneers
Back in Dental DB, click
“Open in Explorer”.

334 | e x o c a d S M I L E D E S I G N & V E N E E R S
27 . You’re Done!
Your individual final veneer
STL files are found here.

Now, you are done.

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 SMILE DESIGN

Mockup Model

336 | e x o c a d S M I L E D E S I G N & V E N E E R S < TABLE OF CONTENTS

 1 . Design Model
When you are all done
with your design and are in
the merge and save step
you should see an option
to design a model. I prefer
to use the design model
and not the quick model.

337 | e x o c a d S M I L E D E S I G N & V E N E E R S
 2 . Click “Design Model”
Select design model. Please
note you can also access
model design from the
dental DB page in the right
menu in the event you
already closed the case.

338 | e x o c a d S M I L E D E S I G N & V E N E E R S
 3 . Next
Once you select design
model you have to hit
“next”.

339 | e x o c a d S M I L E D E S I G N & V E N E E R S
 4 . Digital Waxup Model
To design a model that has
your waxup fused to the
model you need to select
Digital Waxup Model in the
options here.

340 | e x o c a d S M I L E D E S I G N & V E N E E R S
 5 . Position
Click the model and drag it
to position it between the
center of the blue and
green slice planes.

341 | e x o c a d S M I L E D E S I G N & V E N E E R S
 6 . Position
Hold “Control” on the
keyboard to rotate the
model if needed.

342 | e x o c a d S M I L E D E S I G N & V E N E E R S
 7 . Cut Model
Drag the ball in the slider
to crop the model this way
you do not have such a
long tall base.

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 8 . Next
Hit “next” to move on.

344 | e x o c a d S M I L E D E S I G N & V E N E E R S
 9 . Select Teeth
By default, all the waxed
teeth will be on and purple
in the odontogram. You
can click a tooth and turn
it off if you do not want
that waxup in your model.
Also, you can click the
drop-down menu to
explore other options.

345 | e x o c a d S M I L E D E S I G N & V E N E E R S
10 . Select Teeth
The drop-down menu has
options like every other
tooth for quickly creating
models for injection
molding.

346 | e x o c a d S M I L E D E S I G N & V E N E E R S
 11 . Next
Hit “Next” to move on.

347 | e x o c a d S M I L E D E S I G N & V E N E E R S
12 . Antagonist
You can hit “create model” or
skip for the antagonist arch.
Here I chose to skip model
creation.

348 | e x o c a d S M I L E D E S I G N & V E N E E R S
13 . Honeycomb
In the model attachments
choose honeycomb. It is the
best way to fill your base and
does not require drain holes.

349 | e x o c a d S M I L E D E S I G N & V E N E E R S
14 . Honeycomb
To place the honeycomb, left-
click the center of the model.

350 | e x o c a d S M I L E D E S I G N & V E N E E R S
15 . Honeycomb
Scale the honeycomb by
dragging the ball on the slider
bar. I like to make it bigger
around 115%.

351 | e x o c a d S M I L E D E S I G N & V E N E E R S
16 . Next
Hit “next”.

352 | e x o c a d S M I L E D E S I G N & V E N E E R S
17 . Done
Your waxup model is
complete. You can export it
here or find the final STL in
the project folder. If
exporting here make sure to
turn off all other objects
except the model. Right-click
the empty screen area and hit
save scene as: change to STL.
When asked check visible
object only and default
orientation.

353 | e x o c a d S M I L E D E S I G N & V E N E E R S
 All on x

1. Pre-surgical Waxup

1

Pontic Waxup
Dentate Arch

< TABLE OF CONTENTS exocad MASTER GUIDE

Table of Contents
01 Ultra Fast Temps 5
02 Case Duplication Techniques 47
03 Face Scan Mounting 155
04 CBCT Mounting 191

< TABLE OF CONTENTS exocad MASTER GUIDE

 FU L L M O U T H R E STO RAT I O N S

Ultra Fast Temps

5 | exocad FULL MOUTH RESTORATIONS < TABLE OF CONTENTS

 1 . Pre-Preparation Mockup
Every large case should have
a diagnostic mockup made
prior to preparation day. This
is best designed in exocad
using Mockup. Often times
this being waxed at a new
vertical dimension. Always
photos are highly
recommended.

6 | exocad FULL MOUTH RESTORATIONS

 2 . Complete Mockup Waxup
Complete a diagnostic
mockup following along with
our smile design handout in
this manual. You do NOT
want to hit Adapt design to
jaw scan hard cut or hit “Cut
all intersections”.

7 | exocad FULL MOUTH RESTORATIONS

 3 . Adapt Occlusion and Approximal
You can adapt occlusion and
approximate.

8 | exocad FULL MOUTH RESTORATIONS

 4 . Adapt Occlusion and Approximal
Adapt occlusion and
approximal.

9 | exocad FULL MOUTH RESTORATIONS

 5 . Click “Next” and Finish
The case will be completed
and closed.

10 | e x o c a d FULL MOUTH RESTORATIONS

 6 . Game Day
On prep day find the original
design mockup file and load
the case by hitting design and
hit load scene file.

11 | e x o c a d FULL MOUTH RESTORATIONS

 7 . Click Expert Mode
Immediately go to expert
mode.

12 | e x o c a d FULL MOUTH RESTORATIONS

 8 . Click Model and Find Trash Can
Click the model and find the
delete trash can on the
bottom right of the screen in
the blue menu bar. Then
navigate to this window.

13 | e x o c a d FULL MOUTH RESTORATIONS

 9 . Find Virtual Waxup Bottom
Delete the virtual wax up
bottom.

14 | e x o c a d FULL MOUTH RESTORATIONS

10 . Click “OK”
Click “OK”.

15 | e x o c a d FULL MOUTH RESTORATIONS

 11 . Repeat
You also need to delete any
merged or completed parts.
This would be if you finished
the original mockup design. I
did not have any to show you
in this design but it would be
called merged parts.

16 | e x o c a d FULL MOUTH RESTORATIONS

 12 . Click “Tools”
Click “tools”.

17 | e x o c a d FULL MOUTH RESTORATIONS

 13 . Add / Remove Mesh
You are still in expert mode.
Click tools-add remove the
mesh.

18 | e x o c a d FULL MOUTH RESTORATIONS

 14 . Extra Jaw Scan
Click extra jaw scan.

19 | e x o c a d FULL MOUTH RESTORATIONS

 15 . Click “Load”
Click “load”.

20 | e x o c a d FULL MOUTH RESTORATIONS

 16 . Navigate to The New Prep Scan
Find the prep scan you just
did on tooth preparation day.

21 | e x o c a d FULL MOUTH RESTORATIONS

 17 . Click “No”
The prep scan will NOT be
aligned. This does NOT
matter at all.

22 | e x o c a d FULL MOUTH RESTORATIONS

 18 . Click “OK”
You do not align the models
here. Just hit ok.

23 | e x o c a d FULL MOUTH RESTORATIONS

 19 . Click “Wizard”
Go back to the wizard.

24 | e x o c a d FULL MOUTH RESTORATIONS

20 . Align Models
The wizard should take you to
an automatic alignment
feature.

25 | e x o c a d FULL MOUTH RESTORATIONS

 21 . Click Common Spot
Rotate each model. The green
one is the new model with
preps. The stone one is the
old one from the waxup. Click
common spots.

26 | e x o c a d FULL MOUTH RESTORATIONS

22 . Hold Control
Hold control and click
common spots between the
models if you need multiple
spots to align.

27 | e x o c a d FULL MOUTH RESTORATIONS

23 . Evaluate Alignment
Green means a good
alignment. If it is bad, hold
control and click more spots.
Otherwise hit next.

28 | e x o c a d FULL MOUTH RESTORATIONS

24 . Click Replace Whole Scan
Click replace whole jaw scan.
The new prep model will not
replace the old preop model.

29 | e x o c a d FULL MOUTH RESTORATIONS

25 . Set Path of Insertion of All Preps
One of the downsides is this
only lets you pick a unified
path of insertion for the
whole arch. Rotate and hit
select from view.

30 | e x o c a d FULL MOUTH RESTORATIONS

26 . Rotate Set From View
Try to find the common path
of the insertion for the arch
Then hit set from view.

31 | e x o c a d FULL MOUTH RESTORATIONS

27 . Click “Apply”
Click apply to evaluate the
“Blockout Model”.

32 | e x o c a d FULL MOUTH RESTORATIONS

28 . Look for Wax
Exocad will flow wax into
undercuts including margins.
This means that the area may
be open a bit. You can hit
freeform and remove wax at
the risk of the temp, not
seating.

33 | e x o c a d FULL MOUTH RESTORATIONS

29 . Free-Form
Click “Free-Forming” tab.

34 | e x o c a d FULL MOUTH RESTORATIONS

30 . Risky
If you know what you are
doing you can remove some
wax in key areas. Especially if
you will break the arch up
into sextants for delivery.
Hold Shift to remove wax

35 | e x o c a d FULL MOUTH RESTORATIONS

 31 . Focus on Margins
I am going to break this into
sextants so will remove some
wax based on my view of the
quadrant.

36 | e x o c a d FULL MOUTH RESTORATIONS

32 . Free-Form
Your old wax-up is present.
Freeform areas that may need
to be sculpted based on the
preparations.

37 | e x o c a d FULL MOUTH RESTORATIONS

33 . Free-Form
Continue.

38 | e x o c a d FULL MOUTH RESTORATIONS

34 . Cover Margins
If wax-up is shy of margins
add wax to cover margins
using the largest large brush
size.

39 | e x o c a d FULL MOUTH RESTORATIONS

35 . Add Wax to Margins
Add wax to the margins.

40 | e x o c a d FULL MOUTH RESTORATIONS

36 . Adapt in This Order
Adapt static occlusion.

Adapt approximate.

Adapt design to jaw scan.

41 | e x o c a d FULL MOUTH RESTORATIONS

37 . Click “Next”
Click the “Next” button.

42 | e x o c a d FULL MOUTH RESTORATIONS

38 . Done
Your arch is now adapted to
the preps. Specifically the
blockout Model.

43 | e x o c a d FULL MOUTH RESTORATIONS

39 . Export Sections
Export Sections

44 | e x o c a d FULL MOUTH RESTORATIONS

40 . Export
Turn on the amount of teeth
you want to export as a
combined unit. For example,
if the whole arch is inserted
splinted, make sure the whole
arch is visible and nothing
else but the finished
“merged” parts. Right-click
the blank screen, save the
scene as, stl, visible objects
only “yes”, default
orientation.

45 | e x o c a d FULL MOUTH RESTORATIONS

 41 . Export
If you want to deliver this in
sections turn off all other
teeth except the section you
want splinted and repeat
export: right-click blank
screen, save the scene as, stl,
visible objects only “yes”,
default orientation.

46 | e x o c a d FULL MOUTH RESTORATIONS

 FU L L M O U T H R E STO RAT I O N

Case Duplication Technique

47 | e x o c a d FULL MOUTH RESTORATIONS < TABLE OF CONTENTS

 1 . Mockup Waxup
Step one if to follow the
mockup lesson in this
handout to do the initial
mockup.

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 2 . Complete Waxup
Take your waxup all the way
to completion.

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 3 . Re-Open Case
Open dental DB and hit load.
Find the mockup. This is
often many weeks after the
original mockup was
completed and now the
patient is back for tooth
preparations.

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 4 . Search for the Patient Name
Find the original mockup file
that was originally designed
in exocad.

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 5 . Load
Load files.

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 6 . Click “Design”
Click “Design”.

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 7 . Click “Load Scene”
Click “Load Scene”.

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 8 . Merged Parts
You should be advanced to
the last step of exocad the
merge and save step. You
should see your Mockup.

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 9 . Expert Mode
Enter expert mode.

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10 . Click “Tools”
Click tools and find the Add
Remove Mesh Button.

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 11 . Select the Mesh Type
Click here and find generic
visualization mesh.

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 12 . Click Here
Click here from the drop-
down menu.

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 13 . Load Pre-Op Scan
Hit load and find your new
prep scan.

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 14 . Load Prep Scan
Navigate to where your prep
scan is stored.

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 15 . Click “No”
The prep scan will not be
aligned to the waxup as it was
made at a later date .

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 16 . Not Aligned
Notice the scan is not aligned
at all. This does not matter as
we will align it here.

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 17 . Rotate the Prep Scan
This can be tricky.Left click
the prep scan top drag it.
Hold control and left clic the
prep model to rotate it. Right
click the screen to rotate
BOTH the waxup and the
prep scan together.

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 18 . Get Them Oriented
Orientate the models like this
so the prep scan is next to the
waxup and at a similar
orientation but besides the
waxup.

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 19 . Align Meshes
Now we are ready to align the
prep scan to the preop
waxup. Hit Align meshes.

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20 . Click Pre-Scan First
Find common areas between
the prep scan and the
preoperative scan. First click
a point on the prep scan.

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 21 . Click Pre-Operative Scan
Next, click the same exact
point on the preoperative
scan.

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22 . Repeat
Always click first on the prep
scan, then on the
preoperative.

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23 . Repeat
Always click first on the prep
scan then on the
preoperative.

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24 . Repeat
Always click first on the prep
scan then on the
preoperative.

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25 . Repeat
Always click first on the prep
scan then on the
preoperative.

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26 . After 5 Points
5 or more points are needed.
Notice the blue arrows point
to the preoperative model.

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27 . Click “Perform Alignment”
Click “Perform Alignment”.

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28 . Click Best Fit Matching
Best fit match allows the
iterative closest point
algorithm to occur making the
alignment better.

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29 . Evaluate Colors
Any color is good. Pink
means it is over 100 microns
off. look for colors on
common areas between the
two scans.

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30 . Option Step
If unhappy with the alignment
click undo. We can use an
additional tool to further
perfect alignment.

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 31 . Click Match Exclude Selected Parts
We can use a powerful tool to
paint the areas we want the
alignment algorithm to focus
on for the matching. This is
especially powerful for cases
where very little exists in
common between the scans.

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32 . Change Brush Size
Change brush size.

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33 . Paint Common Areas
Paint areas that are common
to the scans.

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34 . Click Invert
We have to invert the painting
because the painting is telling
the exocad what not to look
at when matching, when you
hit invert it will only look at
those areas.

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35 . Perform Alignment
Now hit preform alignment.

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36 . Best Fit Match
Not hit best fit match.

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37 . Un-Click This Box
To see the colors we have to
unclick the matching exclude
selected parts.

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38 . Click “Show Distances”
Now we can see the new
alignment.

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39 . Click “OK”
Click Ok to save the
alignment.

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40 . Title
Now your prep scan is
perfectly aligned to the
waxup scan. We now need to
export the prep scan to the
project folder.

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 41 . Turn Off All Other Objects
Make sure everything is
complete turned off except
your prep scan (the generic
visualization mesh). Notice all
the eyes have lines.

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42 . Export Aligned Preps
Nothing else is visible on the
screen except the preps.
Right-click the blank screen.

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43 . Save Scene As
Save scene as.

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44 . Change to OBJ
Change the file type to OBJ.
Also do not change the
location. It will automatically
open to the project folder.

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45 . OBJ
Select obj file.

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46 . Change Name
Do not erase the case
number. Keep it the same.
But you must add a “-upper
jaw” or “-lower jaw”
depending on the arch. No
capitals. No spaces.

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47 . Click “Save”
Click “Save”.

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48 . Click “Yes”
Click yes to visible objects
only. That means it will only
save the object you see on
the screen and nothing else.

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49 . Original Coordinates
Use original coordinates.

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50 . Turn Off Prep Scans
Turn off the prep scans.

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 51 . Turn On Antagonist
Turn on the antagonist.

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52 . Right-Click Screen
We need to repeat the same
for the lower .

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53 . STL or OBJ
Stl or OBJ.

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54 . STL or OBJ
Stl or OBJ.

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55 . Rename to “x-lowerjaw”
Keep the long serial number
project identification and add
-lower jaw.

No spaces, no capitals.

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56 . Click Here
Click here.

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57 . Save
Click “save”.

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58 . Yes
Yes to visible objects only.

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59 . Original Coordinates
Original Coordinates

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60 . Back to Wizard
Back to wizard mode.

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 61 . Click “Done” and “Save”
Click “done” and “save”.

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62 . Click “Next”
Click “Next” and continue.

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63 . Save if Prompted
Save if prompted.

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64 . Verify
You should now see the
models aligned with your
upper and lower here in the
preview window in dental DB.

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65 . Models Visible Here
Models visible here.

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66 . Click “Duplicate”
Click “Duplicate”.

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67 . Click Scan Data
Click scan data.

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68 . Click Designed Files
Click “designed files”.

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69 . Click “OK”
Click “OK”.

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70 . Change Prescription
exocad has made a duplicate
case including your scans and
waxup. Now we change a
prescription from mockup to
veneers or crowns.

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 71 . Change Presciption
Here I am now doing veneers.

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72 . All Teeth Changed
Make sure to change all teeth
to whatever the preps are. Hit
Save. Then hit design.

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73 . Click “Design”
Have to hit save first then
design.

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74 . Click “Yes”
Yes load previously designed
teeth models.

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75 . Click “Load”
If you used photos in your
original mockup hit yes to
bring them in. Please note
this can be a little buggy.

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76 . Skip
We do not need to do smile
creator again because it was
done back when the original
mockup was done.

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77 . Mark Margins
Mark your prep margins tooth
by tooth.

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78 . Continue with Margination
Keep following the wizard to
mark margins.

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79 . Keep Marking Margins
Keep making your margins
following wizard.

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80 . Path of Insertion
Some indications such as
veneers exocad will ask you
to verify path of insertion for
each unit. Rotate to ideal
insertion and hit “set from
view”

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 81 . Continue
Pick insertion for each tooth.

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82 . Splinted Units
If splinting units for a
temporary you must hit this
button “unique insertion for
bridges”

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83 . Select the Units
Select all the units that will
be splinted.

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84 . Select the Units
Select all the units that will
be splinted.

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85 . Rotate
Rotate to an ideal insertion
for all the units. Please note
compromises may be needed.
Hit “set from view” to reset
the insertion to the new
orientation.

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86 . Set From View
Set current view as insertion

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87 . Check Model
You can now see the new
insertion direction. Areas with
undercuts will be blocked out
except at the margins. Keep
this in mind when prepping.

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88 . Click Here
Click “Next”.

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89 . Hit “Next” Tooth Placement
In the tooth placement tab
you should see all your waxup
teeth exactly the locations
you waxed them. You have
complete freedom to move
things around if needed
otherwise hit next.

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90 . Next
Hit “Next”.

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 91 . Adapt
In freeform you have full
power to sculpt. Don’t forget
to adapt proximal contacts
and occlusion if needed. You
can also load a new bite scan
if you have one using expert
mode-tools- add remove
mesh

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92 . Adapt
Adapt

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93 . Adapt Approximal
Adapt Approximal

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94 . Check Proximal Contacts
With show contact areas the
color should be teal blue (0)
in strength.

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95 . Smooth and Add if Needed
Smooth and add if needed.

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96 . Contacts Should Be Flat
Flat or slightly convex but
NEVER concave contact
areas.

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97 . Next
Hit the “Next” button.

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98 . Save if Prompted
Hit “yes”.

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99 . All Done
All the teeth are now adapted
to margins. You now have the
final parts or merged parts!
This is what you need to
manufacture.

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100 . Turn Off Segments
If printing in segments turn
off teeth to view only the
ones you want in the
segment.

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101 . Right-Click
Right-click.

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102 . Save Scene
This was the segment I told
the software to make from the
same patch of insertion.

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103 . STL
Change to STL.

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104 . Save
Save somewhere easy to find.

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105 . Yes
Visible objects only.

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106 . Default
Notice here we use default.
Anytime I export out of
exocad I use default. Anytime
I am within exocad I use
original.

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107 . All Done!
Repeat for other segments or
units. Please note all
individual units are saved as
individuals in the project
folder.

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 FU L L M O U T H R E STO RAT I O N

Face Scan Articulator Mounting

155 | e x o c a d FULL MOUTH RESTORATIONS < TABLE OF CONTENTS

 1 . Soft Tissue Landmarks
It is best to mark the soft
tissue landmarks with the
patient smiling before taking
the face scan in order to
make mounting the case
easier. The two points we
need to use for mounting are
orbitale (most inferior point
on the orbital rim) to help
with locating Frankfort
horizontal plane and
Bergstrom’s point posteriorly.

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 2 . Jaw Scan Orientation
The first step for any design
is always to set your jaw scan
orientation.

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 3 . Expert Mode
Click next and then click the
expert mode button in the top
right corner

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 4 . Tools
Once in expert mode click the
tools menu.

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 5 . Add/Remove Mesh
Now select “Add/Remove
Mesh”.

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 6 . Retracted Face Scan
Select Face Scan and then
load to bring in the retracted
face scan first. The retracted
face scan will be used for
matching to the Intraoral
scans.

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 7 . Yes or No
Unless the Face Scan was
matched in another software
it won’t matter if you click yes
or no here as it won’t be
aligned the the scans

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 8 . Face Scan and Intra-Oral Scan
Using left click to translate
and ctrl + left click to rotate
move the Face Scanso that is
in the same orientation but
beside the intra-oral scans.

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 9 . Align Meshes
Now click the “Align Meshes”
tab to move in to the
alignment tool.

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10 . Align Meshes
Using the left click and
starting on the Face
Scan(floating mesh) select
5-6 points that are coincident
between the two meshes.
The points on the Face Scan
should be green denoting the
floating mesh.

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 11 . Perform Alignment
Click “Perform Alignment.” It
is not advised to use the
best-fit matching tool
because the triangle size from
the two meshes are
significantly different in size
so this would decrease the
accuracy of the matching.

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 12 . Load Again
Now select load again to
bring in the smiling face scan.
Now we’ll align the smiling
face scan to the retracted
face scan which we just
aligned to the intra-oral scans

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 13 . Select “No”
Even if previously aligned the
two Face Scans are no longer
matched so select “No…”

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 14 . Align Meshes
Using left click to translate
and ctrl + left click to rotate
move the smiling Face Scan
so that is in the same
orientation but beside the
retracted face scan. Now
click “Align Meshes”

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 15 . Select Points
Starting on the smiling face
scan (floating mesh) pick 5-7
points that are coincident
between the two face scans
that are at the canthus of the
eye and superior

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 16 . Match Accuracy
Turn the matching parts ratio
to around 10% and the max
influence distance to around
4 mm. This helps improve
the match accuracy

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 17 . Select “Matching Exclude Selected Parts”
Select “Matching Exclude
selected parts”

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 18 . Highlight Blue
Using the left click highlight
blue around each point that
you selected for matching
along with the forehead

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 19 . Invert Markings
Click invert markings.

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20 . Perform Alignment
Click “perform alignment” to
align the meshes and then
“best fit matching”since these
meshes are similar quality
(triangle size).

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 21 . Exit Mesh Alignment
Click ok to exit the mesh
alignment tool once the
alignment is complete.

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22 . Add / Remove Mesh
Click ok to exit the add/
remove mesh tool now that all
the meshes are in the scene
and aligned.

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23 . Enter Virtual Articulor
Now it’s possible to enter the
virtual articulator and mount
the arches.

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24 . Virtual Articulator
In the virtual articulator make
sure you are in the articulator
jaw correction tool and if not
then select “rearticulate
models virtually” to enter this
tool

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25 . Adjust Settings
Click the boxes to turn on the
vertical, front facing, and
additional planes. These
planes will help to make
mounting the case easier.

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26 . Check Settings
Check Settings

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27 . Mounting Planes Visible
Click the box to turn off the
articulator so only the
mounting planes are visible.

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28 . Mounting Planes Visible
Click the box to turn off the
articulator so only the
mounting planes are visible.

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29 . Planes Visible
Now all the planes needed to
mount the case are visible
and positioned correctly.

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30 . Face Scan Visible
Use the window in the upper
left corner to make the
smiling Face Scan visible.

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 31 . Hinge Reference Point Marking
Using the left click to
translate and the ctrl + left
click to rotate position the
smiling face scan so that the
front-facing plane bisects the
hinge reference point marking

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32 . Midline Plane
The last plane to align is the
midline plane (vertical plane).
Using the same movement
tools position the face scan
so that the vertical plane
bisects the middle of the
face. Glabella is a useful
reference for this alignment.

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33 . Turn the Articulator Back On
Now the articulator can but
turned back on and click “ok”
on the articulator jaw
correction tab.

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34 . Start Articulator Movement Simulation
Now click “Start articulator
movement simulation” to
simulate the movements
based on the custom
mounting.

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35 . Click “OK”
Now click “Ok” to exit the
articulator and move forward
with the design.

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 FU L L M O U T H R E STO RAT I O N

CBCT Articulator Mounting

191 | e x o c a d FULL MOUTH RESTORATIONS < TABLE OF CONTENTS

 1 . Jaw Scan Orientation
The first step for any design
is always to set your jaw scan
orientation.

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 2 . Expert Mode
Click next and then click the
expert mode button in the top
right corner.

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 3 . Tools
Once in expert mode click the
tools menu.

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 4 . Add/Remove Mesh
Now select “Add/Remove
Mesh”.

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 5 . Generic Visualization
Select Generic Visualization
Mesh and then load to bring
in the Stl of the CBCT.

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 6 . Continue
Unless the CBCT mesh was
matched in another software
it won’t matter if you click yes
or no here as it won’t be
aligned with the scans.

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 7 . Intra-Oral Scan
Using left click to translate
and ctrl + left click to rotate
move the CBCT stl so that is
in the same orientation but
beside the intra-oral scans

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 8 . Align Meshes
Now click the “Align Meshes”
tab to move in the alignment
tool.

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 9 . CBCT .STL
Using the left click and
starting on the CBCT stl
(floating mesh) select 5-6
points that are coincident
between the two meshes.
The points on the CBCT stl
should be green denoting the
floating mesh.

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10 . Matching Accuracy
Turn the ratio of the matching
part to around 10% and the
max influence distance to
around 4 mm. This helps
improve the matching
accuracy.

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 11 . Matching Exclude Selected Parts
Select “Matching Exclude
selected parts”

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 12 . Highlight Blue
Using the left click highlight
blue around each point that
you selected for matching.

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 13 . Invert Markings
Click invert markings

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 14 . Perform Alignment
Click perform alignment to
align the meshes. If the
meshes are of similar quality
(triangle size) you can also
use the best fit matching tool.

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 15 . Add/Remove Mesh
Click ok to exit the add/
remove mesh tool once the
alignment is complete.

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 16 . Virtual Articulator
Now it’s possible to enter the
virtual articulator and mount
the arches.

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 17 . Re-articulate Models Virtually
In the virtual articulator make
sure you are in the articulator
jaw correction tool and if not
then select “rearticulate
models virtually” to enter this
tool

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 18 . CBCT .STL Visible
Use the window in the upper
left corner to make the CBCT
stl visible.

209 | e x o c a d FULL MOUTH RESTORATIONS

 19 . Adjust Settings
Click the boxes to turn on the
vertical, front-facing, and
additional planes. These
planes will help to make
mounting the case easier

210 | e x o c a d FULL MOUTH RESTORATIONS

20 . Slider Adjustment
Use the height slider to adjust
the additional plane so that it
corresponds to the frankfort
horizontal reference plane on
the articulator.

211 | e x o c a d FULL MOUTH RESTORATIONS

 21 . Check Planes
Now all the planes needed to
mount the case are visible
and positioned correctly.

212 | e x o c a d FULL MOUTH RESTORATIONS

22 . Mounting Planes Visible
Click the box to turn off the
articulator so only the
mounting planes are visible.

213 | e x o c a d FULL MOUTH RESTORATIONS

23 . Rotate CBCT Position
Using the left click to
translate and the ctrl + left
click to rotate position the
CBCT stl so that the front
facing plane bisects the
middle of the condylar head

214 | e x o c a d FULL MOUTH RESTORATIONS

24 . Plane Alignment
Using the same movement
tools now to align the CBCT
stl with Frankfort horizontal.
The additional plane is our
Frankfort horizontal so it
needs to align with orbitale
anteriorly and superior
border of external auditory
meatus posteriorly.

215 | e x o c a d FULL MOUTH RESTORATIONS

25 . Last Plane Alignment
The last plane to align is the
midline plane (vertical plane).
Using the same movement
tools position the CBCT stl so
that the vertical plane bisects
the middle of the skull. The
anterior nasal spine is a
useful reference for this
alignment

216 | e x o c a d FULL MOUTH RESTORATIONS

26 . Close Articulator Jaw Correction Tool
Now turn back on the
articulator can but turned
back on and click “Ok” to
close the articulator jaw
correction tool

217 | e x o c a d FULL MOUTH RESTORATIONS

27 . Run Articulator Simulation
Once back in the full
articulator mode run the
articulator simulation and
click ok to close the
articulator and move back to
your design workflow with a
fully custom mounted
articulator simulation to
design with.

218 | e x o c a d FULL MOUTH RESTORATIONS

 All on x

1. Pre-surgical Waxup

1

Pontic Waxup
Dentate Arch

< TABLE OF CONTENTS exocad MASTER GUIDE

FREE .STL DOWNLOAD

MOD Tissue Tracker

Insures easy alignment of pre-surgical and post surgical scans.
Non-repeating 3D geometry insures better fit alignment. The included tracker holder
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SCAN TO DOWNLOAD
Table of Contents
01 Pre-Surgical Waxup: Dentate Single Arch 1
02 Anatomic Waxup Technique 101
03 Pre-Surgical Waxup: Pontic Waxup Day Of 179
04 Surgery Conversion: Edentulous Arch 269
05 Pre-Surgical Waxup: Dual Arch 352
06 Universal Method: Day of Surgery 465
07 Using a Scanned Denture 605
08 Bar Design: Convert to Split File 696
09 iCam Day of Surgery 806

< TABLE OF CONTENTS exocad MASTER GUIDE

 ALL ON X

Pre-Surgical Waxup
D E N TAT E S I N G L E A RC H

1 | exocad ALL ON X STEP-BY-STEP GUIDE < TABLE OF CONTENTS

 1 . Anatomic Pontic Technique-Dentate Arch
My favorite way to wax is
still using anatomic pontic
with gingiva and exporting
the merged part. It is easy
and always works. Some
prefer the pontic waxup
because it allows editing
tissue in the project easier
however I prefer this
anatomic pontic. I will
show you pontic waxup
techniques too in other
chapters.

2 | exocad ALL ON X STEP-BY-STEP GUIDE

 2 . Open Dental DB
I am using exocad 3.2.

3 | exocad ALL ON X STEP-BY-STEP GUIDE

 3 . Click Default Client
Select Here.

4 | exocad ALL ON X STEP-BY-STEP GUIDE

 4 . Click “Default Client”
Select “Default Client” in
the drop down menu.

5 | exocad ALL ON X STEP-BY-STEP GUIDE

 5 . Enter Patient Name
Enter the patient’s name
in the type field.

6 | exocad ALL ON X STEP-BY-STEP GUIDE

 6 . Click Distal-Most Tooth
To start the pre-surgical
wax up we need to set the
case up as anatomic wax
up.

7 | exocad ALL ON X STEP-BY-STEP GUIDE

 7 . Save the Case
Click “Anatomic Pontic”.

8 | exocad ALL ON X STEP-BY-STEP GUIDE

 8 . 3D Print
Select 3D print and virtual
gingiva “yes”. Then click
“OK”.

9 | exocad ALL ON X STEP-BY-STEP GUIDE

 9 . Duplicate Shift-Click
Duplicate and shift-click to
all the teeth in the arch you
want to wax with these
settings.

10 | exocad ALL ON X STEP-BY-STEP GUIDE

10 . Virtual Extraction
For 7-14 I will change the
prescription to virtual
extraction. Even though this
can be accessed in expert
mode any time.

11 | exocad ALL ON X STEP-BY-STEP GUIDE

 11 . Save the Case
Hit “Save”.

12 | exocad ALL ON X STEP-BY-STEP GUIDE

12 . Design
If the design is grayed-out
you have not hit “save” yet.

13 | exocad ALL ON X STEP-BY-STEP GUIDE

13 . Load your Files
You just need the
preoperative scans and the
antagonist.

14 | exocad ALL ON X STEP-BY-STEP GUIDE

14 . Rotate the Jaw Scan
Rotate the arch so that you
are looking down on the
occlusal like this and hit
“next”.

15 | exocad ALL ON X STEP-BY-STEP GUIDE

15 . Start Smile Creator
We are going to use a photo
to design. I have one photo
for this case, which is not a
good one.

16 | exocad ALL ON X STEP-BY-STEP GUIDE

16 . Load Photo
You need a full face photo. I
could onky find a smile
photo. Normally, I have a
retracted photo and smile
photo. I am going to load my
smile photo.

17 | exocad ALL ON X STEP-BY-STEP GUIDE

17 . Load Smile Photo
Select common points. Zoom
into the photo and select
points one on the left and one
on the right.

18 | exocad ALL ON X STEP-BY-STEP GUIDE

18 . Load Smile Photo
Select common points. Zoom
into the photo and select
points one on left and one on
the right. Click the same
exact points on the intraoral
scans. You can click a dot
and drag to refine. If you do
not see dots when you click
zoom out, you accidentally
dropped them somewhere.

19 | exocad ALL ON X STEP-BY-STEP GUIDE

19 . Click “Next”
Click “next” when the dots
are identical.

20 | exocad ALL ON X STEP-BY-STEP GUIDE

20 . Fine-Tune Merge
Right-click to alter the
angulation of the intraoral
scan.

21 | exocad ALL ON X STEP-BY-STEP GUIDE

21 . Fine-Tune Merge
Then, left-click the center of
a dot and move the photo.
Repeat on the other side.

22 | exocad ALL ON X STEP-BY-STEP GUIDE

22 . Fine-Tune Merge
Repeat as many times as
need to get a perfect match.

23 | exocad ALL ON X STEP-BY-STEP GUIDE

23 . Click “Next”
Click “next” to move on.

24 | exocad ALL ON X STEP-BY-STEP GUIDE

24 . Mark the Lip
This should be fast.

25 | exocad ALL ON X STEP-BY-STEP GUIDE

25 . Mark Pupils
This photo has the eyes
closed. This case was
referred to me. The referring
team made the photos. It is
nice to have something to
work with, but ideally the
records process will lead to
better photos.

26 | exocad ALL ON X STEP-BY-STEP GUIDE

26 . Move Smile Arc
Move the smile arc to the
midline.

27 | exocad ALL ON X STEP-BY-STEP GUIDE

27 . Move Smile Arc
Move the proportion gauge.
The horizontal line should be
on the proposed incisal edge
of the centrals. The vertical
bar aligned with the midline.
The cuspid bars on the distal
of cuspids or alar of the
nose. Click “next”.

28 | exocad ALL ON X STEP-BY-STEP GUIDE

28 . Global Movement
In this tab, I only do global
movements. Look at your
midline incisal edge position
and anterior-posterior
position.

29 | exocad ALL ON X STEP-BY-STEP GUIDE

29 . Global Movement
Make sure the box is around
all the teeth as shown. If not
left click and draw a big box
around the arch. This way you
can move all teeth. Click the
center of the box to move the
teeth.

30 | exocad ALL ON X STEP-BY-STEP GUIDE

30 . Global Movement
Fine-tune the position of the
arch and focus on the
anteriors. Click measurement
and click the central to
determine the tooth size. You
want a central 10-11mm long

31 | exocad ALL ON X STEP-BY-STEP GUIDE

31 . Central Size
Fine-tune the position of the
arch and focus on the
anteriors. Click measurement
and click the central to
determine the tooth size. You
want the central to be
10-11mm long.

32 | exocad ALL ON X STEP-BY-STEP GUIDE

32 . Central Size
Click the blue dot on top of
the box in the facial image
and drag to increase or
decrease the length of the
centrals.

33 | exocad ALL ON X STEP-BY-STEP GUIDE

33 . Next
Hit “next” when happy. I do
not move individual teeth in
this module, only the entire
arch.

34 | exocad ALL ON X STEP-BY-STEP GUIDE

34 . Skip
Just click “next” to skip this
step. We do not need it.

35 | exocad ALL ON X STEP-BY-STEP GUIDE

35 . Done
Hit “done”.

36 | exocad ALL ON X STEP-BY-STEP GUIDE

36 . Virtual Extraction
Follow the wizard for virtual
extractions if you set this up
in dental DB it will be a
wizard step. I not you can
find this in expert mode by
entering expert mode, right
click model and hit extract.

37 | exocad ALL ON X STEP-BY-STEP GUIDE

37 . Virtual Extraction
Follow the wizard for virtual
extractions if you set this up
in dental DB it will be a
wizard step. If not, you can
find this in expert mode by
entering the expert mode,
right-click the model, and hit
“extract”.

38 | exocad ALL ON X STEP-BY-STEP GUIDE

38 . Virtual Extraction
I told exocad to see the
extracted tooth as a preop.
Extraction socket 2mmm is
good. The arrow is for socket
angle but it does not matter
because we will do bone
reduction here.

39 | exocad ALL ON X STEP-BY-STEP GUIDE

39 . Extract Each Tooth
Proceed with each tooth. It
doe not matter of they are not
perfect we will edit the mesh.

40 | exocad ALL ON X STEP-BY-STEP GUIDE

40 . Extract Each Tooth
Once done with extractions
hit “Next” or “OK”.

41 | exocad ALL ON X STEP-BY-STEP GUIDE

41 . Expert Mode
We need to jump into expert
mode to refine the model and
do bone reduction.

42 | exocad ALL ON X STEP-BY-STEP GUIDE

42 . Expert Mode
Right-click the model to edit
the mesh.

43 | exocad ALL ON X STEP-BY-STEP GUIDE

43 . Reduce Ridge
Hold shift on keyboard and
click a line across the ridge.

44 | exocad ALL ON X STEP-BY-STEP GUIDE

44 . Reduce Ridge
Do not close the circle, leave
it open.

45 | exocad ALL ON X STEP-BY-STEP GUIDE

45 . Reduce Ridge
Now hit “delete” to start the
bone reduction.

46 | exocad ALL ON X STEP-BY-STEP GUIDE

46 . Close Hole
We now need to seal the
hole.

47 | exocad ALL ON X STEP-BY-STEP GUIDE

47 . Close Hole
Draw a big circle around the
hole make sure to close the
circle and orange around the
entire hole.

48 | exocad ALL ON X STEP-BY-STEP GUIDE

48 . Close Hole
Hit “close hole” and “OK”.

49 | exocad ALL ON X STEP-BY-STEP GUIDE

49 . Free Form
Still in expert mode. Click the
arch and on the bottom m
venue hit freeform scan data.

50 | exocad ALL ON X STEP-BY-STEP GUIDE

50 . Flatten and Remove
Use flatten and remove tools
to reduce and smooth the
ridge. These tools are
activated by holding shift on
the keyboard and clicking in
the add/remove or smooth/
flatten tool. When done hit
“OK”.

51 | exocad ALL ON X STEP-BY-STEP GUIDE

51 . To Wizard
Jump back to wizard.

52 | exocad ALL ON X STEP-BY-STEP GUIDE

52 . Chain Mode
Jump into chain mode in the
tooth placement step.

53 | exocad ALL ON X STEP-BY-STEP GUIDE

53 . Lock the Centrals
Click the green balls on the
centrals to lock them in
location.

54 | exocad ALL ON X STEP-BY-STEP GUIDE

54 . Unlock Molars
Click the red balls to green in
the molar area to unlock
them. If you can’t find the red
balls look form the intaglio.

55 | exocad ALL ON X STEP-BY-STEP GUIDE

55 . Set Molar Position
Now, click the molars or
distal-most tooth and drag
them to a location on both
sides of the arch. This will set
the arch length.

56 | exocad ALL ON X STEP-BY-STEP GUIDE

56 . Set Molar Position
Turn on preoperative teeth if
this helps you with your
molar position.

57 | exocad ALL ON X STEP-BY-STEP GUIDE

57 . Advanced
Now click advanced to exit
chain mode.

58 | exocad ALL ON X STEP-BY-STEP GUIDE

58 . Advanced
Click the eye icon and the
instant anatomic morph icon
and the apply to all icon.

59 | exocad ALL ON X STEP-BY-STEP GUIDE

59 . Fine-Tune Individual Teeth
Now, we can fine-tune tooth
position. Click a tooth to
move it. Control left click to
rotate. Control and shift left
click to stretch. Shift left click
to scale.

60 | exocad ALL ON X STEP-BY-STEP GUIDE

60 . Fine-Tune Individual Teeth
Now, we can fine-tune tooth
position. Click a tooth to
move it. Control left click to
rotate. Control and shift left
click to stretch. Shift left click
to scale.

61 | exocad ALL ON X STEP-BY-STEP GUIDE

61 . Next
All of your teeth should have
good occlusion (but not
perfect) before hitting next.
They should all be touching
with no spaces or diastema.

62 | exocad ALL ON X STEP-BY-STEP GUIDE

62 . Adjust Static Occlusion
In freeform, the only thing
that you need to do is refine
contacts. Notice how I have
dynamic occlusion marks but
never used the articulator. In
my settings, I have selected
to use auto articulator (this is
in settings - add on modules-
auto articulation) this way I
do not have to mount this.

63 | exocad ALL ON X STEP-BY-STEP GUIDE

63 . Turn Off Dynamic
Focus on static fist so turn off
dynamic.

64 | exocad ALL ON X STEP-BY-STEP GUIDE

64 . Add/Remove
Use add remove to make sure
each tooth has a static
occlusion mark.

65 | exocad ALL ON X STEP-BY-STEP GUIDE

65 . Adapt
Click adapt.

66 | exocad ALL ON X STEP-BY-STEP GUIDE

66 . Adapt
Adapt proximal, Basal and
Static by clicking each one.
Do not hit cut all.

67 | exocad ALL ON X STEP-BY-STEP GUIDE

67 . Dynamic
We now need to adjust
dynamic occlusion. Click the
little chevron on the dynamic
button.

68 | exocad ALL ON X STEP-BY-STEP GUIDE

68 . Protect the Incisal Edge
Click exclude select parts
and paint the very tips of the
incisal edges of the anteriors.

69 | exocad ALL ON X STEP-BY-STEP GUIDE

69 . Adapt Dynamic
Now click the dynamic button
to cut the dynamic .

70 | exocad ALL ON X STEP-BY-STEP GUIDE

70 . Fine-Tune
We have cut our dynamic and
now we need to fine-tune.

71 | exocad ALL ON X STEP-BY-STEP GUIDE

71 . Group Function
Click the articulator button,
choose lower if it has an
option, and slide the scale.
Make sure that the dynamic is
off on the color map.

72 | exocad ALL ON X STEP-BY-STEP GUIDE

72 . Protrusion
Use add remove to adjust the
protrusion.

73 | exocad ALL ON X STEP-BY-STEP GUIDE

73 . Right Lateral Movements
The more you slide the bar,
the more you will see lateral
movements. Use add remove
to get group function in right
movements.

74 | exocad ALL ON X STEP-BY-STEP GUIDE

74 . Left Lateral Movements
The more you slide the bar,
the more you will see lateral
movements. Use add remove
to get group function in left
movements.

75 | exocad ALL ON X STEP-BY-STEP GUIDE

75 . Click Next
We need to hit “next”.

76 | exocad ALL ON X STEP-BY-STEP GUIDE

76 . Skip
Skip this step and hit “next”.
We do not want to adapt to a
preop and usually never do.

77 | exocad ALL ON X STEP-BY-STEP GUIDE

77 . Set from View
Rotate the arch to the path of
insertion, usually occlusal
view and hit “set from view”.

78 | exocad ALL ON X STEP-BY-STEP GUIDE

78 . Next
Hit “next”.

79 | exocad ALL ON X STEP-BY-STEP GUIDE

79 . Draw Tissue
Click and draw a horseshoe
shape around the arch for
your tissue. Remember go
wider than you think.

80 | exocad ALL ON X STEP-BY-STEP GUIDE

80 . Draw Tissue
Keep drawing.

81 | exocad ALL ON X STEP-BY-STEP GUIDE

81 . Draw Tissue
Keep drawing.

82 | exocad ALL ON X STEP-BY-STEP GUIDE

82 . Draw Tissue
Double click first dot to
render.

83 | exocad ALL ON X STEP-BY-STEP GUIDE

83 . Change Thickness
Change thickness to 2mm.
Edit the margin if needed by
dragging the balls. Hit
“Apply” to render changes.

84 | exocad ALL ON X STEP-BY-STEP GUIDE

84 . Next
Hit “Next”.

85 | exocad ALL ON X STEP-BY-STEP GUIDE

85 . Free Form Tissue
Use a small region to pull
down the papillas from this
view.

86 | exocad ALL ON X STEP-BY-STEP GUIDE

86 . Free Form Tissue
Use add remove and mouth
flatten to smooth the tissue.
We do not need to festoon.

87 | exocad ALL ON X STEP-BY-STEP GUIDE

87 . Done!
You are done. Now you need
to export a few files to save
for day of surgery.

88 | exocad ALL ON X STEP-BY-STEP GUIDE

88 . Export Merged Part
Make sure noting else is
visible. Right-click the screen
and hit “save scene as”.

89 | exocad ALL ON X STEP-BY-STEP GUIDE

89 . Export Merged Part
You should export to Plain
STL.

90 | exocad ALL ON X STEP-BY-STEP GUIDE

90 . Export Merged Part
Visible objects only.

91 | exocad ALL ON X STEP-BY-STEP GUIDE

91 . Export Merged Part
Default orientation.

92 | exocad ALL ON X STEP-BY-STEP GUIDE

92 . Export Pre-Op
Turn on your preoperative
with the teeth and the tissue
as shown. Nothing else
should be on.

93 | exocad ALL ON X STEP-BY-STEP GUIDE

93 . Export Pre-Op
Right-click “Save Scene As”.

94 | exocad ALL ON X STEP-BY-STEP GUIDE

94 . Export Pre-Op
Export as plain STL.

95 | exocad ALL ON X STEP-BY-STEP GUIDE

95 . Export Pre-Op
Visible only.

96 | exocad ALL ON X STEP-BY-STEP GUIDE

96 . Export Pre-Op
Default coordinate system.

97 | exocad ALL ON X STEP-BY-STEP GUIDE

97 . Export Antagonist
This is optional as I usually
don’t use it on day of surgery
same thing. Right click-plain
stl-visible only-default.

98 | exocad ALL ON X STEP-BY-STEP GUIDE

98 . Save the Case
Close the case. Remember
where you saved those files
for day of surgery.

99 | exocad ALL ON X STEP-BY-STEP GUIDE

99. Save the Case
Close the case. Remember
the name you set the case up
because on the day of surgery
you need to be able to locate
this case and open it. If using
the anatomic waxup workflow
you can take this case to the
final merged part.

100 | exocad ALL ON X STEP-BY-STEP GUIDE

 ALL ON X

Anatomic Waxup Technique

101 | exocad ALL ON X STEP-BY-STEP GUIDE < TABLE OF CONTENTS

 1 . Anatomic Waxup Technique: Surgery Day
We need to load the files on
day of surgery and convert
this waxup to an all on x
prosthetic.

102 | exocad ALL ON X STEP-BY-STEP GUIDE

 2 . Open Dental DB
Begin, day of surgery, by
opening Dental DB.

103 | exocad ALL ON X STEP-BY-STEP GUIDE

 3 . Click “Default Client”
Select default client from the
drop down menu here.

104 | exocad ALL ON X STEP-BY-STEP GUIDE

 4 . Enter Patient Name
Enter the patient’s name in
the type field.

105 | exocad ALL ON X STEP-BY-STEP GUIDE

 5 . Click a Tooth that has an Implant
To start the conversion, we
need to click one of the teeth
that has an implant.

106 | exocad ALL ON X STEP-BY-STEP GUIDE

 6 . Click Here
Select “Anatomic Waxup”.

107 | exocad ALL ON X STEP-BY-STEP GUIDE

 7 . Screw Retained
Select “3D Print” as the
material and “Screw
Retained”, then hit “OK”.

108 | exocad ALL ON X STEP-BY-STEP GUIDE

 8 . Click OK
Click “OK” to save.

109 | exocad ALL ON X STEP-BY-STEP GUIDE

 9 . Copy to Other Implant Teeth
Copy this prescription to all
teeth that have an implant.
Use control to copy or click
and drag . Click Save.

110 | exocad ALL ON X STEP-BY-STEP GUIDE

10 . Click “Design”
If you can not click “design”,
it means that you did not hit
“save”.

111 | exocad ALL ON X STEP-BY-STEP GUIDE

 11 . Load Scans
What Files are needed?

You need all the files from

hour last design that you
exported. The preop you will
bring in as the arch, the
waxup you bring in as the
waxup. The antagonist as the
antagonist. You also need a
unified scan body scan. This
is made on the day of surgery.

You also need a pre surgical

marker scan and a surgical
tissue cap scan.

112 | exocad ALL ON X STEP-BY-STEP GUIDE

12 . Load Your Scans
You need to load the
appropriate scans.

113 | exocad ALL ON X STEP-BY-STEP GUIDE

13 . Immediately go to Expert Mode
It is a good idea to predesign
the gingiva incase you need to
use the anatomic waxup
method taught later on in this
series.

114 | exocad ALL ON X STEP-BY-STEP GUIDE

14 . Tools: Add / Remove Mesh
We need to load some
surgical scans to help with
scanbody location.

115 | exocad ALL ON X STEP-BY-STEP GUIDE

15 . Generic Mesh
Select generic visualization
mesh as mesh type and hit
“load”.

116 | exocad ALL ON X STEP-BY-STEP GUIDE

16 . Load Pre-Surgical Marker Scan
We need to merge the pre-
surgical marker scan, hit “no”
here.

117 | exocad ALL ON X STEP-BY-STEP GUIDE

17 . Orientation Marker Scan
Left-click the marker scan
and drag it to the side.
Control left click to rotate it.
Get it to be next to and in the
same orientation as the other
scans.

118 | exocad ALL ON X STEP-BY-STEP GUIDE

18 . Align Meshes
Turn off everything except the
preoperative scan and the
pre-surgical marker scan. Hit
“Align Meshes”.

119 | exocad ALL ON X STEP-BY-STEP GUIDE

19 . Pick Common Points
Always start on the marker
scan and go to the
preoperative scan and click
the same exact spot. Notice
the direction of the arrows.

120 | exocad ALL ON X STEP-BY-STEP GUIDE

20 . Perform Alignment
Click “Perform Alignment”.

121 | exocad ALL ON X STEP-BY-STEP GUIDE

21 . Best Fit Match
Click “Best fit Match”.

122 | exocad ALL ON X STEP-BY-STEP GUIDE

22 . Evaluate Merge
You should see an accurate
merge of common areas.

123 | exocad ALL ON X STEP-BY-STEP GUIDE

23 . OK
Click “OK” on the small
window but stay in add
remove mesh.

124 | exocad ALL ON X STEP-BY-STEP GUIDE

24 . Replace Jaw Scan
Now that the marker scan is
aligned to the preop. We
need to replace the jaw scan
with the surgical tissue cap
scan. We are still in expert
mode add remove mesh
module. Hit extra jaw scan
and hit “load”.

125 | exocad ALL ON X STEP-BY-STEP GUIDE

25 . Replace Jaw Scan
Hit “no” and it will not
come in aligned.

126 | exocad ALL ON X STEP-BY-STEP GUIDE

26 . Click “OK”
Click “OK” here.

127 | exocad ALL ON X STEP-BY-STEP GUIDE

27 . Tools-Align Mesh
We need to align the new jaw
scan.

128 | exocad ALL ON X STEP-BY-STEP GUIDE

28 . Manually
Use manual mode first. Be
careful not to click any other
model or move any other
model.

129 | exocad ALL ON X STEP-BY-STEP GUIDE

29 . Automatically
Select “Automatically”.

130 | exocad ALL ON X STEP-BY-STEP GUIDE

30 . Click Common Spots
Notice the direction of the
arrows. Focus mostly on the
markers. At least 5 spots.

131 | exocad ALL ON X STEP-BY-STEP GUIDE

31 . Exclude Elect Spots
Hit matching exclude selected
spots and then paint the
common areas.

132 | exocad ALL ON X STEP-BY-STEP GUIDE

32 . Invert
Click invert to change the
selection as shown

133 | exocad ALL ON X STEP-BY-STEP GUIDE

33 . Perform Alignment
Click “perform alignment”.

134 | exocad ALL ON X STEP-BY-STEP GUIDE

34 . Best Fit Match
Now hit “best fit”. Exocad will
only look at the Data that is
not blue.

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35 . Evaluate
Turn off the matching exclude
selected parts and turn on
show distances. The markers
should be accurate.

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36 . OK
Click “OK”.

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37 . Back to Align Meshes
Now we can merge the unified
scanbody scan to the surgical
tissue cap scan.

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38 . Manually
Go to manually and move and
rotate the unified scanbody
scan to make them off to the
side but in the same location
as the surgical tissue cap
scan.

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39 . Automatically
Now click “automatically”.

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40 . Common Spots
Always start on the unified
scanbody scan. One spot per
scanbody. Notice direction of
the arrows.

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41 . Perform Alignment
Click “Perform Alignment”.

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42 . Best Fit Match
It is ok to have some errors.
The weak link is the tissue
scan.

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43 . OK
We are now done merging.

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44 . Wizard
Jump back to wizard mode.
We are at step 1. Rotate the
arch looking straight down
the arch from occlusal. Hit
“next”.

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45 . Skip
Skip this merge step do not
click the models just hit next.
We already aligned them in a
better way.

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46 . Replace
Click replace the whole scan.

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47 . Merge Standby
Find the implant library that
matches the surgical caps you
scanned with and allows
direct to MUA. Click the tooth
number as indicated in the
wizard in the spot as shown
on the rendered scan cap
where the red dot is.

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48 . Merge Standby
You can turn off the tissue
scan if it distracts you.

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49 . Perfect Merge
If it is not all blue you may
have picked the wrong
library, if you do not see
colors hold control when
clicking the scanbody.

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50 . Follow Wizard and Merge
Hit “next” and on to the next
one. Make sure to check the
tooth is correct.

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51 . Follow Wizard and Merge
Hit “next” and on to the next
one. Make sure to check the
tooth is correct.

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52 . Follow Wizard and Merge
Hit “next” and on to the next
one. Make sure to check the
tooth is correct.

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53 . Follow Wizard and Merge
This is the last one.

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54 . Follow Wizard and Merge
This is the last one.

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55 . Click “Next”
All done.

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56 . MUA
You should now see virtual
MUA abutments. If your
tissue cap scan does not have
holes in it, it is because a bad
exocad library. You can cut
them out manually by expert
mode, edit mesh.

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57 . Define Emergence Profile
Keep hitting “next” we do not
do anything here.

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58 . Abutment Bottoms
Keep hitting “next” for this as
well. We do not do anything
here.

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59 . Free Form Step
Add remove and smooth
flatten to bulk and smooth
areas.

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60 . Tissue
I underestimated the bone
reduction when I did my
original waxup. See the space
here. Easy fix.

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61 . Anatomic Paint Pull
Go to anatomic paint pull.

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62 . Paint Pull
Paint the tissue of the waxup.

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63 . Paint Pull
Pull it.

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64 . Paint Pull
Pull it to tissue.

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65 . Flatten
Use Flatten.

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66 . Flatten
Use Flatten.

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67 . Check Tissue Pressure
Change the color scale to
distance to scan data. Make
sure to hit nearest point
distance.

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68 . Check Tissue Pressure
Change the color scale to
0.01-1mm.

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69 . Cut Tissue
Go to adapt -basal. Drag to
-350 microns. And hit the
basal button.

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70 . Cut Tissue
Go to adapt-basal. Drag to
-350 microns, then hit basal
button.

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71 . Cut Tissue
Go to adapt -basal. Drag to
-350 microns. And hit the
basal button.

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72 . Flatten
After the cut just flatten the
tissue surface, it should be
smooth, convex, or flat, and
cleanable.

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73 . Festoon
Do some festooning.

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74 . Festoon
Do some festooning.

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75 . Next
Hit “Next”.

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76 . Next Again
Hit “next” again.

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77 . All Done
You are now done and ready
to print.

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 ALL ON X

Pre-Surgical Waxup
PONTIC WAXUP
EDENTULOUS ARCH

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 1 . Pontic Waxup Edentulous Arch
Typically you will have a
scan of an old denture. This
denture ideally is relined
and fits well. Then you have
a photograph or 3D face
scan off the old denture in
place. You will then use that
information to wax the arch
and have it ready for surgery
day. The patient does not
like the esthetics of this
denture so we will need to
wax the arch just using the
old tenure as a guideline to
align the scans to the face.

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 2 . Open Dental DB
AI features are only
available in some regions
and on exocad 3.2-9 or
later.

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 3 . Click “Default Client”
Select Here.

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 4 . Click “Default Client”
Select “Default Client” in
the drop down menu.

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 5 . Enter Patient Name
Enter the patient’s name
in the type field.

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 6 . Click Distal Most Tooth
To start the pre-surgical
wax up, we need to set the
case up as pontic wax up.

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 7 . Click Here
Select pontic wax up.

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 8 . Click “3D Print”
Select “3D print” as the
material.

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 9 . Click Virtual Gingival and Pre-Op
It is a good idea to
predesign the gingiva
incase you need to use the
anatomic waxup method
taught later on in this
series. Also select Preop
so you can bring in the old
denture scan.

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10 . Click “Yes, Design Digitally”
This means you do not have a
scanned wax up and you are
designing yourself

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 11 . Click “OK”
Click the “OK” button to
continue.

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12 . Click “Contralateral Tooth”
Select the distal-most
contralateral tooth while
holding shift on the keyboard.
This will copy the
prescription.

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13 . Click “Save”
You have to hit save so you
can design.

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14 . Click “Design”
We will need to load the files
next.

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15 . Load Proper Files
You will need to load

1) tissue scan

2) denture scan

3) opposing

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16 . Orientate Scan Date
Rotate the tissue scan looking
top down like this.

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17 . Click “Next”
Click next. If your scans are
not aligned you need to align
them by going to expert mode
tools, align meshes. Mine are
already all aligned form the
scanner software. If you do
not know how to do this with
your scanner I think you need
training on scanning.

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18 . Smile Creator
We will start smile creator. If
you do not have photos to
work with, you should. I
would never do any of this
without at least photos and
preferentially face scans. You
would skip this whole step by
hitting next.

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19 . Load Retracted Photo
Click “load retracted photo”.

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20 . Navigate to Retracted Photo
If this cloud feature menu
pops up just hit “confirm”.
We will not be using the AI
features as this is not
available everywhere.

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21 . Use Manual Alignment
Exocad does have AI cloud
alignment but it rewires
segmentation. Segmentation
is still buggy.

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22 . Click “Contralateral Tooth”
Select the distal most
contralateral tooth while
holding shift on the keyboard.
This will copy the
prescription.

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23 . Click “Common Spots”
Left-click the patient's right
cuspid CEJ and then left
cupid cusp tip.

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24 . Click “Common Spots”
Left click the patient right
cuspid CEJ and then left
cupid cusp tip.

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25 . Repeat Dots on Scan of Denture
Select the same dots in the
same order on the denture
scan.

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26 . Repeat Dots on Scan of Denture
Select the same dots in the
same order on the denture
scan. Then hit “next”. It helps
if the denture scan is rotated
in the same orientation as the
denture in the photo before
hitting next.

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27 . Fine Tune Match
I typically first right-click the
midline and drag the mouse
to rotate the detour scan and
split the difference in error
between right and left sides. I
then left click the center of
the dot and drag the balls
slightly so the silhouette is
better in alignment to the
photo. I repeat this a few
times until perfect. For more
information on smile design
check out our smile design
exocad manual.

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28 . Fine Tune Match
First right click midline and
drag to rotate the denture.

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29 . Fine Tune Match
Then left click the center of a
dot and move the dot slightly
to help the alignment.

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30 . Repeat
Repeat until you have a
perfect match all the way to
the molar region. Pay
attention to midline and
incisal embrasures.

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31 . Click “Next”
Click next when satisfied with
alignment. At first this takes
a while but an experienced
designer this is a 60 second
step.

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32 . Click “Load Smile Image”
We now will load a smile
image. The smile image
should be made after the
retracted image and from the
same angle. If the camera or
the patient moved between
the retracted image and smile
image the images will be
worthless. Use a tripod and
make sure to coach the
patient to keep the head still
when removing the retractors.

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33 . Automatic Alignment
If you did the photos
correctly the images will
automatically align. My
images always automatically
align perfectly. My team has
the shot protocol dialed. If
you do not take the photos
correctly, they will never
align. You can try all you
want and might get a few
teeth to align but you really
can’t trust the data.

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34 . Lips
Mark the lip line. Click the
line to get more control
points. Hit “next” when done

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35 . Pupils
Drag the pupil dots to be
perfectly in the center of the
pupils. Hit “next” when done.

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36 . Midline
First focus on facial midline.
Drag the midline dot left or
right to the desired facial
midline. Exact puts midline
equal distance between
pupils. It often needs
refinement as people are very
asymmetrical.

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37 . Gingival Zenith Line
Drag the gingival zenith line
to the new midline position. If
you do not have this line
check your settings and
exocad version. You can
manually add the line using
add lines and curves.

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38 . Smile Arc Line
Drag the smile line to the new
midline position. If you do not
have this line, check your
settings and exocad version.
You can manually add the line
using add lines and curves.

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39 . Proportion Gauge
I change from the golden
ration to the 100-65-60
ration and then move the
vertical bar to midline, then
the horizontal bar to the
desired location of 8 and 9
incisal edge. Then you set the
cuspid bar any clicking here
and moving the cuspid line to
the distal of the cuspid or
alar region of the nose.

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40 . Smile Creator Modeling
I do not spend a lot of time
here. I mainly dial in my front
4 teeth. I only do global
movements where I move all
the teeth at the same time.
Make sure the bounding box
is around all the teeth. If you
do not see a box click and
draw a square around all the
teeth. Here we are making a
massive change to midline
compared to the old denture.

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41 . Roate Proclination
Step one for me is to always
rotate the proclamation of the
arch. Usually, I have to rotate
the teeth more palatal.

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42 . Establish Incisal Edge Location
Left-click the center of the
box in the silhouette and drag
the entire arch to where the
incisal edge is on the
horizontal line of the
proportion gauge. Make sure
the midline is also in line with
the proportion gauge.

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43 . Establish Tooth Length
Click measurements then
click the central then click 3
the blue dot to lengthen or
shorten the teeth. Ideally
your central is 10-11mm
2
long.
1

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44 . Establish Overjet
Focus on the center row on
the left column. Click the
center of the square and
move the arch anterior or
posterior looking at the
overjet.

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45 . Check Your Values
Check midline, incisal edge
location, tooth size and
overjet. Hit Next when done.
Please not we have a smile
design handout that goes into
much more details on smile
deign.

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46 . Hit “Next”
I do not use this tool so hit
“next”.

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47 . Click “Done”
I do not use this PDF so hit
“done”.

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48 . Tooth Placement-Chain
Most of the design happens in
tooth placement. Click chain
mode.

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49 . Lock the Centrals
Lock the centrals by clicking
the green balls and turning
them red. This will keep our
tooth size and midline where
we had created it from the
facial photos.

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50 . Unlock the Molars
Unlock the molars by clicking
the red dot to green. If you
can’t find the red dot check
the intaglio surface.

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51 . Move Molars
Set the arch size by drawing
the molars. You click them
and move them. You can use
the preoperative denture as a
guide. In this case, the old
denture was very bad so I am
only using it as a loose
guideline.

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52 . Advanced
I tend to get out of chain
mode quick. I only lock the
centrals unlock the molars
and move the molars. Then I
head to advanced.

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53 . Click on the Eye Icon
Select the eye icon and
instant atomic morphing and
apply to all.

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54 . Move Individual Teeth
Each tooth can be refined
now individually. The
occlusion will be equilibrated
as you move the tooth. Click
to move, control left click to
rotate, control and shift and
left click to stretch (my
favorite). Work your way
around the arch refining the
teeth.

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55 . Refine Tooth Positions
Work your way around the
arch and refine tooth
locations.

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56 . Check Occlusion
The teeth should have
occlusion and it should be
mostly blue color of you have
show contact areas as your
selected color range. It is ok
if they are not perfect as we
will refine them in the
freeform stage. All the teeth
should be touching with no
unintentional diastema. Hit
“next” when happy with tooth
location and basic tooth
contacts.

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57 . Free Form
Select add/remove and add to
areas that need occlusal
contact and remove areas
that you do not want to have
contact.

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58 . Free Form
Select add/remove and add to
areas that need occlusal
contact and remove areas
that you do not want to have
contact.

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59 . Free Form
Select add/remove and add to
areas that need occlusal
contact and remove areas
that you do not want to have
contact.

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60 . Adapt
Click adapt and static
occlusion to further refine
contact strength. Ideally true
blue is the color when show
contact areas is the color
scale of exocad. Be careful
some versions of exocad
default to show interference
contacts in which case blue is
too hard of a contact. You
can change the color map in
the top color scale menu bar
in the show distances tab or
in settings.

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61 . Adapt
Now we have good static
occlusion. What about
dynamic occlusion?

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62 . Expert Mode
We can jump into expert
mode and mount this on the
virtual articulator.

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63 . Tools: Articulator
Navigate to tools and then
find the articulator icon.

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64 . Automatic Alignment
One thing that is nice about
exocad 3.2 is automatic
alignment in the skull articulator
and the ability for mandibular or
maxillary movement. If you don’t
have this feature, you can drag
the model into the articulator
using control to rotate. Or you
can click automatically and select
the 3 points indicated. Once
happy with the position of the
teeth in the articulator, hit ok on
the small box. A merged face
scan helps with mounting. Check
our face scan chapter in our
exocad handouts to learn more.

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65 . Leave the Gap
Exocad will detect a gap
between the tissue scan and
the antagonist. Leave the
gap.

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66 . Start Movements
Click start articulator
movements.

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67 . Click “OK”
Click ok to save the
movements.

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68 . Click “Wizard”
Enter back into wizard to go
back to the freeform tab.
Except now we will have
dynamic occlusion.

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69 . Adapt Dynamic
You should see new colors
now and have a dynamic
option in the free-adapt tab.

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70 . Exclude Selected Parts
Click the small box on
exclude selected parts.

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71 . Paint Incisal Edges
Paint the incisal edges of the
anterior teeth and then hit the
dynamic button. What his
does is it prevents the
software from slicing away
the incisal due to lateral and
protrusive movements but it
will adapt the dynamic
occlusion everywhere else.

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72 . Use Slider to Fine Tune
First turn off dynamic
contacts. Then drag the slider
in protrusive and
laterotrusion left and right.
Use the add remove tool to
refine.

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73 . Group Function
We want group function
where when the patient slides
into laterotrusion left al the
teeth cuspid back hit at the
same time and with the same
pressure. Then we want to
eliminate not working side
contacts.

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74 . Group Function
We want group function
where when the patient slides
into laterotrusion left al the
teeth cuspid back hit at the
same time and with the same
pressure. Then we want to
eliminate non working side
contacts.

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75 . Anterior Guidance
When the patient goes into
protrusive movements you
want equal pressure through
the first 4 mm of protrusive
motions which usually covers
the most physiological range
of movement in most people.
It is worth noting Modjaw for
other jaw motion data can
easily be imported for more
accurate movements.

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76 . Proximal Contacts and Basal
We need to adapt basal
contacts which will slice the
pontics from the tissue.

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77 . Click “Next”
Click “next” to move on.

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78 . Adapt to Pre-Op Scan
The software will ask if you
want to adapt your new tech
to match the preop denture.
This is a hard NO. we do not
want to copy that old thing.
Just hit “next”.

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79 . Virtual Waxup Bottom
Rotate the model form the
occlusal view with a slight
facial bias and hit set from
view then hit next.

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80 . Virtual Waxup Bottom
Rotate the model form the
occlusal view with a slight
facial bias and hit set from
view then hit next. We will
update this on the day of
surgery with our new surgical
scan but it save a few
seconds on day of surgery to
do it once now.

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81 . Next
Hit “next”.

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82 . Draw Your Tissue
Draw your tissue margin.
Remember we are making a
conversion out of this. We do
not really know exactly where
the implants will be so make
it a little bigger than you
think.

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83 . Render Tissue
Double click on first dot to
render the tissue.

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84 . Change Thickness and Refine
Change thickness to 2mm.
Click any green balls on the
tissue and drag them as
needed to adjust the tissue
borders. Hit apply to see the
changes rendered.

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85 . Change Thickness and Refine
Change thickness to 2mm.
Click any green balls on the
tissue and drag them as
needed to adjust the tissue
borders. Hit apply to see the
changes rendered.

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86 . Next
Hit “Next”.

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87 . Sculpt Tissue
Use the small region tool
under anatomic to drag
papilla down into the gingival
embrasures.

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88 . Free-Form
Use the Free- add/remove
tool to bulk the tissue then
use the smooth tool to
smooth it. You should not
festoon at this point.

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89 . Save and Exit
Go ahead and save and exit.
We are done with the pre
surgical design. Remember
what you called this case so
on the day of surgery you can
bring it back up.

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 ALL ON X

Day of Surgery Conversion

EDENTULOUS ARCH

269 | exocad ALL ON X STEP-BY-STEP GUIDE < TABLE OF CONTENTS

 1 . Day of Surgery Conversion
Day of surgery conversion
is a game of aligning
meshes. This is very easy
to do when experienced. It
can be frustrating when
not experienced. Ultra-
aggressive bone reduction
and lack of tissue markers
can make it very difficult.
CBCT alignment may help
in these scenarios.

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 2 . Open Dental DB
Open dental DB.

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 3 . Load Pre-Surgical Wax Up
We need to load the pre-
surgical wax up.

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 4 . Find the Pre-Surgical Design
Search for the pre-surgical
design.

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 5 . Click Load
Hit “load”.

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 6 . Click “Design”
Click Design to reopen the
design file where you left
off.

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 7 . Click Load Scene
Load the scene.

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 8 . Enter Expert Mode
Immediately enter expert
mode.

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 9 . Click Tools
Hit Tool- Add Remove
Mesh. We need to add the
pre-surgical marker scan.
This scan is often done at
the beginning of surgery to
help with the alignment of
the post surgical scan to
the preoperative scan.

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10 . Generic Visualization
Select generic
visualization mesh.

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 11 . Click “Load”
Click load and search for
the newly made day of
surgery intermediate
marker scan. This scan is
critical for accurate
alignment.

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12 . Click “No”
It does not matter what
you select here.

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13 . Rotate, Then Pin
Click the newly imported
scan and drag it. Hold
control and left-click the
center of the new scan to
rotate it. To rotate the
entire scene left-click the
blank screen. You want to
get the new scan next to
and in the same
orientation as the
preoperative scan.

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14 . Align Meshes
Once the models are next
to each other at similar
orientations click the
“Align Meshes” box.

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15 . Find Common Data
First, click a spot on the
newly imported day of
surgery marker scan.
Then, click the same spot
on the original
preoperative scan. Repeat
at least 5 times. Notice
the arrows point from the
new scan to the old scan.
Letting you know the
direction the scan is
moving. This is important
as the old scan has the
waxup aligned to it.

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16 . Exclude Selected Spots
Due to local infiltration
the day of surgery marker
scan will have differences
compared to the pre-
operative scan. Check this
box to exclude selected
parts.

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17 . Paint Common Data
Paint common data blue.
Avoid movable tissues.

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18 . Invert
Click invert. This will
make the all other areas
blue except where you
painted. Exocad will not
take blue areas into
consideration when doing
the best fit match.

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19 . Perform Alignment
Click perform aliment to
bring the two scans
together based exclusively
on the points you
selected.

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20 . Evaluate
Unclick matching exclude
selected parts and then
click the show distances
to see the color map of
alignment. The distances
are indicated in the color
map bar below the check
box. Stay in the add
remove mesh module.

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21 . Click “OK”
Click ok on the small
window, but stay in this
add-remove mesh module.
Now, you wait for the
surgical tissue cap scan
and the unified scan body
export. These are two
different files. First,
merge the surgical tissue
cap scan to this
intermediate visualization
mesh that you just
merged.

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22 . Load Surgical Tissue Cap Scan
Click extra jaw scan.

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23 . Load Surgical Tissue Cap Scan
Click load and navigate to
the new surgical tissue cap
scan.

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24 . Click “No”
It does not matter what
you select here.

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25 . Click “OK”
The tissue cap scan will
not be aligned to the other
scans. That is ok. We will
do that alignment in a
different module. Just
click ok to save.

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26 . Click Tools-Align Meshes
We will now enter the
align meshes tool to merge
the surgical tissue cap
scan to the intermediate
marker scan.

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27 . Move and Rotate
Only move the surgical
tissue cap scan. Be careful
not to move the other two
scans. Left click on the
tissue cap scan and drag it
off to the side. Then
control and left-click the
middle of the tissue cap
scan to rotate it. Get it to
be side by side and at the
same orientation as the
other scans.

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28 . Click Automatically
You can now click
automatically. Turn off the
preoperative scan and
only show the
intermediary marker scan.

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29 . Click Common Points
Focusing on the marker
and non-movable tissues
find common spots.
Always first click the
surgical tissue cap scan
then, click the
intermediary marker scan
in the exact spot.

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30 . Repeat 5 times
Repeat at least 5 times,
but the more spots the
better.

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31 . Exclude Elected Parts
Click the “exclude
selected parts” box.

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32 . Paint Common Areas
Paint common data
between the scans.

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33 . Invert Selection
Flip the colors by clicking
invert. Exocad will not use
the blue data for the
alignment.

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34 . Perform Alignment
Click perform alignment.
This moves the sriuagical
cap scan to the
intermediary marker scan
using only your dots
selected.

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35 . Click “Best Fit Match”
Click best fit match and
now all the data that is
painted will be considered
for the matching. Millions
of points will be analyzed.

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36 . Evaluate Merge
To see the color uncheck
exclude selected parts box
and check show distance.

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37 . Click “OK”
Click OK to save the
merging.

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38 . Tools: Add/Remove Mesh
We need to bring the
unified scanbody scan in.

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39 . Select Scan Marker Scan
Select scan marker scan
and hit load. Find the
unified scan body scan
that was exported from
your Grammetry,
photogrammetry or IPG
device. Make sure it was
the same export as the
tissue caps you used.

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40 . Click “No”
Click no or yes it does not
matter.

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41 . Move the Scan Marker Scan
Click and drag the scan
marker scan. Hold control
and left click to rotate
them. Make sure you click
them to rotate and not the
scene.

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42 . Get Them in Position
You want the scan markers
in the same orientation
and facing the same way
as they are on the surgical
tissues cap scan.

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43 . Align Meshes
Click the align meshes
button.

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44 . Click Common Spots
Click one spot on each
scanbody tissue cap.
Always start on the newly
imported unified
scanbody scan and then
pick the same point on the
surgical tissue cap scan.
Notice the direction of the
arrows. They go from the
unified scanbody scan to
the surgical tissue cap
scan.

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45 . Perform Alignment
Click here.

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46 . Best Fit Match
Use best fit match to
refine alignment.

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47 . Evaluate
It is normal to have
discrepancy here. The
weakest link is the surgical
tissue cap scan. The
unified scanbody scan is
much more accurate. It is
important to understand
this concept. The surgical
tissue cap scan has noting
to do with implant to
implant position and only
aids in aligning the unified
scan to the waxup and soft
tissue.

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48 . Click “OK”
Click OK to save.

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49 . Click Wizard
Click back to the wizard

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50 . Click “Next”
Do NOT align the models
here. We already aligned
them using more
sophisticated alignment
tools. Just ignore this and
hit “next”.

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51 . Click Replace the Whole Scan Data
Click replace scan data,
this will remove the old
pre surgical scan that the
waxup was made on and
replace it with the surgical
tissue cap scan.

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52 . Back to Expert Mode
Before the waxup
calculates head to expert
mode.

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53 . Select Implant Teeth
In expert mode, click a
tooth that is where your
implant is, and then on the
bottom menu hit select
implant type.

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54 . Click “Screw Retained”
Click screw retained then
“OK”.

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55 . Repeat for Every Implant Tooth
Repeat the steps for each
implant, changing the
tooth to the screw-
retained. However many
implants are placed are
how many teeth should be
changed.

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56 . Back to Wizard
Head back to wizard for
scanbody alignment

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57 . Find Proper Library
You need to find the
exocad library for the
screw you want to use and
that is the same geometry
as the tissue cap you
scanned with and the
tissue cap you imposed as
a unified scanbody.

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58 . Merge Scanbody
If you want to hide your
jaw so you only see the
sandy hit “S” on the
keyboard. Now click the
spot on the scanbody the
is indicated by the red dot
in the preview window.
Make sure you are working
tooth number the tooth
prompted in the wizard.

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59 . Evaluate Mesh
It should have one true
blue, which indicates a
perfect match. If you do
not see colors hold control
and clock the dot again.
Any other color means you
have the wrong library.

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60 . Click “Next”
Click next to move onto
the next tooth.

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61 . Repeat
Just repeat for each
tooth.

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62 . Repeat
The last tooth is being
merged now. Next we will
evaluate the substation of
the tissue caps. Hit Next

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63 . Evaluate Tissue Cap Delete
The tissue caps should
one deleted from the
surgical cap scan and you
should now be able to see
the digital MUA.

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64 . Expert Mode
Almost always you see
areas remaining of the
surgical caps. We can
delete this and also
regenerate virtual waxup
bottom in expert mode.

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65 . Edit Mesh
In expert mode right click
the tissue scan and hit edit
mesh.

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66 . Select
Select the area around the
remains tissue cap scan.

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67 . Delete
Hit delete to remove then
hit OK.

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68 . Click Virtual Wax Up Bottom
Click the model than go to
virtual wax up bottom

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69 . Click Update
Click update.

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70 . Click “OK”
Next click ok and save.

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71 . Back to Wizard
We need to go back to
wizard.

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72 . Define Emergence Profile
We do not need to do
anything here except hit
next for each implant.

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73 . Abutment Bottoms
We do not need to do
anything here except hit
next for each implant.

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74 . Virtual Wax Up
A virtual wax up scan will
be generated.

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75 . Free-Form
Most of the freeform is
spent smoothing tissue
surfaces. At first, the
design will be concave and
uinclensable. Use the
free- smooth flatten tool
to smooth the fitting
surface and shrink the
distal extensions.

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76 . Free-Form
Most of the freeform is
spent smoothing tissue
surfaces. At first the
design will be concave
and uinclensable. Use the
free- smooth flatten tool
to smooth the fitting
surface and shrink the
distal extensions.

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77 . Check Tissue Pressure
Click distance to scan
data. Nearest point
distance checked. Change
the scale not 0.1-1mm

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78 . Adjust Tissue Pressure
A color coded map of
tissue pressure can be
seen now. You can go to
adapt tool and hit BASAL
or you can smooth it here.
I tend to like bout 300-500
microns of pressure.
Depending in the ridge.
Make sure no concavities,
creases or uinclensable
areas exist. Please note a
printed provisional will be
more thick compared to
the final

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79 . Adjust Tissue Pressure
A color coded map of
tissue pressure can be
seen now. You can go to
adapt tool and hit BASAL
to get you to a target
number then you can
smooth it from there.

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80 . Click “Next”
Click next to add screw
channels.

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81 . Click “Next”
Nothing to do here except
next.

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82 . All Done
You are all done with the
design and now can print.
Any issue with merging is
most likely a library issue
or your waxup had errors.

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 ALL ON X

Pre-Surgical Waxup
DUAL ARCH

352 | exocad ALL ON X STEP-BY-STEP GUIDE < TABLE OF CONTENTS

 1 . Pontic Waxup Technique: Denate Arch
This technique is favored
by a lot of people
especially where a lot of
bone reduction is done.
This technique allows for
fast and easy tissue
surface modifications on
day of surgery. However
this technique is more time
consuming and if less than
2mm of bone reduction is
done this technique is not
as good as the “easy”
technique.

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 2 . Open Dental DB
AI features are only
available in some regions
and on exocad 3.2-9 or
later.

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 3 . Click “Default Client”
Select “Default Client” in
the drop down menu.

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 4 . Enter Patient Name
Enter the patient’s name
in the type field.

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 5 . Click the Distal-Most Tooth
To start the pre surgical
waxup we need to set the
case up as pontic waxup.

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 6 . Click Here
Select pontic waxup.

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 7 . Click “3D Print”
Select 3D print as the
material.

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 8 . Click “Virtual Gingiva”
It is a good idea to
predesign the gingiva
incase you need to use the
anatomic waxup method
taught later on in this
series.

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 9 . Click “Yes, Design Digitally”
This means you do not have a
scanned waxup and you are
designing yourself.

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10 . Click “OK”

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 11 . Click “Contralateral Tooth”
Select the distal most
contralateral tooth while
holding shift on the keyboard.
This will copy the
prescription.

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12 . Select “Opposing Arch Tooth ”
Click and hold the mouse
button down and drag one of
the prescription teeth from
the upper arch to the distal
most tooth in the lower arch
assuming you are waxing both
arches.

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13 . Click Contralateral Tooth
Hold shift and click the distal
most contra later tooth to
copy the prescription across
the lower arch.

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 14 . Click “Save”
Click save or you can’t
proceed to design.

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 15 . Click “Design”
Now hit “Design”.

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16 . Load Files
In a dual arch case, exocad
will ask for upper first then
lower. Any OBJ, STL, or PLY
works. The scans will come
into the scene with the same
occasion that you scanned
them in with your IOS.
Therefore if wanting to open
the vertical it is easies to do
that with a deprogrammer or
Lucia jig, leaf gauge, or other
method and scan at the
desired vertical. Alternatively,
you can open on the virtual
articulator

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 17 . Adjust Orientation
Rotate the models so you are
looking down the occlusal of
the lower arch like shown
here. Hit next when ready.

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18 . Click Load Retracted
If you do not have
photographs you really need
to ask yourself why. I would
never design a case without
photos.

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19 . Find Retracted Photo
Navigate to a retracted photo.

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20 . Click First Point
I usually like to click the CEJ
of tooth 6 and the cusp tip of
tooth 11 starting on the photo
then, moving to the Intraoral
scan (IOS)and repeating the
same spots. If you can see a
dot when you click, you must
have already placed it
somewhere. Zoom out and
search for it.

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 21 . Click Second Point
My second point is usually
the cusp tip of 11. It is
unwise to cross the arch and
go to the mandible as you
can’t be sure the patient is in
proper occlusion and the
occlusion is the same as the
IOS.

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22 . Click First Point IOS
Click CEJ of 6 on the IOS. It
helps if the IOS is in the same
angle and orientation as the
photo.

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23 . Click Second Point IOS
Click cusp tip of 11 in the
IOS.

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24 . Click “Next”
Click the “Next” button.

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25 . Rotate First
At the midline and right click
and drag the mouse to rotate.
We have to align the IOS to
the photo. Small movements
are best. Split the difference
in the error on both sides
equally rather than trying to
match one side perfectly at
the expense of the other.

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26 . Refine Dots
Click the center of the dot
using the left lick and move
the ball slightly to refine the
match. Repeat on the
contralateral dot.

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27 . Click “Next”
When the match is perfect
including both the anterior
and posterior teeth you can
hit next. You may have to
repeat the previous two steps
several times to get a perfect
match.

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28 . Load Smile
Navigate to your smile photo.
It is important that the smile
and retracted photos are
taken at the same head
position and that a tripod for
your camera is used. If done
correctly, exocad will
automatically align the smile
and the retracted.

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29 . Evaluate Merge
You can tell a good smile
merge with the retracted
photo by zooming in on the
teeth. The front 6 teeth
should be clear with no
ghosting or blur. If they are
not perfect, you can tweak
the dots by clicking the
center of the dot and moving
them. If you have bad photos
no amount of adjustments
here will create a better
alignment. Hit “Next” when
happy.

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30 . Mark the Lip
Click the line to add more
control points as needed to
move the lip outline. Click
“next” when happy.

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 31 . Mark the Pupils
AI will auto detect the eyes
and add a dot near the
middle of the pupil. Click the
dot and move it to refine the
location. Hit next when done.

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32 . Refine Smile Helper Lines
Typically I move the facial
midline to be more inline with
the nose and maxilla. I then
move my gingival zenith and
smile arc lines to match. I
then move my proportion
gauge to the midline and place
the horizontal bar where I
want my incisal edges of the
centrals to be. Then I contract
the proportion gauge so the
last line is matching to the
distal of the cusp or nares of
the nose. The width of the
central should be 8-9mm.

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33 . Hit “Next”
When happy with helper lines
hit “next”.

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34 . Adjust Proclination
The bottom right corner box I
usually click the chevron and
rotate the arch to adjust
proclination. Usually I have to
move the incisal edges
towards the palatal.

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35 . Reposition Smile
Click the center of the central
and move the entire arch up
to where the incisal edge of
the central is on the
horizontal line of the
proportion gauge. Make sure
you are moving all teeth here.
You should have a box around
all the teeth. If not, click and
drag a big square around all
the teeth in any of the left
windows.

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36 . Measure Central
Click measurement and then
click the central incisor.

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37 . Adjust Tooth Length
Click the blue dot above the
central indoor around the box
that is encompassing your
smile silhouette. Drag the
blue dot to shrink or lengthen
the teeth. Most people will
have a central on the
10-11mm range.

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38 . Adjust Anterior-Posterior Position
This is ultra critical. Click
the middle box on the right of
the screen and move the
entire arch anterior or
posterior to the desired
location. Before hitting next
check your silhouette to make
sure it is correct and you did
not accidentally move the
midline while position the
arch.

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39 . Click “Next”
There is a lot more you can
do in this step, but I prefer to
finalize my tooth positions in
the Tooth Placement tab due
to chain mode and instant
anatomic morphing. Hit
“next”.

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40 . Click “Continue Without”
Here we will not use AI
photorealistic preview.

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41 . Click “Next”
Click “Next” as I do not use
this step or show the patient
this.

393 | exocad ALL ON X STEP-BY-STEP GUIDE

42 . Click “Done”
I also do not use the PDF
report so I click “done”.

394 | exocad ALL ON X STEP-BY-STEP GUIDE

43 . Tooth Placement
Click Chain mode and lock
the front 4 teeth and unlock
the back teeth.

395 | exocad ALL ON X STEP-BY-STEP GUIDE

44 . Lock the Incisors
Click the green balls to turn
them red on the incisors.

396 | exocad ALL ON X STEP-BY-STEP GUIDE

45 . Unlock the Molars
Click the red balls to green on
the molar region. If you can’t
find them, look underneath
the model.

397 | exocad ALL ON X STEP-BY-STEP GUIDE

46 . Move Molars
Set the arch length by moving
the molars to the proper
location. Lock the molars and
then move the premolars and
cupids using small
movements.

398 | exocad ALL ON X STEP-BY-STEP GUIDE

47 . Hit “Next”
Once the upper arch is set
appropriately, hit “next”. If
you need to move individual
teeth, we will do that once we
set the lower arch.

399 | exocad ALL ON X STEP-BY-STEP GUIDE

48 . Expert Mode
Before creating the virtual
waxup bottom we need to
extract the teeth. Hit expert
mode. Then right-click the
upper arch. Click “Extract
Tooth” in the menu.

400 | exocad ALL ON X STEP-BY-STEP GUIDE

49 . Extract Teeth
Using the extraction tool, all
you do is click virtual preop
as the option and then click
the center of a tooth. The
software will extract the tooth
and then keep a copy as a
preop so you can always refer
back to it.

401 | exocad ALL ON X STEP-BY-STEP GUIDE

50 . Identify The Tooth
Identify the tooth that you
extracted.

402 | exocad ALL ON X STEP-BY-STEP GUIDE

 51 . Keep Extracting
Click extract another tooth.

403 | exocad ALL ON X STEP-BY-STEP GUIDE

52 . Keep Extracting
Click the center of the next
tooth you want to extract.

404 | exocad ALL ON X STEP-BY-STEP GUIDE

53 . Keep Extracting
Repeat this across the entire
arch.

405 | exocad ALL ON X STEP-BY-STEP GUIDE

54 . Keep Extracting
Work your way to the distal
most tooth in the arch.

406 | exocad ALL ON X STEP-BY-STEP GUIDE

55 . Click “OK”
Click “OK” to save your
extractions.

407 | exocad ALL ON X STEP-BY-STEP GUIDE

56 . Smooth Model
We now need to right-click
the upper model and hit
freeform scan date.

408 | exocad ALL ON X STEP-BY-STEP GUIDE

57 . Smooth /Flatten
Click smooth/flatten and
flatten the ridge by holding
shift on the keyboard and
clicking the ridge. You can
also use the remove tool to
simulate bone reduction.

409 | exocad ALL ON X STEP-BY-STEP GUIDE

58 . Refine the Ridge
Use the remove and flatten
tools smoothing the ridge.

410 | exocad ALL ON X STEP-BY-STEP GUIDE

59 . Click “OK”
To save the edits to the scan
data click “ok”.

411 | exocad ALL ON X STEP-BY-STEP GUIDE

60 . Click Wizard
We will now go back to the
wizard.

412 | exocad ALL ON X STEP-BY-STEP GUIDE

61 . Click “Next”
Just hit next to skip adapting
your new waxup to the old
proper teeth form.

413 | exocad ALL ON X STEP-BY-STEP GUIDE

62 . Rotate
Rotate the model to the path
of iteration of the arch and hit
set from view.

414 | exocad ALL ON X STEP-BY-STEP GUIDE

63 . Set from View
This will create the angle of
block-out for the virtual
waxup bottom.

415 | exocad ALL ON X STEP-BY-STEP GUIDE

64 . Next
Click “next” and the virtual
wax up bottom will be
generated.

416 | exocad ALL ON X STEP-BY-STEP GUIDE

65 . Lower Arch
We are now asked to do the
angle of insertion for the
lower, but since we need to
extract teeth, we must go to
expert mode first and remove
the teeth as we did on the
maxilla.

417 | exocad ALL ON X STEP-BY-STEP GUIDE

66 . Expert Mode
Click expert mode.

418 | exocad ALL ON X STEP-BY-STEP GUIDE

67 . Right-Click the Lower Scan
Right-click the lower scan.

419 | exocad ALL ON X STEP-BY-STEP GUIDE

68 . Extract Tooth
Click extract tooth.

420 | exocad ALL ON X STEP-BY-STEP GUIDE

69 . Click a Tooth
Click the center of the
straight facial for anterior
teeth and the central groove
of posterior teeth.

421 | exocad ALL ON X STEP-BY-STEP GUIDE

70 . Identify the Tooth
Identify what tooth you
extracted. Repeat the process
for the remaining teeth.

422 | exocad ALL ON X STEP-BY-STEP GUIDE

 71 . Correct Errors
If the software accidentally
adds two teeth together for
the extraction click the
correction icon. Hold short
and paint the area you want
to remove from the selection
area. Make sure to remove all
the yellow except from the
tooth you want to extract. If
you need to add yellow do
not hold shift while left
clicking.

423 | exocad ALL ON X STEP-BY-STEP GUIDE

72 . Correct Errors
Once the areas have been
corrected, hit apply to see
the changes take effect.

424 | exocad ALL ON X STEP-BY-STEP GUIDE

73 . Click “OK”
Once all the teeth have been
extracted hit OK to save.

425 | exocad ALL ON X STEP-BY-STEP GUIDE

74 . Free-Form
Right click the model and hit
Free-Form scan data.

426 | exocad ALL ON X STEP-BY-STEP GUIDE

75 . Smooth
Smooth the extraction areas
and reduce the ridge like we
did on the maxilla and then
hit ok.

427 | exocad ALL ON X STEP-BY-STEP GUIDE

76 . Back to Wizard
Jump back to the Wizard
mode by clicking the Wizard
icon here. It should take you
to tooth placement for the
lower arch.

428 | exocad ALL ON X STEP-BY-STEP GUIDE

77 . Click Gingiva Area of Left Molar
Here we are going to place
the lower tooth models. Do
not worry they will come in
not so perfect but in the next
tab it is easy to adjust. Click
the tissue area of the distal
most left molar.

429 | exocad ALL ON X STEP-BY-STEP GUIDE

78 . Click Gingiva area of Right molar
Click the tissue area of the
distal most right molar. It
does not really matter if you
select by contact point or
tissue area here.

430 | exocad ALL ON X STEP-BY-STEP GUIDE

79 . Click “Next”
The teeth will look bad. Do
not worry, hit “Next”.

431 | exocad ALL ON X STEP-BY-STEP GUIDE

80 . Tooth Placement
Jump to chain mode.

432 | exocad ALL ON X STEP-BY-STEP GUIDE

 81 . Free All the Lower Teeth
All the lower teeth including
the distal ring should have
green dots. Click the dot to
turn it from red to green.

433 | exocad ALL ON X STEP-BY-STEP GUIDE

82 . Free All Lower Teeth
Make sure to check both
sides for red dots.

434 | exocad ALL ON X STEP-BY-STEP GUIDE

83 . Move Entire Lower
Now the entire lower arch is
movable and scalable
uniformly. Click the arch and
drag it. Hold shift and click-
drag to scale the arch smaller
and bigger. Your goal is to
match the lower anterior as
close as possible to the
preoperative or if there are
not lower teeth in the
preoperative condition you
want anterior overjet with the
lower central occluding on the
lingual incisal 1/3 of the
upper.

435 | exocad ALL ON X STEP-BY-STEP GUIDE

84 . Match Anteriors First
Match the anteriors. You can
hold control to rotate the
entire arch when clicking.
Shift to scale and clic to drag
to translate.

436 | exocad ALL ON X STEP-BY-STEP GUIDE

85 . Lock Anteriors
Now you want to lock your
lower anteriors. Turn the
green balls red. Remember
the maxilla was set to ideal
esthetics so we do not want
to move those too much now
and we are focused on the
mandibular.

437 | exocad ALL ON X STEP-BY-STEP GUIDE

86 . Move Molars
Now, drag your mandibular
first molars to the correct
position on both sides of the
arch by clicking the molar
tooth in the center and
dragging it.

438 | exocad ALL ON X STEP-BY-STEP GUIDE

87 . Move Molars
Make sure to look form all
angles when moving teeth.

439 | exocad ALL ON X STEP-BY-STEP GUIDE

88 . Move Molars
Repeat on the contralateral
side. Click the center of the
molar tooth and drag it where
you want it. Do not worry too
much about perfecting
occlusion yet.

440 | exocad ALL ON X STEP-BY-STEP GUIDE

89 . Advanced Tab
Now we exit chain mode by
clicking the advanced tab.

441 | exocad ALL ON X STEP-BY-STEP GUIDE

90 . Change Settings
You want to have the eye
highlighted orange in the
menu bar and the instant
anatomic Morphing icons on
both upper and lower
highlighted orange as shown.
Make sure the apply to all
text box is highlighted.

442 | exocad ALL ON X STEP-BY-STEP GUIDE

91 . Change Settings
Match these settings.

443 | exocad ALL ON X STEP-BY-STEP GUIDE

92 . Refine Individual Teeth
You can click a single tooth to
move it. You can scale a tooth
by holding shift and click
dragging the mouse. Control
and click dragging the mouse
will rotate the tooth. My
favorite is Control and Shift
at the same time and click
dragging the mouse to morph
the tooth in the direction of
the arrow as shown here.

444 | exocad ALL ON X STEP-BY-STEP GUIDE

93 . Tooth by Tooth
Go tooth by tooth on the
maxilla and mandible. Hiding
teeth can be tricky. Use X
and N on the keyboard. Also
try holding control and
clicking the roller ball button
down on the object you want
to hide. If you want it back
hold Control and Shift and
click the roller ball and the
object will return in the order
it was removed.

445 | exocad ALL ON X STEP-BY-STEP GUIDE

94 . Click “Next”
Click “next” when happy with
the location and contact
areas. Further refinement is
done to occlusion in the next
tab.

446 | exocad ALL ON X STEP-BY-STEP GUIDE

95 . Freeform
Use the add remove tools to
refine contact location. You
do not want a lot to do here.
Too many new designers
spend way too much time
here. This should take 5
minutes or less.

447 | exocad ALL ON X STEP-BY-STEP GUIDE

96 . Smooth Roots
Smooth flatten protruding
roots.

448 | exocad ALL ON X STEP-BY-STEP GUIDE

97 . Cut All Intersections.
Lastly, hit cut all intersections
to ensure contacts are ideal
and pints get cut.

449 | exocad ALL ON X STEP-BY-STEP GUIDE

98 . Next
Click “next” when done with
free forming.

450 | exocad ALL ON X STEP-BY-STEP GUIDE

99. Skip
If asked to adapt to preop hit
next to skip this step.

451 | exocad ALL ON X STEP-BY-STEP GUIDE

100 . Single Gingiva
If asked you want to click
design signal gingiva. If you
do not, get this option you
may have set the case up
wrong and not selected
gingiva. You can design it in
expert mode if that is the
case.

452 | exocad ALL ON X STEP-BY-STEP GUIDE

101 . Draw Tissue
Click the ridge and draw a
margin of tissue a little wider
than you anticipate incase
implants locations are not
ideal. I generally want the
tissue to be 2mm thick.

453 | exocad ALL ON X STEP-BY-STEP GUIDE

102 . Change Base Thickness
Change the base thickness to
2mm and hit apply.

454 | exocad ALL ON X STEP-BY-STEP GUIDE

103 . Evaluate
If you need to move the tissue
line click a greed ball and
drag it and then hit apply
again to make the change.
When done editing hit next.

455 | exocad ALL ON X STEP-BY-STEP GUIDE

104 . Next
Hit “next”. The tissue may not
be perfect but it is not
important.

456 | exocad ALL ON X STEP-BY-STEP GUIDE

105. Mandibular Tissue
If asked, design a single
gingiva.

457 | exocad ALL ON X STEP-BY-STEP GUIDE

106 . Draw Tissue Border
Click to draw your border.
Go all the way around and
double click on the first ball
to close the tissue line.

458 | exocad ALL ON X STEP-BY-STEP GUIDE

107 . Thickness
Change the thickness to the
desired thickness.

459 | exocad ALL ON X STEP-BY-STEP GUIDE

108 . Thickness
Somewhere around 2mm is
sufficient at first.

460 | exocad ALL ON X STEP-BY-STEP GUIDE

109 . Apply
You have to hit apply to have
thickness changes take
effect.

461 | exocad ALL ON X STEP-BY-STEP GUIDE

110 . Hit “Next”
Hit “next” when done.

462 | exocad ALL ON X STEP-BY-STEP GUIDE

111 . Save the Case
This is a good stopping point
to save the case and have it
ready to go for day of
surgery.

463 | exocad ALL ON X STEP-BY-STEP GUIDE

112 . Save the Case
Close the case. Remember
the name you set the case up
as because on the day of
surgery you need to be able
to locate this case and open
it. If using the anatomic
waxup workflow you can take
this case to the final merged
part.

464 | exocad ALL ON X STEP-BY-STEP GUIDE

 ALL ON X

Universal Method: Day of surgery

465 | exocad ALL ON X STEP-BY-STEP GUIDE < TABLE OF CONTENTS

 1 . Aligning Scan Data
Really this is a game of aligning scans. A
diagnostic preoperative scan is made. A
waxup is made on this model. Many ways
exist to do this including waxup pontic and
anatomic pontic. The advantage of using
waxup pontics is you can change to an implant
restoration in expert mode. The waxup is
done before the surgery appointment. Then on
day of surgery you need an intermediate pre
surgical marker scan. This will be aligned to
the original preoperative scan. Typically the
scan has surgical markers. Then you need a
post surgery soft tissue scan. This scan has
some type of tissue scan caps. This is
important as the caps determine the expand
library. Not to be confused with scan bodies.
The scanbody scan comes from IO Connect or
similar scanbody, or Shining IPG or Micron
mapper style Photogrammetry. The system
converts the more accurate scan to an
exported unified scanbody scan that is the
same library as the soft tissue caps used
which is linked to the exocad library.

466 | exocad ALL ON X STEP-BY-STEP GUIDE

 2 . Unified Scanbody Scan
The concept of the unified tissue cap export is
genius. It is a system where a more accurate
way of capture is achieved using grammetry,
photogrammetry, or Intraoral
photogrammetry, and a unified scan body
scan is exported as a tissue cap of choice.
This will then get align with the intraoral
surgical tissue cap scan. This allows using
easy workflows in exocad. IO Connect, Micron
Mapper, Shining IPG and many other system
use this workflow. It is important to
understand when you align this unified
scanbody scan to the intraoral tissue scan it is
only for positioning the scan bodies into the
arch and does not impact implant to implant
position therefore ensuring passivity of fit
(assuming manufacturing is accurate). It only
serves to align the scanbody scan to the jaw
and the premade waxup. Furthermore when
using the exocad scanbody alignment wizard
you are not changing implant positions form
the unified scanbody scan. It will be identical.

467 | exocad ALL ON X STEP-BY-STEP GUIDE

 3 . Shining IPG
Really this is a game of aligning scans. A
diagnostic preoperative scan is made. A
waxup is made on this model. Many ways
exist to do this including waxup pontic and
anatomic pontic. The advantage of using
waxup pontics is you can change to an implant
restoration in expert mode. The waxup is
done before the surgery appointment. Then on
day of surgery you need an intermediate pre
surgical marker scan. This will be aligned to
the original preoperative scan. Typically the
scan has surgical markers. Then you need a
post surgery soft tissue scan. This scan has
some type of tissue scan caps. This is
important as the caps determine the expand
library. Not to be confused with scan bodies.
The scanbody scan comes from IO Connect or
similar scanbody, or Shining IPG or Micron
mapper style Photogrammetry. The system
converts the more accurate scan to an
exported unified scanbody scan that is the
same library as the soft tissue caps used
which is linked to the exocad library.

468 | exocad ALL ON X STEP-BY-STEP GUIDE

 4 . TruAbutment IO Connect
IO connect you must do a
scanbody scan and a soft tissue
scan with the IO Connect caps.
The IO connect software will
convert the more accurate
scanbody scan made with their
proprietary diving board style
scanbody into a soft tissue cap
scanbody scan with a unified
position. IO connect has a
library for the Truabutment
direct to MUA screw, Rosen and
Powerball screw. IO Connect is
the best way to scan all on x if
you do not have photogrammetry
and own a Trios.

469 | exocad ALL ON X STEP-BY-STEP GUIDE

 5 . The Screw
I only do direct to MUA
prosthetics. The direct to MUA
screw you want to use is
determined by your exocad
library. You need to have the
proper library to use to align to
the unified tissue cap scan that
was exported from your
Photogrammetry, grammetry or
IPG system. Powerball continue to
be great and has the best exocad
and CAM libraries. It has angle
correction and is tried and true.
Everyone and their mom has a
screw these days. I like to stick
with ones that have been proven.

470 | exocad ALL ON X STEP-BY-STEP GUIDE

 6 . Load Pre-Surgical exocad Design
To start the conversion on the
day of surgery you should
load the previously made
waxup that was made using
the technique I demonstrated
earlier.

471 | exocad ALL ON X STEP-BY-STEP GUIDE

 7 . Load Original exocad Design
Navigate to the pre-surgical wax
up.

472 | exocad ALL ON X STEP-BY-STEP GUIDE

 8 . Load Original exocad Design
Go back into design.

473 | exocad ALL ON X STEP-BY-STEP GUIDE

 9 . Load Original exocad Design
Your waxup will load just as
you left it. Immediately go
into expert mode.

474 | exocad ALL ON X STEP-BY-STEP GUIDE

10 . Expert Mode
Immediately go to expert
mode.

475 | exocad ALL ON X STEP-BY-STEP GUIDE

 11 . Tools
Go back into tools.

476 | exocad ALL ON X STEP-BY-STEP GUIDE

 12 . Add/Remove Mesh
Go back into add remove
mesh. We need to align the
intermediate surgical scan to
the original preoperative
scan. This should be done at
the beginning of the surgical
appointment and be aligned
and ready to go for the
conversion.

477 | exocad ALL ON X STEP-BY-STEP GUIDE

 13 . Select Generic Visualization Mesh
Make sure to select generic
visualization mesh.

478 | exocad ALL ON X STEP-BY-STEP GUIDE

 14 . Click “Load”
We are going to load a mesh
to merge to the original
scans. We are going to load
an intermediate surgical day
scan. This scan is made the
day of surgery with some type
of markers in place and is
made before the extractions,
flap or ridge augmentation.

479 | exocad ALL ON X STEP-BY-STEP GUIDE

 15 . Find Pre-Surgical Marker Scans
Find the pre-surgical marker
scan that is made on the day
of surgery.

480 | exocad ALL ON X STEP-BY-STEP GUIDE

 16 . Click “No”
It does not matter what you
click here.

481 | exocad ALL ON X STEP-BY-STEP GUIDE

 17 . Manual Position Scan
Click the new scan and rotate
it to be in the same
orientation as the arch you
want to merge it to. Control
left click the scan will rotate
the scan. Left-clicking the
scan will move the scan.
Left-clicking the empty
screen will rotate all objects
at the same time.

482 | exocad ALL ON X STEP-BY-STEP GUIDE

 18 . Manual Position
Ideally, you have them
positioned like this where you
have the occlusal surface
facing you. The preop teeth
should be on and the new
marker scan should be off to
the side, but at the same
orientation.

483 | exocad ALL ON X STEP-BY-STEP GUIDE

 19 . Automatic Merging
Click the align meshes
button.

484 | exocad ALL ON X STEP-BY-STEP GUIDE

20 . Select Common Points
Alway start by clicking the
floating mesh. The floating
mesh is the new scan you
want to move to the original
scan. So we click the molar of
the newly imported scan.

485 | exocad ALL ON X STEP-BY-STEP GUIDE

 21 . Select Common Points
Click the second point on the
preoperative original scan
data.

486 | exocad ALL ON X STEP-BY-STEP GUIDE

22 . Notice Arrows
Notice the direction of the
arrows is pointing from the
new marker scan to the old
preoperative scan.

487 | exocad ALL ON X STEP-BY-STEP GUIDE

23 . Repeat at Least 5 Spots
A minimum of 5 spots should
be selected spread
throughout the arch. Make
sure your arrows are all
pointing in the same
direction.

488 | exocad ALL ON X STEP-BY-STEP GUIDE

24 . Perform Alignment
Click perform alignments to
move the arch to the
preoperative model based
exclusively on your points.

489 | exocad ALL ON X STEP-BY-STEP GUIDE

25 . Best Fit Matching
Click best fit matching to
allow exocad to use
mathematical triangle
approximation to better align
the data together.

490 | exocad ALL ON X STEP-BY-STEP GUIDE

26 . Cut View
Evaluate the colors. Any color in
the range is acceptable. Use the
cut tool and drag the slicer to
further evaluate the merge.
Because we did some digital
education of the ridge, the teeth
are the most accurate objects.
If you had a scenario where you
did not have hard tissues to
merge you would not have done
bone reduction on the original
scans for a better merge.
Alternatively, you could load
unedited original scans as a
Preop and use that for this
merging.

491 | exocad ALL ON X STEP-BY-STEP GUIDE

27 . Hit “OK”
If happy with the merge hit
OK on the smaller box as
shown.

492 | exocad ALL ON X STEP-BY-STEP GUIDE

28 . Load Lower Arch
Click Load and find the lower
pre surgical marker scan.

493 | exocad ALL ON X STEP-BY-STEP GUIDE

29 . Select
It does not matter what you
hit here. I usually hit no.

494 | exocad ALL ON X STEP-BY-STEP GUIDE

30 . Manual Position New Scan
Manually position new scan
to be in the same angle as the
preoperative jaw but off to
the side as shown.

495 | exocad ALL ON X STEP-BY-STEP GUIDE

 31 . Select Common Points
Select common points
starting on the newly
imported scan.

496 | exocad ALL ON X STEP-BY-STEP GUIDE

32 . Select Common Points
Find the same exact spot on
the original scan data. Notice
the arrows are pointing from
the new scan to the original
scan.

497 | exocad ALL ON X STEP-BY-STEP GUIDE

33 . Repeat 5 Times
Repeat a minimum of 5 spots
spread throughout the arch.

498 | exocad ALL ON X STEP-BY-STEP GUIDE

34 . Perform Alignment
Click perform alignment to
move the new scan data to
the original based exclusive
on your spots selected.

499 | exocad ALL ON X STEP-BY-STEP GUIDE

35 . Click “Best Fit Matching”
Click best fit match to allow
exocad to refine the
alignment based on millions
of data points.

500 | exocad ALL ON X STEP-BY-STEP GUIDE

36 . Evaluate Match
Use the slicer tool to verify
alignment. Evaluate color
coded accuracy.

501 | exocad ALL ON X STEP-BY-STEP GUIDE

37 . Click “OK”
Click OK on the small
window.

502 | exocad ALL ON X STEP-BY-STEP GUIDE

38 . Load Surgical Tissue Scan
Now we need to load the
surgical tissue cap scan as a
jaw scan. Navigate to extra
jaw scan.

503 | exocad ALL ON X STEP-BY-STEP GUIDE

39 . Load Extra Jaw Scan
Delineate what arch you are
loading.

504 | exocad ALL ON X STEP-BY-STEP GUIDE

40 . Select the Arch
Choose what arch the jaw
scan is for dual arch cases.

505 | exocad ALL ON X STEP-BY-STEP GUIDE

 41 . Load
Navigate to the surgical tissue
scan for the arch selected.

506 | exocad ALL ON X STEP-BY-STEP GUIDE

42 . Click “No”
It does not matter what you
click. The tissue scan will not
be aligned. Please note we do
not align it here. It will be
wrong and come in not
aligned. Don’t panic. It’s ok.
Click No then Click OK.

507 | exocad ALL ON X STEP-BY-STEP GUIDE

43 . Tools-Align Meshes
Stay in expert mode. Click
tools, align meshes.

508 | exocad ALL ON X STEP-BY-STEP GUIDE

44 . Manual Movement
Click the new tissue scan and
drag it. This is frustrating for
new users. If you left click the
new tissue scan you will move
it. Control left click the new
scan to rotate it. Do not move
the pre surgical marker scan.
If you left click the blank
screen the scene will move
together. That’s ok.

509 | exocad ALL ON X STEP-BY-STEP GUIDE

45 . Side by Side
Manipulate the new scan until
it is side by side with the pre
surgical marker scan.

510 | exocad ALL ON X STEP-BY-STEP GUIDE

46 . Automatic Alignment
Once they are side by side
and similar orientation click
the automatically button.

511 | exocad ALL ON X STEP-BY-STEP GUIDE

47 . Common Points
Click common points first
starting on the new surgical
tissue scan (floating mesh).
Then clicking the same point
on the pre surgical scan.
Repeat a minimum of 7 spots
focusing on the markers and
any non movable tissues. The
blue arrows should point from
the surgical tissue cap scan to
the pre-surgical scan.

512 | exocad ALL ON X STEP-BY-STEP GUIDE

48 . Exclude Selected Parts
Check the box.

513 | exocad ALL ON X STEP-BY-STEP GUIDE

49 . Paint Common Areas
Paint both models blue where
they have similar data like the
markers.

514 | exocad ALL ON X STEP-BY-STEP GUIDE

50 . Invert Selection
Hit invert selection area and
the common data will now not
be blue and everything else
will be blue. Blue means
exocad will not use that data
for the matching.

515 | exocad ALL ON X STEP-BY-STEP GUIDE

 51 . Change Settings
Max influence distance
around 4mm and matching
parts ratio around 10%. Play
with values to see what works
for you.

516 | exocad ALL ON X STEP-BY-STEP GUIDE

52 . Perform Alignment
This will move the tissue cap
scan to the pre-surgical scan
using only your selected
points.

517 | exocad ALL ON X STEP-BY-STEP GUIDE

53 . Best Fit Match
This will use millions of data
points and find a better
match.

518 | exocad ALL ON X STEP-BY-STEP GUIDE

54 . Evaluate
Uncheck the exclude selected
parts box and check the show
distances. Now you can see
color map of alignment
accuracy. Blue and green are
nearly perfect. Due to
swelling and bone reduction
and sutures many areas may
not align. This is why marker
scans are so important. CBCT
data can also be used for
alignment.

519 | exocad ALL ON X STEP-BY-STEP GUIDE

55 . Click “OK”
Click OK to save the
alignment.

520 | exocad ALL ON X STEP-BY-STEP GUIDE

56 . Repeat for Lower
Now we have to repeat for the
lower arch . Go to tools- add
remove mesh- extra jaw scan
and find the lower surgical
tissue scan. Then click Ok to
save the loaded scan. It will
not be aligned.

521 | exocad ALL ON X STEP-BY-STEP GUIDE

57 . Tools-Align Meshes-Manual
Once the lower is loaded go
to tools- align meshes and
select manual. Rotate and
drag the lower surgical scan
to be next to and at the same
orientation as the pre surgical
marker scan.

522 | exocad ALL ON X STEP-BY-STEP GUIDE

58 . Switch to “Automatically”
Now we will go into automatic
alignment.

523 | exocad ALL ON X STEP-BY-STEP GUIDE

59 . Common Points
Start with the tissue markers.
Click first on the newly
imported surgical tissue cap
scan. Then click the same
exact spot on the pre-surgical
marker scan.

524 | exocad ALL ON X STEP-BY-STEP GUIDE

60 . Common Spots
Find the same exact spot on
the pre-surgical scan.

525 | exocad ALL ON X STEP-BY-STEP GUIDE

 61 . Common Spots
Keep finding common spots.
Always first click the surgical
cap scan then the pre surgical
scan. Focus on areas that
would not have changed
between the scans. This is
why markers are so
important.

526 | exocad ALL ON X STEP-BY-STEP GUIDE

62 . Exclude Selected Parts
Check the box, Matching
excuse selected parts.

527 | exocad ALL ON X STEP-BY-STEP GUIDE

63 . Paint Common Data
Pin the markers and any
areas you see in common that
have not moved.

528 | exocad ALL ON X STEP-BY-STEP GUIDE

64 . Invert
Invert the markings.

529 | exocad ALL ON X STEP-BY-STEP GUIDE

65 . Change Ratios
Alter settings to your liking.
10% and 4mm are a good
start.

530 | exocad ALL ON X STEP-BY-STEP GUIDE

66 . Perform Alignment
Click perform alignment.

531 | exocad ALL ON X STEP-BY-STEP GUIDE

67 . Best Fit Match
Best fit match will fine tune
the alignment. It will ignore
all the blue data.

532 | exocad ALL ON X STEP-BY-STEP GUIDE

68 . Evaluate
Look for high accuracy on the
markers. A midline marker on
the mandible is very helpful.
A strategically kept tooth is
also very helpful.

533 | exocad ALL ON X STEP-BY-STEP GUIDE

69 . Click “OK”
Click “Ok” when done.

534 | exocad ALL ON X STEP-BY-STEP GUIDE

70 . Load Scanbody Scans
Exocad will detect that you
brought new jaw scans.

535 | exocad ALL ON X STEP-BY-STEP GUIDE

 71 . Tools
Go to tools- add remove
mesh.

536 | exocad ALL ON X STEP-BY-STEP GUIDE

72 . Add/Remove Mesh
Go to mesh type.

537 | exocad ALL ON X STEP-BY-STEP GUIDE

73 . Scanbody Scan
Navigate to scan marker scan
in the menu.

538 | exocad ALL ON X STEP-BY-STEP GUIDE

74 . Choose Jaw
Choose the jaw and then hit
load.

539 | exocad ALL ON X STEP-BY-STEP GUIDE

75 . Hit “No”
It does not matter what you
select.

540 | exocad ALL ON X STEP-BY-STEP GUIDE

76 . Move the Scan Bodies
This is a unified scanbody
scan meaning all the scabies
are in a locked orientation.
Click and move them off to
the side and in the same
orientation as the surgical
scan.

541 | exocad ALL ON X STEP-BY-STEP GUIDE

77 . Align Meshes
Click align meshes once the
scanbody scan is orientated.

542 | exocad ALL ON X STEP-BY-STEP GUIDE

78 . Find Common Points
Select common spots first
click the scanbody scans then
click the same spot on the
surgical tissue cap scan. You
need at least one for each
scanbody.

543 | exocad ALL ON X STEP-BY-STEP GUIDE

79 . Find Common Points
It is important to understand
the only reason to align the
scanbody scan to the tissue is
for soft tissue alignment and
this has noting to do with
implant locations in space as
those are fixed by the unified
scanbody scan and will not be
changed.

544 | exocad ALL ON X STEP-BY-STEP GUIDE

80 . Perform Alignment
Click perform alignment.

545 | exocad ALL ON X STEP-BY-STEP GUIDE

 81 . Best Fit Match
Hit best fit match for
automatic alignment.

546 | exocad ALL ON X STEP-BY-STEP GUIDE

82 . Evaluate
It is not uncommon to have
small discrepancies in
location from the unified
scanbody scan and the
surgical tissue scan. This is
because tissue scan is not as
accurate.

547 | exocad ALL ON X STEP-BY-STEP GUIDE

83 . Repeat for Lower
Change to lower jaw.

548 | exocad ALL ON X STEP-BY-STEP GUIDE

84 . Load Lower Unified Scan Body Scan
Find the lower unified
scanbody scan. Click and
drag them to be next to the
surgical tissue scan. Control
and clock them to rotate
them. They should be in the
same orientation like shown.

549 | exocad ALL ON X STEP-BY-STEP GUIDE

85 . Align Meshes
Click align meshes for
common point match.

550 | exocad ALL ON X STEP-BY-STEP GUIDE

86 . Common Points
First select a spot on the
unified scanbody scan then
find the same spot on the
surgical tissue scan. Repeat
for each scanbody.

551 | exocad ALL ON X STEP-BY-STEP GUIDE

87 . Perform Alignment
Click perform alignment.

552 | exocad ALL ON X STEP-BY-STEP GUIDE

88 . Best Fit Match
Next click best fit match.

553 | exocad ALL ON X STEP-BY-STEP GUIDE

89 . Evaluate
It is normal to have
discrepancies as the weakest
link is the soft tissue scan.

554 | exocad ALL ON X STEP-BY-STEP GUIDE

90 . Click “OK”
Click “ok” to save.

555 | exocad ALL ON X STEP-BY-STEP GUIDE

 91 . Select Implant Teeth
Still in expert mode. Click a
tooth that is where one of the
implants is located.

556 | exocad ALL ON X STEP-BY-STEP GUIDE

92 . Select Implant Type
In the lower menu bar that
will pop up when you select a
tooth you will see select
implant type. Click it. This
will not pop up if you select
multiple teeth. Only 1 at a
time.

557 | exocad ALL ON X STEP-BY-STEP GUIDE

93 . Select Implant Type
Change to screw retained.

558 | exocad ALL ON X STEP-BY-STEP GUIDE

94 . Select Screw Retained
Select screw retained.

559 | exocad ALL ON X STEP-BY-STEP GUIDE

95 . Click “OK”
Click ok to save.

560 | exocad ALL ON X STEP-BY-STEP GUIDE

96 . Repeat for Each Implant Tooth
Repeat for each implant tooth
on the maxilla and mandible.
Only click the tooth
immediately over the implant.
Do not select all the teeth.
The amount of teeth selected
should be identical to the
number of implants in each
arch.

561 | exocad ALL ON X STEP-BY-STEP GUIDE

97 . Wizard Mode
Jump back to wizard once
you have selected and
changed to screw retained the
appropriate amount of teeth.

562 | exocad ALL ON X STEP-BY-STEP GUIDE

98 . Wizard Mode
When jumping back to wizard
mode if asked to align the jaw
scans in the wizard skip the
step and just hit next. We
already aligned using a more
sophisticated and accurate
alignment method. To
preserve our alignment SKIP
this by hitting next.

563 | exocad ALL ON X STEP-BY-STEP GUIDE

99. Wizard Mode
Click replace entire jaw scan
to now have exocad recognize
the surgical tissue cap scan
as the jaw scan. This way
when we are using the adapt
feature it will adapt the
prosthetic to this scan with
the bone reduction and not
the old pre-surgical scan.

564 | exocad ALL ON X STEP-BY-STEP GUIDE

100 . Wizard Mode
Repeat same for lower jaw. If
it asks you to align in the
wizard just hit next.
Remember we already aligned
these using a more powerful
tool in expert mode.

565 | exocad ALL ON X STEP-BY-STEP GUIDE

101 . Wizard Mode
Replace the whole scan data.

566 | exocad ALL ON X STEP-BY-STEP GUIDE

102 . Pick Library
Exocad will now want you to
pick the exocad library.
Remember you need a direct
to MUA library that can align
to the tissue cap you
scanned with and that has the
screw you want to use.

567 | exocad ALL ON X STEP-BY-STEP GUIDE

103 . Align Library
Click the scanbody where the
red dot is on the virtual
scanbody image. Make sure
you are selecting the correct
tooth number as the wizard
wants.

568 | exocad ALL ON X STEP-BY-STEP GUIDE

104 . Check Alignment
Remember you are actually
signing to the unified
scanbody scan not the tissue
scan. The cap aliment should
be all blue indicating perfect
alignment. If not you
probably have the wrong
library. If you can’t see
alignment colors hit control
on your keyboard and click
again. Once satisfied hit next
to move onto the next
implant.

569 | exocad ALL ON X STEP-BY-STEP GUIDE

105 . Repeat for all Implants
Keep following the wizard for
each implant for both upper
and lower jaws.

570 | exocad ALL ON X STEP-BY-STEP GUIDE

106 . Continue on to Lower
Keep matching and remember
to check what tooth the
wizard is on.

571 | exocad ALL ON X STEP-BY-STEP GUIDE

107 . Define Emergence
When you get to the define
emergence step. Stop and go
to expert mode.

572 | exocad ALL ON X STEP-BY-STEP GUIDE

108 . Check Tissue Cap Removal
Depending on the library you
may or may not have your
tissue caps removed from the
scan and holes in the scan.
Even if it did cut the caps out
you may have little parts
remaining, we need to clean
this up. If this did not
happen automatically and
you are having to do this
manually like I am it is a bad
library.

573 | exocad ALL ON X STEP-BY-STEP GUIDE

109 . Edit Mesh
Right click the tissue scan
and hit edit mesh in the menu
options.

574 | exocad ALL ON X STEP-BY-STEP GUIDE

110 . Circle the Caps
Circle each cap and hit
delete. If exocad did this for
you then make sure it
removed all the caps.

575 | exocad ALL ON X STEP-BY-STEP GUIDE

111 . Delete the Caps
Circle all the caps making
them orange.

576 | exocad ALL ON X STEP-BY-STEP GUIDE

112 . Delete the Caps
Hit delete.

577 | exocad ALL ON X STEP-BY-STEP GUIDE

113 . Load Original exocad Design
You now have holes and that
is ok. Click OK.

578 | exocad ALL ON X STEP-BY-STEP GUIDE

114 . Repeat for Upper
Right click upper jaw. Edit
mesh. Cycle each cap that
was not automatically
deleted. Then hit delete.

579 | exocad ALL ON X STEP-BY-STEP GUIDE

115 . Hit “OK”
Once deleted hit “OK”.

580 | exocad ALL ON X STEP-BY-STEP GUIDE

116 . Regenerate Virtual Waxup Bottom
Left click the tissue scan. Go
to the menu bar at the
bottom. Hit virtual waxup
bottom.

581 | exocad ALL ON X STEP-BY-STEP GUIDE

117 . Regenerate Virtual Waxup Bottom
Hit Update to regenerate the
virtual waxup bottom for the
new tissue scans.

582 | exocad ALL ON X STEP-BY-STEP GUIDE

118 . Click “OK”
Hot ok to save. If you need to
change the insertion angle hit
set from view then update
then ok.

583 | exocad ALL ON X STEP-BY-STEP GUIDE

119 . Repeat for Upper Arch
Repeat these steps for the
upper arch if doing dual
arches.

584 | exocad ALL ON X STEP-BY-STEP GUIDE

120 . Back to Wizard: Define Emergence
When going back to wizard it
will take you to the define
emergence profile. Just hit
next for each implant.

585 | exocad ALL ON X STEP-BY-STEP GUIDE

121 . Abutment Bottoms
Just hit next for each
abutment bottom step.

586 | exocad ALL ON X STEP-BY-STEP GUIDE

122 . Virtual Wax Up Calculation
Now exocad will take the
previous waxup and make a
virtual waxup calculation.

587 | exocad ALL ON X STEP-BY-STEP GUIDE

123 . Freeform Wax Up
The only free forming you
really need to do is on the
tissue surface and maybe
around the implant areas to
increase strength.

588 | exocad ALL ON X STEP-BY-STEP GUIDE

124 . Focus on Tissue Surface
We need to smooth and make
this cleanable and add the
desired amount of tissue
pressure. I first use the
smooth flatten tool and hold
shift to flatten.

589 | exocad ALL ON X STEP-BY-STEP GUIDE

125 . Smooth/Flatten Tissue Surfaces
Go to free.

590 | exocad ALL ON X STEP-BY-STEP GUIDE

126 . Smooth/flatten
Click on the “Smooth/
Flatten” tool.

591 | exocad ALL ON X STEP-BY-STEP GUIDE

127 . Max Strength and Size
Make size maximum and
strength.

592 | exocad ALL ON X STEP-BY-STEP GUIDE

128 . Smooth Flatten Tissue Surfaces
Spend a lot of time
smoothing. Toggle to add/
remove to add material then
back to smooth.

593 | exocad ALL ON X STEP-BY-STEP GUIDE

129 . Distance to Scan Data
Turn on show distances, hit
the chevron here at the top
color bar.

594 | exocad ALL ON X STEP-BY-STEP GUIDE

130 . Distance to Scan Data
Change to distance to scan
data.

595 | exocad ALL ON X STEP-BY-STEP GUIDE

131 . Change Color Scale
0.01min-1.4mm max. Check
the nearest point distance.

596 | exocad ALL ON X STEP-BY-STEP GUIDE

132 . Auto Cut Using Adapt
Go to adapt and basal.

597 | exocad ALL ON X STEP-BY-STEP GUIDE

133 . Auto Cut Using Adapt
Go to adapt and basal .
Change pressure to positive
350 microns or your desired
pressure.

598 | exocad ALL ON X STEP-BY-STEP GUIDE

134 . Hit Basal
Hit basal to have exocad slice
the tissue surface to the
desired pressure.

599 | exocad ALL ON X STEP-BY-STEP GUIDE

135 . Hit Basal
Hit basal to have exocad slice
the tissue surface to the
desired pressure.

600 | exocad ALL ON X STEP-BY-STEP GUIDE

136 . Smooth Flatten Tissue Surfaces
Remove any folds concavities
creases or plaque traps.
Surface should be flat or
convex. Smooth distal
extension to minimize them.
Remember this is a printed
prototype and will be more
bulky compared to the final
design. Hit NEXT when done.

601 | exocad ALL ON X STEP-BY-STEP GUIDE

137 . Screw Channel
Just hit next here.

602 | exocad ALL ON X STEP-BY-STEP GUIDE

138 . Done
Your final prosthetic is done.
If you need to smooth an area
you can freeform merged.
Otherwise you are all set.

603 | exocad ALL ON X STEP-BY-STEP GUIDE

139 . Merge Issues
If you have issues where your
screw channels are sealed
and not cut or your MUA is
deformed or sealed it can be
from two common problems.
Most likely it is a library
issues. Otherwise your digital
waxup could have issues such
as inverted triangles, creases,
floater meshes. This comes
with experience on how to
deal with these.

604 | exocad ALL ON X STEP-BY-STEP GUIDE

 ALL ON X

Using a Scanned Denture

DAY O F S U R G E R Y C O N V E R S I O N
ENDENTULOUS ARCH

605 | exocad ALL ON X STEP-BY-STEP GUIDE < TABLE OF CONTENTS

 1 . Using a Scanned Denture
You will laugh but I do this all
the time. Patient has an old
denture. I reline it and scan it.
This technique always works.
Just like we did in the 90’s
when we drilled holes on a
denture, cut the palate out and
picked it up on temp cylinders,
but all digitally. This works
great. It can be a scan or STL
of anything such as a denture,
new or old waxup, old dentate
arch. Just make sure it is a
solid model that you import in
as the “waxup” when doing
this technique.

606 | exocad ALL ON X STEP-BY-STEP GUIDE

 2 . Scans Needed
1 2 3 4 5

350 denture scan Preoperative tissue Pre-surgical post-surgical Unified scanbodyu

as the “waxup” scan. The denture marker scan. This tissue cap scan scan as “scan
should be aligned will be aligned to This will be marker” scan. This
to this scan scan 2. aligned to scan3. will be aligned to
already. scan 4.

You can optionally have an antagonist although it is not mandatory.

607 | exocad ALL ON X STEP-BY-STEP GUIDE

 3 . Open Dental DB
Open dental DB.

608 | exocad ALL ON X STEP-BY-STEP GUIDE

 4 . Client and Name
Select client and patent
name.

609 | exocad ALL ON X STEP-BY-STEP GUIDE

 5 . Click Implant Location
Click a tooth that will be
near one of the implants
placed.

610 | exocad ALL ON X STEP-BY-STEP GUIDE

 6 . Click Anatomic Waxup
Anatomic waxup is
selected.

611 | exocad ALL ON X STEP-BY-STEP GUIDE

 7 . 3D Print and Screw-Retained
Click screw retained.

612 | exocad ALL ON X STEP-BY-STEP GUIDE

 8 . Click “OK”
Click “OK” to save.

613 | exocad ALL ON X STEP-BY-STEP GUIDE

 9 . Copy to All Implant Sites
An easy way to copy a
prescription and jump
around the arch is to hold
control on the keyboard
and click the other teeth.

614 | exocad ALL ON X STEP-BY-STEP GUIDE

10 . Click “OK”
Click save to be able to
design.

615 | exocad ALL ON X STEP-BY-STEP GUIDE

 11 . Click “Design”
Click design.

616 | exocad ALL ON X STEP-BY-STEP GUIDE

12 . Load Files
You need the following
files.

1) soft tissue scan

2) denture scan (as waxup)

3) scan body scan

4) opposing

617 | exocad ALL ON X STEP-BY-STEP GUIDE

13 . Immediately Enter Expert Mode
Rotate the model so you
are looking down on the
arch then go to expect
mode. Your unified
scanbody scan will not be
aligned to the models.
Your denture may or may
not be aligned to the
preoperative maxillary
soft tissue scan. Mine is
aligned already from the
scan software.

618 | exocad ALL ON X STEP-BY-STEP GUIDE

14 . Tools: Add/Remove Mesh
We need to bring the
intermediate marker scan
into the scene and merge
it with the preoperative
tissue scan.

619 | exocad ALL ON X STEP-BY-STEP GUIDE

15 . Generic Visualization Mesh
Select generic
visualization as the mesh
typo and hit load.

620 | exocad ALL ON X STEP-BY-STEP GUIDE

16 . Find Pre-Surgical Marker Scan
Navigate to the pre
surgical marker scan.

621 | exocad ALL ON X STEP-BY-STEP GUIDE

17 . Find Pre-Surgical Marker Scan
Navigate to the pre
surgical marker scan.

622 | exocad ALL ON X STEP-BY-STEP GUIDE

18 . Click “No”
It does not matter what
you select here.

623 | exocad ALL ON X STEP-BY-STEP GUIDE

19 . Rotate, then Pin
Click the newly imported
scan and drag it. Hold
control and left click the
venter of the new scan to
rotate it. To rotate the
entire scene left click the
blank screen. You want to
get the new scan next to
and in the same
orientation as the
preoperative scan.

624 | exocad ALL ON X STEP-BY-STEP GUIDE

20 . Align Meshes
Once the models are next
to each other at similar
orientations click the align
meshes box.

625 | exocad ALL ON X STEP-BY-STEP GUIDE

21 . Find Common Data
First click a spot on the
newly imported day of
surgery marker scan. Then
click the same spot on the
original preoperative scan.
Repeat at least 5 times.
Notice the arrows point
from the new scan to the
old scan. Letting you know
the direction the scan is
moving. This is important
as the old scan has the
waxup aligned to it.

626 | exocad ALL ON X STEP-BY-STEP GUIDE

22 . Exclude Selected Spots
Due to local infiltration
the day of surgery marker
scan will have differences
compared to the pre-
operative scan. Check
this box to exclude
selected parts.

627 | exocad ALL ON X STEP-BY-STEP GUIDE

23 . Paint Common Data
Paint common data blue.
Avoid movable tissues.

628 | exocad ALL ON X STEP-BY-STEP GUIDE

24 . Invert
Click invert. This will
make the all other areas
blue except where you
painted. Exocad will not
take blue areas into
consideration when doing
the best fit match.

629 | exocad ALL ON X STEP-BY-STEP GUIDE

25 . Perform Alignment
Click perform aliment to
bring the two scans
together based exclusively
on the points you
selected.

630 | exocad ALL ON X STEP-BY-STEP GUIDE

26 . Evaluate
Unclick matching exclude
selected parts and then
click the show distances
to see the color map of
alignment. The distances
are indicated in the color
map bar below the check
box. Stay in the add
remove mesh module.

631 | exocad ALL ON X STEP-BY-STEP GUIDE

27 . Click “OK”
Click ok on the small
window but stay in this
add remove mesh module.
Now you wait for the
surgical tissue cap scan
and the unified scanbody
export. These are two
different files. First merge
the surgical tissue cap
scan to this intermediate
visualization mesh that
you just merged.

632 | exocad ALL ON X STEP-BY-STEP GUIDE

28 . Load Surgical Tissue Cap Scan
Click extra jaw scan.

633 | exocad ALL ON X STEP-BY-STEP GUIDE

29 . Load Surgical Tissue Cap Scan
Click load and navigate to
the new surgical tissue cap
scan.

634 | exocad ALL ON X STEP-BY-STEP GUIDE

30 . Click “No”
It does not matter what
you select here.

635 | exocad ALL ON X STEP-BY-STEP GUIDE

31 . Click “OK”
The tissue cap scan will
not be aligned to the other
scans. That is ok. We will
do that alignment in a
different module. Just
click ok to save.

636 | exocad ALL ON X STEP-BY-STEP GUIDE

32 . Tools: Align Meshes
We will now enter the
align meshes tool to merge
the surgical tissue cap
scan to the intermediate
marker scan.

637 | exocad ALL ON X STEP-BY-STEP GUIDE

33 . Move and Rotate
Only move the surgical
tissue cap scan. Be carful
not to move the other two
scans. Left click on the
tissue cap scan and drag it
off to the side. Then
control and left click the
middle of the tissue cap
scan to rotate it. Get it to
be side by side and at the
same orientation as the
other scans.

638 | exocad ALL ON X STEP-BY-STEP GUIDE

34 . Click “Automatically”
You can now click
automatically. Turn off the
preoperative scan and
only show the
intermediary marker scan.

639 | exocad ALL ON X STEP-BY-STEP GUIDE

35 . Click “Common Points”
Focusing on the marker
and non movable tissues
find common spots.
Always first click the
surgical tissue cap scan
then click the
intermediary marker scan
in the exact spot.

640 | exocad ALL ON X STEP-BY-STEP GUIDE

36 . Repeat 5 Times
Repeat at least 5 times but
the more spots the better.

641 | exocad ALL ON X STEP-BY-STEP GUIDE

37 . Exclude Elected Parts
Click the exclude selected
parts box.

642 | exocad ALL ON X STEP-BY-STEP GUIDE

38 . Paint Common Areas
Paint common data
between the scans.

643 | exocad ALL ON X STEP-BY-STEP GUIDE

39 . Invert Selection
Flip the colors by clicking
invert. Exocad will not use
the blue data for the
alignment.

644 | exocad ALL ON X STEP-BY-STEP GUIDE

40 . Perform Alignment
Click perform alignment.
This moves the sriuagical
cap scan to the
intermediary marker scan
using only your dots
selected.

645 | exocad ALL ON X STEP-BY-STEP GUIDE

41 . Click “Best Fit Match”
Click best fit match and
now all the data that is
painted will be considered
for the matching. Millions
of points will be analyzed.

646 | exocad ALL ON X STEP-BY-STEP GUIDE

42 . Evaluate Merge
To see the color uncheck
exclude selected parts box
and check show distance.

647 | exocad ALL ON X STEP-BY-STEP GUIDE

43 . Click “OK”
Click OK to save the
merging.

648 | exocad ALL ON X STEP-BY-STEP GUIDE

44 . Tools: Align Meshes
We need to merge the
scan marker scan to this
surgical tissue cap scan.

649 | exocad ALL ON X STEP-BY-STEP GUIDE

45 . Click “Manually”
You need to left-click and
drag the scan body scan off
to the side. Then control left-
click the scan body scan to
rotate them. You want them
in the same orientation but
off to the side of the surgical
cap scan. You should be
using a unified scan body
scan from grammetry,
photogrammetry or Shining
IPG.

650 | exocad ALL ON X STEP-BY-STEP GUIDE

46 . Click “Manually”
Please note we are only
moving scan bodies. Don’t
click other things and move
them by accident. If you did
hit undo or cancel and try
again.

651 | exocad ALL ON X STEP-BY-STEP GUIDE

47 . Click “Automatically”
Now we can use automatic
alignment.

652 | exocad ALL ON X STEP-BY-STEP GUIDE

48 . Click Common Spots
Click one spot on each
scanbody tissue cap.
Always start on the newly
imported, unified
scanbody scan and then
pick the same point on the
surgical tissue cap scan.
Notice the direction of the
arrows. They go from the
unified scanbody scan to
the surgical tissue cap
scan.

653 | exocad ALL ON X STEP-BY-STEP GUIDE

49 . Perform Alignment
Click perform alignment.

654 | exocad ALL ON X STEP-BY-STEP GUIDE

50 . Best Fit Match
Use best fit match to
refine alignment.

655 | exocad ALL ON X STEP-BY-STEP GUIDE

51 . Evaluate
It is normal to have
discrepancy here. The
weakest link I the surgical
tissue cap scan. The
unified scanbody scan is
much more accurate. It is
important to understand
this concept. The surgical
tissue cap scan has noting
to do with implant to
implant position and only
aids in aligning the unified
scan to the waxup and soft
tissue.

656 | exocad ALL ON X STEP-BY-STEP GUIDE

52 . Click “OK”
Click OK to save.

657 | exocad ALL ON X STEP-BY-STEP GUIDE

53 . Edit Denture Scan
Your denture should be
merged to the files. If not
it you can do it in align
meshes. Here mine is
aligned already. I am
going to edit the denture
scan by right clicking the
denture and hitting edit
mesh.

658 | exocad ALL ON X STEP-BY-STEP GUIDE

54 . Remove Palate
Look down on the palatial
area. Make sure you have
select through selected
circle the distal extension
and palate. Do not close
the lasso and hit delete.
By not closing the lasso it
will create a smoother cut.

659 | exocad ALL ON X STEP-BY-STEP GUIDE

55 . Close Holes
We have holes in the
denture scan now. Rotate
and you will see open
mesh data.

660 | exocad ALL ON X STEP-BY-STEP GUIDE

56 . Close Holes
We have holes in the
denture scan now. Rotate
and you will see open
mesh data.

661 | exocad ALL ON X STEP-BY-STEP GUIDE

57 . Close Holes
Circle a big circle around
the entire denture and
highlight the denture
surface. Then hit close
holes. You must have the
entire denture selected
otherwise the holes will
not close.

662 | exocad ALL ON X STEP-BY-STEP GUIDE

58 . Close Holes
We can now see the holes
are sealed. Wasn’t that
easier than using a acrylic
bur?

663 | exocad ALL ON X STEP-BY-STEP GUIDE

59 . Cut Flange
Now look from the facial
and circle the flange of the
denture. Do not close the
lasso. Hit delete.

664 | exocad ALL ON X STEP-BY-STEP GUIDE

60 . Cut Flange
Now look from the facial
and circle the flange of the
denture. Do not close the
lasso. Hit delete.

665 | exocad ALL ON X STEP-BY-STEP GUIDE

61 . Close Holes
We cut the flange but now
have additional holes.

666 | exocad ALL ON X STEP-BY-STEP GUIDE

62 . Close Holes
Highlight the entire
denture by drawing a big
circle around it and
closing the circle. Then hit
close holes.

667 | exocad ALL ON X STEP-BY-STEP GUIDE

63 . Click “OK”
Click ok. We have now
prepared the denture
digital for the implant
pickups.

668 | exocad ALL ON X STEP-BY-STEP GUIDE

64 . Back to Wizard
In wizard we will be at the
first step but now with
everything aligned.

669 | exocad ALL ON X STEP-BY-STEP GUIDE

65 . Rotate Models
In the wizard route the
model to the occlusal view
as shown and then hit
next.

670 | exocad ALL ON X STEP-BY-STEP GUIDE

66 . Skip by Hitting “Next”
Step two in wizard will be
skipped. Just hit next. We
do not want to use this
alignment feature as the
one we used was more
powerful.

671 | exocad ALL ON X STEP-BY-STEP GUIDE

67 . Click “Replace the Whole Scan Data”
Click replace scan data,
this will remove the old
pre surgical scan that the
waxup was made on and
replace it with the surgical
tissue cap scan.

672 | exocad ALL ON X STEP-BY-STEP GUIDE

68 . Find Proper Library
You need to find the
exocad library for the
screw you want to use and
that is the same geometry
as the tissue cap you
scanned with and the
tissue cap you imposed as
a unified scanbody.

673 | exocad ALL ON X STEP-BY-STEP GUIDE

69 . Merge Scanbody
If you want to hide your
jaw so you only see the
sandy hit “S” on the
keyboard. Now click the
spot on the scanbody the
is indicated by the red dot
in the preview window.
Make sure you are working
tooth number the tooth
prompted in the wizard.

674 | exocad ALL ON X STEP-BY-STEP GUIDE

70 . Evaluate Match
It should one true blue
which indicated a perfect
match. If you do not see
colors hold control and
clock the dot again. Any
other color means you
have the wrong library.

675 | exocad ALL ON X STEP-BY-STEP GUIDE

71 . Click “Next”
Click next to move onto
the next tooth.

676 | exocad ALL ON X STEP-BY-STEP GUIDE

72 . Repeat
Just repeat for each
tooth.

677 | exocad ALL ON X STEP-BY-STEP GUIDE

73 . Repeat
The last tooth is being
merged now. Next we will
evaluate the substation of
the tissue caps. Hit Next

678 | exocad ALL ON X STEP-BY-STEP GUIDE

74 . Evaluate Tissue Cap Delete
The tissue caps should
one deleted from the
surgical cap scan and you
should now be able to see
the digital MUA.

679 | exocad ALL ON X STEP-BY-STEP GUIDE

75 . Expert Mode
Almost always you see
areas remaining of the
surgical caps. We can
delete this and also
regenerate virtual waxup
bottom in expert mode.

680 | exocad ALL ON X STEP-BY-STEP GUIDE

76 . Edit Mesh
In expert mode right click
the tissue scan and hit edit
mesh.

681 | exocad ALL ON X STEP-BY-STEP GUIDE

77 . Select
Select the area around the
remains tissue cap scan.

682 | exocad ALL ON X STEP-BY-STEP GUIDE

78 . Delete
Hit delete to remove then
hit OK.

683 | exocad ALL ON X STEP-BY-STEP GUIDE

79 . Define Emergence Profile
We do not need to do
anything here except hit
next for each implant.

684 | exocad ALL ON X STEP-BY-STEP GUIDE

80 . Abutment Bottoms
We do not need to do
anything here except hit
next for each implant.

685 | exocad ALL ON X STEP-BY-STEP GUIDE

81 . Virtual Waxup
A virtual waxup scan will
be generated.

686 | exocad ALL ON X STEP-BY-STEP GUIDE

82 . Free-Form
Most of the freeform is
spent smoothing tissue
surfaces. At first the
design will be concave
and uinclensable. Use the
free- smooth flatten tool
to smooth the fitting
surface and shrink the
distal extensions.

687 | exocad ALL ON X STEP-BY-STEP GUIDE

83 . Free-Form
Most of the freeform is
spent smoothing tissue
surfaces. At first the
design will be concave
and uinclensable. Use the
free- smooth flatten tool
to smooth the fitting
surface and shrink the
distal extensions.

688 | exocad ALL ON X STEP-BY-STEP GUIDE

84 . Check Tissue Pressure
Click distance to scan
data. Nearest point
distance checked. Change
the scale not 0.1-1mm.

689 | exocad ALL ON X STEP-BY-STEP GUIDE

85 . Adjust Tissue Pressure
A color coded map of
tissue pressure can be
seen now. You can go to
adapt tool and hit BASAL
or you can smooth it here.
I tend to like bout 300-500
microns of pressure.
Depending in the ridge.
Make sure no concavities,
creases or uinclensable
areas exist. Please note a
printed provisional will be
more thick compared to
the final.

690 | exocad ALL ON X STEP-BY-STEP GUIDE

86 . Adjust Tissue Pressure
A color coded map of
tissue pressure can be
seen now. You can go to
adapt tool and hit BASAL
to get you to a target
number then you can
smooth it from there.

691 | exocad ALL ON X STEP-BY-STEP GUIDE

87 . Click “Next”
Click next to add screw
channels.

692 | exocad ALL ON X STEP-BY-STEP GUIDE

88 . Click “Next”
Nothing to do here except
next.

693 | exocad ALL ON X STEP-BY-STEP GUIDE

89 . All Done
You are all done with the
design and now can print.
Any issue with merging is
most likely a library issue
or your waxup had errors.

694 | exocad ALL ON X STEP-BY-STEP GUIDE

90 . Check Screw Channels and MUA
Everything should be
perfect. If not check your
waxup scan for errors and
your library.

695 | exocad ALL ON X STEP-BY-STEP GUIDE

 ALL ON X

Bar Design
CO N VE R T TO SPLIT FILE BA R DESIGN

696 | exocad ALL ON X STEP-BY-STEP GUIDE < TABLE OF CONTENTS

 1 . Convert Your Design to a Bar Design
You can convert your
monolithic direct to MUA
to a bar design fairly easy.
This works best if
anatomic waxup was the
method used to design the
all on x prosthetic but does
also work with waxup
pontic. It takes about 10
minutes to do once you get
the hang of it.

697 | exocad ALL ON X STEP-BY-STEP GUIDE

 2 . Open Dental DB
Find your designed case
that you have a final
merged part. Look at the
previous guides for how to
Crete a monolithic direct
to MUA prosthetic.

698 | exocad ALL ON X STEP-BY-STEP GUIDE

 3 . Load Case
We need to load the case

699 | exocad ALL ON X STEP-BY-STEP GUIDE

 4 . Find the Design
Search for the case that
has the final merged
parts.

700 | exocad ALL ON X STEP-BY-STEP GUIDE

 5 . Click Load Scene
Load the scene

701 | exocad ALL ON X STEP-BY-STEP GUIDE

 6 . Click Load Scene
You should see the final
merged direct to MUA
prosthetic in the scene.
Jump into expert mode.

702 | exocad ALL ON X STEP-BY-STEP GUIDE

 7 . Export Your Part
Turn only your merged
part on and turn
everything else off. Make
sure no other parts are on
such as implant parts.
Right-click the screen and
hit save scene as. Change
to stl, Visible objects only,
default orientation.

703 | exocad ALL ON X STEP-BY-STEP GUIDE

 8 . Export Your Part
Turn only your merged
part on and turn
everything else off. make
sure no other parts are on
such as implant parts.
Right click the screen and
hit save scene as. Change
to stl, Visible objects only,
default orientation.

704 | exocad ALL ON X STEP-BY-STEP GUIDE

 9 . Export Your Part
Turn only your merged
part on and turn
everything else off. make
sure no other parts are on
such as implant parts.
Right click the screen and
hit save scene as. Change
to stl, Visible objects only,
default orientation.

705 | exocad ALL ON X STEP-BY-STEP GUIDE

10 . Export Your Part
Turn only your merged
part on and turn
everything else off. make
sure no other parts are on
such as implant parts.
Right click the screen and
hit save scene as. Change
to stl, Visible objects only,
default orientation.

706 | exocad ALL ON X STEP-BY-STEP GUIDE

 11 . Delete Merged Part
Now we need to get rid of
that merged part. Click
the prosthetic and then on
the bottom menu bar hit
the trash button.

707 | exocad ALL ON X STEP-BY-STEP GUIDE

12 . Delete Merged Part
Click the merged part.

708 | exocad ALL ON X STEP-BY-STEP GUIDE

13 . Load Scene
Click ok to remove it.

709 | exocad ALL ON X STEP-BY-STEP GUIDE

14 . Click “Tools”
Jump point tools.

710 | exocad ALL ON X STEP-BY-STEP GUIDE

15 . Change Reconstruction Type
We need to change the
reconstruction type.

711 | exocad ALL ON X STEP-BY-STEP GUIDE

16 . Click One of the Teeth
Click one of the anatomic
waxup teeth and it will
change to a reduced
waxup.

712 | exocad ALL ON X STEP-BY-STEP GUIDE

17 . Change Reconstruction Type
Click “OK”.

713 | exocad ALL ON X STEP-BY-STEP GUIDE

18 . Reduce Waxup
Right-click your waxup.

714 | exocad ALL ON X STEP-BY-STEP GUIDE

19 . Anatomic Reduction
Because we changed the
reconstruction type to
reduced now we can
reduce the waxup to make
the bar structure.

715 | exocad ALL ON X STEP-BY-STEP GUIDE

20 . 2mm
Change depth to 2mm.

716 | exocad ALL ON X STEP-BY-STEP GUIDE

21 . Exclude Selected Parts
Click exclude selected
parts.

717 | exocad ALL ON X STEP-BY-STEP GUIDE

22 . Click “Mark All”
Click Mark all.

718 | exocad ALL ON X STEP-BY-STEP GUIDE

23 . Brush Size
The waxup will turn blue.
Change brush size to the
middle size.

719 | exocad ALL ON X STEP-BY-STEP GUIDE

24 . Shift-Click Paint
Hold shift and paint the
prosthetic everywhere
except the bar tissue
surface.

720 | exocad ALL ON X STEP-BY-STEP GUIDE

25 . Shift-Click Paint
Hold shift and paint the
prosthetic everywhere
except the bar tissue
surface.

721 | exocad ALL ON X STEP-BY-STEP GUIDE

26 . Shift-Click Paint
Hold shift and paint the
prosthetic everywhere
except the bar tissue
surface.

722 | exocad ALL ON X STEP-BY-STEP GUIDE

27 . Shift-Click Paint
Depending on the smile
line you may leave a little
blue on the facial ridge.

723 | exocad ALL ON X STEP-BY-STEP GUIDE

28 . Shift-Click Paint
Work to lingual.

724 | exocad ALL ON X STEP-BY-STEP GUIDE

29 . Shift-Click Paint
Work to lingual.

725 | exocad ALL ON X STEP-BY-STEP GUIDE

30 . Shift-Click Paint
Work to lingual. You can
often leave the lingual
margin a little higher up
for added metal thickness.

726 | exocad ALL ON X STEP-BY-STEP GUIDE

31 . Keep Removing Blue
Make sure to not have any
blue specs or islands
anywhere.

727 | exocad ALL ON X STEP-BY-STEP GUIDE

32 . Keep Removing Blue
Remove from occlusal as
well.

728 | exocad ALL ON X STEP-BY-STEP GUIDE

33 . Check
Now under designed parts
you have a reduced waxup
and waxup. Turn off the
waxup to look at the
reduced waxup. It will
look kind of rough.

729 | exocad ALL ON X STEP-BY-STEP GUIDE

34 . Click “OK”
Click “OK”.

730 | exocad ALL ON X STEP-BY-STEP GUIDE

35 . Smooth/Flatten
You have two options to
edit this mesh. You can
right click edit mesh, cut
the bits off and then close
holes. I find this step is
more difficult. I like to
skip to smooth flatten in
freeform. Click the mesh.

731 | exocad ALL ON X STEP-BY-STEP GUIDE

36 . Free-Form
Click the reduced waxup
and then on the lower
menu bar hit Free Form

732 | exocad ALL ON X STEP-BY-STEP GUIDE

37 . Click “Free”
Go to free.

733 | exocad ALL ON X STEP-BY-STEP GUIDE

38 . Smooth/Flatten
Click “Smooth/Flatten”.
Hold shift and left click to
flatten.

734 | exocad ALL ON X STEP-BY-STEP GUIDE

39 . Flatten and Smooth Reduced Waxup
You want to create a
smooth surface that is
relatively flat. Strength on
brush max. Size is
determined by the case. It
should be big enough to
be powerful but not too
big because we do not
want to distort the
external borders.

735 | exocad ALL ON X STEP-BY-STEP GUIDE

40 . Flatten and Smooth Reduced Waxup
Work your way around the
Bar flattening it.

736 | exocad ALL ON X STEP-BY-STEP GUIDE

41 . Keep Smoothing
Avoid the external border.

737 | exocad ALL ON X STEP-BY-STEP GUIDE

42 . Click “Anatomic”
Click the Anatomic button
once the bar is sufficiently
smooth and flat.

738 | exocad ALL ON X STEP-BY-STEP GUIDE

43 . Click “Paint & Pull”
Click paint pull

739 | exocad ALL ON X STEP-BY-STEP GUIDE

44 . Change Brush Size
Brush size around 1.5 to
2.mm

Elastic area around 1 to

1.5mm

740 | exocad ALL ON X STEP-BY-STEP GUIDE

45 . Paint
Paint the top of the bar
with a continuous line
dead center in the bar.

741 | exocad ALL ON X STEP-BY-STEP GUIDE

46 . Paint
Stay in the center of the
bar.

742 | exocad ALL ON X STEP-BY-STEP GUIDE

47 . Finish Painting
Get to the end of the bar.

743 | exocad ALL ON X STEP-BY-STEP GUIDE

48 . Paint Pull
Click Pull.

744 | exocad ALL ON X STEP-BY-STEP GUIDE

49 . Pull the Area Occlusal
Click the painted area and
drag occlusal.

745 | exocad ALL ON X STEP-BY-STEP GUIDE

50 . Drag Bar
The bar needs to be at
least 3mm tall for proper
retention.

746 | exocad ALL ON X STEP-BY-STEP GUIDE

51 . Drag Facial or Lingual
You can move the segment
facial and lingual too.

747 | exocad ALL ON X STEP-BY-STEP GUIDE

52 . Turn On Waxup to See
Turn waxup to half
transparency to see how
the bar is positioned.

748 | exocad ALL ON X STEP-BY-STEP GUIDE

53 . Edit Bar
Hold control to alter the
angle and tilt off the
painted bar segment.
Make sure the bar is in the
ideal location and allows
the superstructure to have
enough thickness.

749 | exocad ALL ON X STEP-BY-STEP GUIDE

54 . Edit Bar
Look from all angles to
make sure the bar is in the
ideal location in relation to
the waxup.

750 | exocad ALL ON X STEP-BY-STEP GUIDE

55 . Back to Free
Go back to free to smooth
and add.

751 | exocad ALL ON X STEP-BY-STEP GUIDE

56 . Back to Free
Smooth any areas that
need it.

752 | exocad ALL ON X STEP-BY-STEP GUIDE

57 . Add Thickness
Add thickens around
implant min thickness
bubbles. Do not make
undercuts when doing
this.

753 | exocad ALL ON X STEP-BY-STEP GUIDE

58 . Add Thickness
Add and then smooth to
make sure it is a nice
surface.

754 | exocad ALL ON X STEP-BY-STEP GUIDE

59 . Click “OK”
Click OK when done.

755 | exocad ALL ON X STEP-BY-STEP GUIDE

60 . Merge and Save Bar
Right-click the bar.

756 | exocad ALL ON X STEP-BY-STEP GUIDE

61 . Merge and Save
Click merge and save.

757 | exocad ALL ON X STEP-BY-STEP GUIDE

62 . Export Merged Bar
You can save the merged
bar and construction data
if needed for milling. To
save the STL right click
the screen. It is already
saved in the project folder
so you really don’t need to
save it unless you want a
backup copy.

758 | exocad ALL ON X STEP-BY-STEP GUIDE

63 . Save Bar
Make sure nothing else is
on or visible on the screen
except the merged bar.
Right click the screen.
Save scene as-STL-Visible
objects only-default
orientation.

759 | exocad ALL ON X STEP-BY-STEP GUIDE

64 . Save Bar
Make sure to pick
someplace you can find it.
This is the final bar so call
it final bar.

760 | exocad ALL ON X STEP-BY-STEP GUIDE

65 . Save Reduced Waxup
Navigate to your files and
turn on your reduced
waxup. You want to save
the reduced waxup on the
jaw scan.

761 | exocad ALL ON X STEP-BY-STEP GUIDE

66 . Save Reduced Waxup
Save this reduced waxup
like we did the merged
bar. Call it Reduced waxup
or something you will
know what it is.

762 | exocad ALL ON X STEP-BY-STEP GUIDE

67 . Save Reduced Waxup
Plain STL.

763 | exocad ALL ON X STEP-BY-STEP GUIDE

68 . Save Reduced Waxup
Select “Yes” when asked if
you want to save visible
objects only.

764 | exocad ALL ON X STEP-BY-STEP GUIDE

69 . Save Reduced Waxup
Select “Use default
coordinate system”.

765 | exocad ALL ON X STEP-BY-STEP GUIDE

70 . Save Case and Exit
Save the scene.

766 | exocad ALL ON X STEP-BY-STEP GUIDE

 71 . Subtract Bar
We now need to boolean
subtract the bar the most
powerful boolean tool in
exocad is the hard cut
found in mockup module.

767 | exocad ALL ON X STEP-BY-STEP GUIDE

72 . Click New
Hit new. We will start a
new case just to use the
more powerful boolean.
Select default client and
call the case bar subtract.

768 | exocad ALL ON X STEP-BY-STEP GUIDE

73 . Click One Tooth
Click only one tooth.

769 | exocad ALL ON X STEP-BY-STEP GUIDE

74 . Mockup
Call it mockup.

770 | exocad ALL ON X STEP-BY-STEP GUIDE

75 . 3D Print
Print now.

771 | exocad ALL ON X STEP-BY-STEP GUIDE

76 . Click “OK”
Nothing special to do
here.

772 | exocad ALL ON X STEP-BY-STEP GUIDE

77 . Save
Hit “Save”.

773 | exocad ALL ON X STEP-BY-STEP GUIDE

78 . Design
You do not need an
antagonist. Hit design.

774 | exocad ALL ON X STEP-BY-STEP GUIDE

79 . Load Scans
The scan you want to load
as the tissue scan is this
scan the you saved with
the tissue bar merged to
the jaw scan. It looks like
this.

775 | exocad ALL ON X STEP-BY-STEP GUIDE

80 . Follow the Wizard
First orientate the model
so you are looking down
like this image below then
hit next. Note that your
model should not have
screw holes like mine. I
will close these. Click
next.

776 | exocad ALL ON X STEP-BY-STEP GUIDE

81 . Change Fit
Use the bottom properties
to change fit.

777 | exocad ALL ON X STEP-BY-STEP GUIDE

82 . Change Fit
Cement gap of around
70-80 microns is ideal.
Smoothing 5-17%. Default
undercut blockout. Make
sure to rotate the scan
from the ideal path of
insertion of the
superstructure and hit set
insertion from view, then
hit update or apply. Hit
next.

778 | exocad ALL ON X STEP-BY-STEP GUIDE

83 . Free-Form
We can go to freeform
after hitting apply to
remove spacer along the
margin.

779 | exocad ALL ON X STEP-BY-STEP GUIDE

84 . Remove
Use remove tool to remove
spacer along the margin.

780 | exocad ALL ON X STEP-BY-STEP GUIDE

85 . Remove
Use remove tool to remove
spacer along the margin.

781 | exocad ALL ON X STEP-BY-STEP GUIDE

86 . Remove
Hold shift to remove
spacer on the margin. You
will not really be able to
tell it’s doing anything but
you are. Once done hit
OK.

782 | exocad ALL ON X STEP-BY-STEP GUIDE

87 . Tools
Select ‘Tools.’

783 | exocad ALL ON X STEP-BY-STEP GUIDE

88 . Add/Remove Mesh
We need to add the
monolithic direct to MUA
prosthetic.

784 | exocad ALL ON X STEP-BY-STEP GUIDE

89 . Click Load
You have to select waxup
scan.

785 | exocad ALL ON X STEP-BY-STEP GUIDE

90 . Click Load
Find the final merged
monolithic direct to MUA
prosthetic and hit yes.

786 | exocad ALL ON X STEP-BY-STEP GUIDE

91 . Click “OK”
Click ok to save.

787 | exocad ALL ON X STEP-BY-STEP GUIDE

92 . Waxup Calculation
Click the imported waxup.

788 | exocad ALL ON X STEP-BY-STEP GUIDE

93 . Waxup Calculation
Click waxup calculation.

789 | exocad ALL ON X STEP-BY-STEP GUIDE

94 . OK
Click “ok”.

790 | exocad ALL ON X STEP-BY-STEP GUIDE

95 . Click the Waxup
Now click the wax up.

791 | exocad ALL ON X STEP-BY-STEP GUIDE

96 . Free-Form
Stay in expert mode. Click
free form.

792 | exocad ALL ON X STEP-BY-STEP GUIDE

97 . Minimum Thickness
Select your minimum
thickness.

793 | exocad ALL ON X STEP-BY-STEP GUIDE

98 . Minimum Thickness
Smooth and add to areas
that are thin.

794 | exocad ALL ON X STEP-BY-STEP GUIDE

99 . Turn on Virtual Waxup Bottom
To see borders and areas
turn on virtual wax up
bottom.

795 | exocad ALL ON X STEP-BY-STEP GUIDE

100 . Check All Around
You can see the bar
margin and you can
remove flash.

796 | exocad ALL ON X STEP-BY-STEP GUIDE

101 . Adapt
Click adapt button.

797 | exocad ALL ON X STEP-BY-STEP GUIDE

102 . Hard Cut
Now click hard cut. This is
the most powerful boolean
operation in exocad. This
works much better than
trying to subtract using
freeform merged and
attachments.

798 | exocad ALL ON X STEP-BY-STEP GUIDE

103 . Super Structure
You now have a super
structure.

799 | exocad ALL ON X STEP-BY-STEP GUIDE

104 . Super Structure
Check your super
structure.

800 | exocad ALL ON X STEP-BY-STEP GUIDE

105 . You Can Load Bar as Tissue
You can load the bar as a
tissue scan to check fit.
Go to tools.

801 | exocad ALL ON X STEP-BY-STEP GUIDE

106 . Add/Remove Mesh
Now click gingiva. Load
the final bar design you
saved earlier.

802 | exocad ALL ON X STEP-BY-STEP GUIDE

107 . Click “Yes”
Yes if you used default
orientation to export.

803 | exocad ALL ON X STEP-BY-STEP GUIDE

108 . Check Fit
Hit ok and now you can
see your bar and
superstructure and can
check fit using cut tool.

804 | exocad ALL ON X STEP-BY-STEP GUIDE

109 . Cut Tool
You can check your fit.

805 | exocad ALL ON X STEP-BY-STEP GUIDE

 All On X

iCAM Day of Surgery

806 | exocad ALL ON X STEP-BY-STEP GUIDE < TABLE OF CONTENTS

110 . Save Super Structure
You can now saves your
superstructure design.

807 | exocad ALL ON X STEP-BY-STEP GUIDE

 1 . Load Original exocad Design
Find the original waxup case
by opening dental DB and
finding the pre surgical waxup
case.

808 | exocad ALL ON X STEP-BY-STEP GUIDE

 2 . Find the Original Design
Find the original pre-surgical
design.

809 | exocad ALL ON X STEP-BY-STEP GUIDE

 3 . Click Design
Click Design.

810 | exocad ALL ON X STEP-BY-STEP GUIDE

 4 . Load Scene File
This should load the scene.

811 | exocad ALL ON X STEP-BY-STEP GUIDE

 5 . Expert Mode
Immediately go into expert
mode: Tools: Add/Remove
Mesh: Generic visualization
mesh.

812 | exocad ALL ON X STEP-BY-STEP GUIDE

 6 . Select “Generic Visualization Mesh”
Make sure to select generic
visualization mesh.

813 | exocad ALL ON X STEP-BY-STEP GUIDE

 7 . Click “Load”
We are going to load a mesh
to merge with the original
scans. We are going to load
an intermediate surgical day
scan. This scan is made on
the day of surgery with some
type of markers in place and
is made before the
extractions, flap, or ridge
augmentation.

814 | exocad ALL ON X STEP-BY-STEP GUIDE

 8 . Find Pre-Surgical Marker Scans
Find the pre surgical marker
scan that is made on day of
surgery.

815 | exocad ALL ON X STEP-BY-STEP GUIDE

 9 . Click “No”
It does not matter what you
click here.

816 | exocad ALL ON X STEP-BY-STEP GUIDE

 10 . Manual Position Scan
Click the new scan and rotate
it to be in the same
orientation as the arch you
want to merge it to. Control
left click the scan will rotate
the scan. Left-clicking the
scan will move the scan.
Left-clicking the empty
screen will rotate all objects
at the same time.

817 | exocad ALL ON X STEP-BY-STEP GUIDE

 11 . Manual Position
Ideally you have them
positioned like this where you
have the occlusal surface
facing you, the preop teeth on
and the new marker scan off
to the side but at the same
orientation.

818 | exocad ALL ON X STEP-BY-STEP GUIDE

 12 . Automatic Merging
Click the align meshes
button.

819 | exocad ALL ON X STEP-BY-STEP GUIDE

 13 . Select Common Points
Alway start by clicking the
floating mesh. The floating
mesh is the new scan you
want to move to the original
scan. So we click the molar of
the newly imported scan.

820 | exocad ALL ON X STEP-BY-STEP GUIDE

 14 . Select Common Points
Click the second point on the
preoperative original scan
data.

821 | exocad ALL ON X STEP-BY-STEP GUIDE

 15 . Notice Arrows
Notice the direction of the
arrows is pointing from the
new marker scan to the old
preoperative scan.

822 | exocad ALL ON X STEP-BY-STEP GUIDE

 16 . Repeat at Least 5 spots
A minimum of 5 spots should
be selected spread
throughout the arch. Make
sure your arrows are all
pointing in the same
direction.

823 | exocad ALL ON X STEP-BY-STEP GUIDE

 17 . Perform Alignment
Click preform alignments to
move the arch to the
preoperative model based
exclusively on your points.

824 | exocad ALL ON X STEP-BY-STEP GUIDE

 18 . Best Fit Matching
Click best fit matching to
allow exocad to use
mathematical triangle
approximation to better align
the data together.

825 | exocad ALL ON X STEP-BY-STEP GUIDE

 19 . Cut View
Evaluate the colors. Any color in
the range is acceptable. Use the
cut tool and drag the slicer to
further evaluate the merge.
Because we did some digital
education of the ridge the teeth
are the most accurate objects.
If you had a scenario where you
did not have hard tissues to
merge you would not have done
bone reduction on the original
scans for a better merge.
Alternatively, you could load
unedited original scans as a
Preop and use that for this
merging.

826 | exocad ALL ON X STEP-BY-STEP GUIDE

20 . Hit “OK”
If happy with the merge hit
OK on the smaller box as
shown.

827 | exocad ALL ON X STEP-BY-STEP GUIDE

 21 . Load Lower Arch
Click Load and find the lower
pre surgical marker scan.

828 | exocad ALL ON X STEP-BY-STEP GUIDE

 22 . Select
It does not matter what you
hit here. I usually hit no.

829 | exocad ALL ON X STEP-BY-STEP GUIDE

 23 . Manual Position New Scan
Manually position new scan
to be in the same angle as the
preoperative jaw but off to
the side as shown.

830 | exocad ALL ON X STEP-BY-STEP GUIDE

 24 . Select Common Points
Select common points
starting on the newly
imported scan.

831 | exocad ALL ON X STEP-BY-STEP GUIDE

 25 . Select Common Points
Find the same exact spot on
the original scan data. Notice
the arrows are pointing from
the new scan to the original
scan.

832 | exocad ALL ON X STEP-BY-STEP GUIDE

26 . Repeat Five Times
Repeat a minimum of 5 spots
spread throughout the arch.

833 | exocad ALL ON X STEP-BY-STEP GUIDE

 27 . Perform Alignment
Click preform alignment to
move the new scan data to
the original based exclusive
on your spots selected.

834 | exocad ALL ON X STEP-BY-STEP GUIDE

28 . Click Best Fit
Click best fit match to allow
exocad to refine the
alignment based on millions
of data points.

835 | exocad ALL ON X STEP-BY-STEP GUIDE

29 . Evaluate Match
Use the slicer tool to verify
alignment. Evaluate color
coded accuracy.

836 | exocad ALL ON X STEP-BY-STEP GUIDE

30 . Click “OK”
Click “OK” twice first on the
small window, then on the
larger window.

837 | exocad ALL ON X STEP-BY-STEP GUIDE

 31 . Save Files in Project Folder
We need to save the newly
aligned marker scans as
preop models for our surgical
conversion. Turn off all other
models except a single arch
of the newly aligned marker
scans. Make sure no other
models are on. You can see
the markers as shown here.

838 | exocad ALL ON X STEP-BY-STEP GUIDE

 32 . Save Scene
Right click the empty screen
area and hit save scene as.

839 | exocad ALL ON X STEP-BY-STEP GUIDE

33 . Plain OBJ
Change type to OBJ or STL.

840 | exocad ALL ON X STEP-BY-STEP GUIDE

34 . Location
Do not change the location.
Keep it in the project folder.

841 | exocad ALL ON X STEP-BY-STEP GUIDE

 35 . Naming
The file naming is very
important. You must add a -
after the project number. No
space. And then add
lowerjaw-situ or upperjaw-
situ

No spacing no capitals.

842 | exocad ALL ON X STEP-BY-STEP GUIDE

36 . Naming
The file naming is very
important. You must add a -
after the project number. No
space. And then add
lowerjaw-situ or upperjaw-
situ

No spacing no capitals. So it
will be exactly this for my
project

2025-03-06_00001-002-
lowerjaw-situ

843 | exocad ALL ON X STEP-BY-STEP GUIDE

 37 . Orientation
Click yes to visible objects
only if prompted. Orientation
is very important. When
saving within exocad projects
select original.

844 | exocad ALL ON X STEP-BY-STEP GUIDE

38 . Repeat for Upper Arch
Make sure no other models
are visible.

845 | exocad ALL ON X STEP-BY-STEP GUIDE

39 . Save Scene As
Right click the black area of
the screen.

846 | exocad ALL ON X STEP-BY-STEP GUIDE

40 . Save Scene As
STL or OBJ as the file type.
Same location make sure you
do not change location.

847 | exocad ALL ON X STEP-BY-STEP GUIDE

 41 . Rename
Rename to the project name-
upperjaw-situ no spacing no
capitals. xyz-xyz-xyzzzz-
upperjaw-situ

848 | exocad ALL ON X STEP-BY-STEP GUIDE

 42 . Save
Click save.

849 | exocad ALL ON X STEP-BY-STEP GUIDE

43 . Visible Only
Visible objects only.

850 | exocad ALL ON X STEP-BY-STEP GUIDE

44 . Original Orientation
Whenever saving in the
project folder use original.

851 | exocad ALL ON X STEP-BY-STEP GUIDE

45 . Close and Save the Scene
Close the case and go back to
dental DB, You should now
see the new scans in the
preview window.

852 | exocad ALL ON X STEP-BY-STEP GUIDE

46 . Duplicate the Case
In dental DB hit duplicate.

853 | exocad ALL ON X STEP-BY-STEP GUIDE

 47 . Scan Data and Design
Select both scan data and
designed files.

854 | exocad ALL ON X STEP-BY-STEP GUIDE

48 . OK
Click Ok, Now the case is
duplicated and you are now
able to change the
prescription.

855 | exocad ALL ON X STEP-BY-STEP GUIDE

49 . Click Implant Sites
Visible select the implant
sites and change the
prescription. Make sure you
select the same teeth that you
entered in the iCAM capture
software.

856 | exocad ALL ON X STEP-BY-STEP GUIDE

50 . Change Prescription
Change the prescription to
anatomic waxup only for the
implant sites.

857 | exocad ALL ON X STEP-BY-STEP GUIDE

 51 . Screw Retained
Select screw retrained.

858 | exocad ALL ON X STEP-BY-STEP GUIDE

 52 . Scanbody Main Scan
Change to scanbody is main
scan.

859 | exocad ALL ON X STEP-BY-STEP GUIDE

 53 . Click “Pre-Op”
Click Preop so the previously
loaded situ scans will
populate.

860 | exocad ALL ON X STEP-BY-STEP GUIDE

54 . Click “OK”
Save changes by hitting ok.

861 | exocad ALL ON X STEP-BY-STEP GUIDE

 55 . Duplicate to All Other Implants
Left click the newly changed
tooth and hold the mouse
button and drag to additional
tooth sites that have the
implants to replicate the
prescription. You can drag to
the mandible arch as well to
clone the prescription.

862 | exocad ALL ON X STEP-BY-STEP GUIDE

56 . Duplicate to All Other Sites
Make sure the new
prescription matches what
you entered in iCAM.

863 | exocad ALL ON X STEP-BY-STEP GUIDE

 57 . Load iCAM Data
Click open in explorer.

864 | exocad ALL ON X STEP-BY-STEP GUIDE

58 . Navigate to iCAM exocad Data
Find the scam exocad implant
position data and jaw scan.

865 | exocad ALL ON X STEP-BY-STEP GUIDE

59 . Copy Data
Select all the icam exocad
data and load it into the
project folder.

866 | exocad ALL ON X STEP-BY-STEP GUIDE

60 . Rename iCAM Data if Needed
If your iCAM data is not
properly named you have to
rename it to the project name
but keep the implant site
which will be in universal
nomenclature. One tiny error
in naming such as a space or
mistranslated number will
mean the implant locations
will not come into the scene.

867 | exocad ALL ON X STEP-BY-STEP GUIDE

 61 . Rename iCAM Data if Needed
Rename your iCAM Data as
shown here:

868 | exocad ALL ON X STEP-BY-STEP GUIDE

 62 . Click “Use Anyway”
Use anyway for the iCAM
implant library. It is
important to have the icam
implant library installed in
your exocad already before
starting this project.

869 | exocad ALL ON X STEP-BY-STEP GUIDE

63 . Load Previous Images
You can optionally load
previous images just
understand this is a little
buggy with case duplication.

870 | exocad ALL ON X STEP-BY-STEP GUIDE

64 . Expert Mode
Most of the design will be
done in expert mode. Click
into expert mode. Hide any
photos or scans that are
distracting you on your
screen. We need to merged
the icam files to the marker
scan.

871 | exocad ALL ON X STEP-BY-STEP GUIDE

65 . Tools
Go to tools and click “Align
Meshes”.

872 | exocad ALL ON X STEP-BY-STEP GUIDE

66 . Hide All Lower Data
Hide all lower data including
implant parts. Make sure all
upper data is visible including
all implant parts. In the
objects browser you should
see the ability to turn all
objects on and off in the
arch.

873 | exocad ALL ON X STEP-BY-STEP GUIDE

 67 . Click Manual
Click Manual. We now need
to make sure we tell exocad
few want to move not only the
surgical scan but also all the
icam data and implant
locations.

874 | exocad ALL ON X STEP-BY-STEP GUIDE

68 . Select Additional Floating Parts
Click the box. We are about
to get into very sophisticated
alignment of 3D meshes. This
is for advanced users only.

875 | exocad ALL ON X STEP-BY-STEP GUIDE

69 . All Visible Objects
Make sure all your lower data
is off and all your upper data
is visible. Including all the
implant information. Then hit
“All Visible”. This means all
visible object will move with
the mesh you select.

876 | exocad ALL ON X STEP-BY-STEP GUIDE

70 . Rotate and Translate
Now rotate and translate the
surgical scan to be in a
similar position as the Pre-
surgical or mid surgical
marker scan. Holding control
and left clicking the model
will rotate it. If you left click
the blank screen the entire
scene moves. Make sure not
to rotate or move the pre
surgical marker scan as this is
perfectly aligned to the
waxup.

877 | exocad ALL ON X STEP-BY-STEP GUIDE

 71 . Automatic Alignment
Now that the surgical scan is
next to the pre surgical scan
and in the same orientation
we can do automatic
alignment.

878 | exocad ALL ON X STEP-BY-STEP GUIDE

 72 . Select Additional Floating Meshes
We have to again tell exocad
that we want all the implant
locations and data to move
along with the surgical scan.

879 | exocad ALL ON X STEP-BY-STEP GUIDE

 73 . All Visible
Like before we hit all visible.

880 | exocad ALL ON X STEP-BY-STEP GUIDE

 74 . Select Common Points
First click a common point on
the surgical scan. Next click
the same common point on
the pre surgical marker scan.
Repeat for at least 5 common
points always starting on the
surgical scan then moving to
the pre-surgical scan. Notice
the blue arrows are pointing
from the surgical scan to the
pre surgical scan.

881 | exocad ALL ON X STEP-BY-STEP GUIDE

 75 . Exclude Selected Parts
Click matching exclude
selected parts.

882 | exocad ALL ON X STEP-BY-STEP GUIDE

 76 . Paint Areas
Paint areas you are certain
did not move or change
between the pre or mid
surgical scan to the post
surgical scan. Areas like the
hard palate, any markers
placed, any teeth that may
have been strategically left in
place.

883 | exocad ALL ON X STEP-BY-STEP GUIDE

 77 . Invert Marking
The blue area is areas that
exocad will not take into
consideration when aligning
the meshes. We need in
invert the markings so exocad
only considers the areas we
painted. The rest of the
model becomes blue and now
the areas painted will not be
blue.

884 | exocad ALL ON X STEP-BY-STEP GUIDE

 78 . Perform Alignment
Now pick preform alignment
to move the surgical model
and all implant data to the
pre surgical model which has
the waxup aligned to it.

885 | exocad ALL ON X STEP-BY-STEP GUIDE

 79 . Change Distance Calculations
Around 10% and 4mm always
seems to be the best for me.

886 | exocad ALL ON X STEP-BY-STEP GUIDE

80 . Best Fit Match
After you hit perform
alignment hit best fit match
so exocad will use
mathematical closest point
algorithms to refine the
alignment.

887 | exocad ALL ON X STEP-BY-STEP GUIDE

 81 . Evaluate Colors
Now to see the color you turn
of the match exclude selected
parts check box.

888 | exocad ALL ON X STEP-BY-STEP GUIDE

 82 . Show Distance
Turn on show distances.

889 | exocad ALL ON X STEP-BY-STEP GUIDE

83 . Evaluate Colors
Evaluate the merge. Andy
color other than pink is
acceptable. Blue and green
are very good. Ideally your
markers should be all blue.

890 | exocad ALL ON X STEP-BY-STEP GUIDE

84 . Hit “OK”
Hit ok to save your merge.

891 | exocad ALL ON X STEP-BY-STEP GUIDE

 85 . Repeat for the Lower
We need to repeat for the
lower. Go to tools-align
meshes.

892 | exocad ALL ON X STEP-BY-STEP GUIDE

86 . Hide All Upper Arch Data
Turn everything off except the
lower arch data. You want all
the lower arch data on
including implant parts.

893 | exocad ALL ON X STEP-BY-STEP GUIDE

 87 . Hide All Upper Arch Data
You only want to look at the
lower arch data. We are
about to do some very
advanced file merging. This
can be frustrating and you
want to make sure you are not
doing this for the first time on
the day of surgery.

894 | exocad ALL ON X STEP-BY-STEP GUIDE

88 . Manual Mode
Make sure you are on manual
mode. Click additional
floating part.

895 | exocad ALL ON X STEP-BY-STEP GUIDE

89 . All Visible
Make sure you select all
visible on the window so that
all the implant data moves
along with the surgical scan.

896 | exocad ALL ON X STEP-BY-STEP GUIDE

90 . Rotate the Surgical Scan
Rotate the surgical scan and
portion it next to the pre-
surgical marker scan. Control
left clicking the surgical scan
should move the surgical scan
and all the implant data. Left
clicking the screen will move
rotate the scene. Make sure
not to move the pre surgical
marker scan by accident.

897 | exocad ALL ON X STEP-BY-STEP GUIDE

 91 . Automatic Alignment
We now can add common
points and focus on the
markers. Make sure to select
additional floating meshes
and all visible.

898 | exocad ALL ON X STEP-BY-STEP GUIDE

 92 . Click a Spot on Markers
Start with a spot on the
marker that is the surgical
scan.

899 | exocad ALL ON X STEP-BY-STEP GUIDE

93 . Keep Clicking Common Spots
Click the same spot on the
pre surgical marker scan.

900 | exocad ALL ON X STEP-BY-STEP GUIDE

94 . Click More Spots
This case is difficult because
we only have markers in the
retromolar pad area and did
not place one in the midline
area. Making a merge more
difficult especially after bone
reduction. Always try to have
3 markers.

901 | exocad ALL ON X STEP-BY-STEP GUIDE

95 . Matching Exclude Parts
Click matching excluding
selected parts and paint the
markers blue and any other
small areas that may have not
changed between the surgery
and pre surgery scan.

902 | exocad ALL ON X STEP-BY-STEP GUIDE

96 . Matching Exclude Parts
Paint all the common areas on
both arches blue.

903 | exocad ALL ON X STEP-BY-STEP GUIDE

 97 . Invert Markings
Click invert to convert all
areas. The blue means
exocad will not look at the
data for the merge. We need
to invert that.

904 | exocad ALL ON X STEP-BY-STEP GUIDE

98 . Perform Alignment
Click Perform alignment.

905 | exocad ALL ON X STEP-BY-STEP GUIDE

99 . Best Fit Match
To see the colors make sure
to uncheck the exclude
selected parts icon and select
show distance. If you need to
fine tune the merge change
the settings to matching parts
ratio 10% and max distance
to 3mm.

906 | exocad ALL ON X STEP-BY-STEP GUIDE

100 . Click “OK”
Once happy with the merge
hit OK.

907 | exocad ALL ON X STEP-BY-STEP GUIDE

101 . Back to Wizard
Head back to the wizard for a
little bit. We will be bouncing
in and out of expert mode
and wizard.

908 | exocad ALL ON X STEP-BY-STEP GUIDE

102 . Next
Do not move any meshes
here. Hit next.

909 | exocad ALL ON X STEP-BY-STEP GUIDE

103 . Next
We do not need to use smile
creator. We already did this
in the original waxup.

910 | exocad ALL ON X STEP-BY-STEP GUIDE

104 . Define Emergence
Hit next for each implant to
skip this step. We do not
need to define emergence.

911 | exocad ALL ON X STEP-BY-STEP GUIDE

105 . Define Emergence
We keep hitting next for each
implant in the mandible as
well.

912 | exocad ALL ON X STEP-BY-STEP GUIDE

106 . Tooth Placement
When you get to the tooth
placement tab go to expert
mode for the rest of the
design. You should see your
waxup perfectly on your
surgical arch with all your
implant data. If not then you
screwed up the alignment
steps.

913 | exocad ALL ON X STEP-BY-STEP GUIDE

107 . Virtual Wax Up Bottom
In expert mode click the arch
and go to virtual waxup
bottom on the bottom popup
screen.

914 | exocad ALL ON X STEP-BY-STEP GUIDE

108 . Set Insertion Direction
Rotate the model looking
down the occlusal surface
straight on the ridge and hit
set from view.

915 | exocad ALL ON X STEP-BY-STEP GUIDE

109 . Click “OK”
Click ok to save the new
virtual waxup bottom.

916 | exocad ALL ON X STEP-BY-STEP GUIDE

110 . Design Gingiva
Now pick the arch again and
go to design gingiva.

917 | exocad ALL ON X STEP-BY-STEP GUIDE

 111 . Draw Tissue
Click to start drawing your
tissue area.

918 | exocad ALL ON X STEP-BY-STEP GUIDE

112 . Draw Tissue
Keep drawing all the way
around the Prosthetic. For a
temporary that is printed
keep it thick for strength.

919 | exocad ALL ON X STEP-BY-STEP GUIDE

113 . Draw Tissue
Avoid too much ridge-lap on
the facial.

920 | exocad ALL ON X STEP-BY-STEP GUIDE

114 . Draw Tissue
Double click the start point to
start the tissue render.

921 | exocad ALL ON X STEP-BY-STEP GUIDE

115 . Modify
Change thickness to 2mm for
tissue. Move any green tissue
dots you want to modify.
Click apply for changes to
take effect. When done hit
OK.

922 | exocad ALL ON X STEP-BY-STEP GUIDE

116 . Set From View
Rotate the arch so ridges are
facing you and you are
looking down on the arch
from an occlusal view. Hit set
from view.

923 | exocad ALL ON X STEP-BY-STEP GUIDE

117 . OK
Hit “OK” to save.

924 | exocad ALL ON X STEP-BY-STEP GUIDE

118 . Gingival Base Design
Next select gingival base
design from the lower menu
bar.

925 | exocad ALL ON X STEP-BY-STEP GUIDE

119 . Draw Gingiva
Draw your gingival design.
Remember to keep it thicker
for temp prosthetics. 2mm
thick minimum and draw
margins wider.

926 | exocad ALL ON X STEP-BY-STEP GUIDE

120 . Draw Gingiva
Keep drawing your gingival
margins.

927 | exocad ALL ON X STEP-BY-STEP GUIDE

121 . Render Gingiva
Double click on first dot to
render the tissue.

928 | exocad ALL ON X STEP-BY-STEP GUIDE

122 . Change Thickness
Change thickness to 2mm.
Move any green gingival dots
you want to edit the line and
hit apply for changes to take
effect. Then hit OK to save.

929 | exocad ALL ON X STEP-BY-STEP GUIDE

123 . Free-Form Teeth
Shift click all the teeth in the
design. Turn off trusmile so
you can see what teeth you
are selecting. Make sure to
select all of them. They will
turn blue or some color
different than the teeth.

930 | exocad ALL ON X STEP-BY-STEP GUIDE

124 . Free-Form Teeth
Now click Freeform down
below.

931 | exocad ALL ON X STEP-BY-STEP GUIDE

125 . Cut All Intersections
In the freeform tab hit cut all
intersections.

932 | exocad ALL ON X STEP-BY-STEP GUIDE

126 . Click “OK”
Click Ok to save the changes.
I did this one arch at a time
but you can select all the
teeth and do it all at once.

933 | exocad ALL ON X STEP-BY-STEP GUIDE

127 . Free-Form Gingiva
Select one or both arches and
hit freeform gingiva design.

934 | exocad ALL ON X STEP-BY-STEP GUIDE

128 . Add/Smooth
Got to Free- add and add
thickness to the design. Next
smooth the tissue.

935 | exocad ALL ON X STEP-BY-STEP GUIDE

129 . Big Movements
Go to anatomic small region
to drag papilla and move
areas of tissue. Go to large
region if need to move big
areas.

936 | exocad ALL ON X STEP-BY-STEP GUIDE

130 . Click “OK”
Click OK to save the tissue
changes.

937 | exocad ALL ON X STEP-BY-STEP GUIDE

131 . Wizard
Back to wizard to finish
design.

938 | exocad ALL ON X STEP-BY-STEP GUIDE

132 . Next
Click next to skip this step.
We do not want to adapt to a
preop.

939 | exocad ALL ON X STEP-BY-STEP GUIDE

133 . Click “Next”
Click next after the waxup is
generated.

940 | exocad ALL ON X STEP-BY-STEP GUIDE

134 . Sculpt Tissue Surfaces
Sculpt and smooth the fitting
surfaces to add tissue
pressure and remove
concavities.

941 | exocad ALL ON X STEP-BY-STEP GUIDE

135 . Sculpt Tissue Surfaces
Spend most of your time with
smooth/ flatten and add /
remove to make the tissue
surfaces flat, cleanable and
not concave.

942 | exocad ALL ON X STEP-BY-STEP GUIDE

136 . Eliminate Cantelivers
Remove any large cantilevers
by using the smooth flatten
and remove tools.

943 | exocad ALL ON X STEP-BY-STEP GUIDE

137 . Evaluate Tissue Pressure
You can look at tissue
pressure. You can go to
distance to scan data and
evaluate in more detail with a
color heat map or look and
estimate. This is the time to
sculpt tissue, not later after
healing.

944 | exocad ALL ON X STEP-BY-STEP GUIDE

138 . Next
Hit next.

945 | exocad ALL ON X STEP-BY-STEP GUIDE

139 . Thickness Recovery
Click OK if get a minimum
thickness recovery.

946 | exocad ALL ON X STEP-BY-STEP GUIDE

140 . Screw Channels
Hit next.

947 | exocad ALL ON X STEP-BY-STEP GUIDE

141 . Done
You are all done. Evaluate
MUA and screw channel
surfaces. Library issues are
the most common cause of
errors in the hole forming.
Also crease and folds in the
waxup sometimes will cause
errors.

948 | exocad ALL ON X STEP-BY-STEP GUIDE

142 . Evaluate
Screw channel should be
clean and clear.

949 | exocad ALL ON X STEP-BY-STEP GUIDE

143 . Evaluate
MUA surface should be clean
and crisp with no errors.

950 | exocad ALL ON X STEP-BY-STEP GUIDE

144 . Free-Form Merged
Freeform merged if any areas
need to be modified. If you
have errors in your MUA
surface or screw channels
check your library from the
manufacture. Also you can
check your waxup for any
inverted triangles and issues.
You can delete the merged
parts and try to smooth areas
in the waxup and regenerate
the merged parts.

951 | exocad ALL ON X STEP-BY-STEP GUIDE

 All on x

1. Pre-surgical Waxup

Pontic Waxup
Dentate Arch

< TABLE OF CONTENTS exocad MASTER GUIDE

Table of Contents
01 Denture Settings 1
02 Copy Denture 19
03 Renewed Copy Denture 100
04 Merge IOS to Denture and Photos 183
05 Using Face Scans 291
06 MOD Denture Record System 392
07 Digital Denture Rebase 483
08 Immediate Denture: Natural Teeth 515
09 Immediate Denture: Library Teeth 593

< TABLE OF CONTENTS exocad MASTER GUIDE

 REMOVABLES

Denture Settings

1 | exocad DENTURES STEP-BY-STEP GUIDE < TABLE OF CONTENTS

 1 . Types of Dentures: Immediate
Immediate dentures are the best way
to start doing 3D-printed dentures.
Software, like exocad, allows for
rapid digital tooth extraction and
tooth setups. Intraoral scanning for
immediate dentures is a little bit
easier because often a few teeth are
remaining that help the camera track
along the arch. Immediate dentures
are best printed Monolithic and can
be made using denture tooth resin or
a super resin-like ONX Tough or
Rodin Titan. They can be relined
using any silicone soft reline
material such as Pacdent Rodin soft
reline, Voco Ufi Gel soft, or
Tokuyama softliner tough. For hard
relines I prefer Voco Ufi gel hard.

2 | exocad DENTURES STEP-BY-STEP GUIDE

 2 . Types of Dentures: Copy
Copy dentures can be monolithic
but are often made split file where
the tissue is printed using pink
resin, the teeth using tooth resin,
and the two are bonded together
using liquid tissue resin. 3Shape
and exocad have a really easy copy
denture workflow for rapid design
of copy dentures. It is worth noting
that very rarely does a patient
come in with a denture so good you
want to copy it identically.
Typically it is loose, worn, and has
some esthetic issues. The design
process becomes more complicated
when extensive modifications need
to be made to the “copy” denture.

3 | exocad DENTURES STEP-BY-STEP GUIDE

 3 . Types of Dentures: Renewed Copy
When a denture needs major modifications
such as fit alterations and esthetic changes
it is referred to as a renewed copy denture.
Essentially the old denture is used more
like a custom tray and record base. It is
relined for better retention. A full-face
smile and retracted photo is made with the
old denture in the mouth. Then the denture
is removed and scanned 360 degrees with
an IOS. Next, the denture is placed back
in the mouth and the bite record is
recorded with the IOS. If the patient has
lost vertical and you need to open the
vertical dimension then it is best to do this
before you scan the bite. You can use a
leaf gauge, Lucia jig, wax, or resin to open
the vertical in centric relation. Once you
establish a repeatable occlusion at the new
vertical you can scan the open bite in the
mouth. From this information, a new
denture can be easily designed.

4 | exocad DENTURES STEP-BY-STEP GUIDE

 4 . Types of Dentures: MOD Record
What if a patient does not have an old denture and
has nothing? In these cases, you are starting from
scratch. One fast way to get a trial denture or even a
permanent denture made the same day or the next
day is by using the MOD denture record system.
Essentially, you make intraoral digital impressions of
the maxillary and mandibular arches, then use the
MOD Record System as a jaw relation record. Make a
retracted and smile photo with the tray in place and
from this information everything can be designed.
Depending on the quality of the IOS of the
edentulous ridges and the knowledge of the digital
designer you can potentially go to a final denture
with this information. If you are unsure of the quality
of the IOS or your designer lacks knowledge on how
to design on intraoral scans, you can make a
monolithic trial denture. This can then be printed
using tryin resin, border molded, and light body
washed for better fit. Photos can be made with the
trial in place in case any esthetic changes are
needed. The occlusion can be adjusted and then they
can be scanned 360 degrees for final denture design.
I will explain this concept more as we get to the
clinical cases as it is a difficult concept to
understand; especially if you do not know the digital
design process.

5 | exocad DENTURES STEP-BY-STEP GUIDE

 5 . It All Starts with Good Records
Two very important factors
are crucial when designing
digital dentures using truly
all-digital workflows. First is
having world-class records
including intraoral scans, face
scans, and bite records. It is
imperative that teams are
taught how to make digital
records so that a prosthetic
can be fabricated that
requires no adjustments.

6 | exocad DENTURES STEP-BY-STEP GUIDE

 6 . Maxillary Denture Borders
The maxillary arch had
numerous anatomical
landmarks that must be
scanned so that marking the
borders digitally can be
achieved with a great level of
accuracy.

7 | exocad DENTURES STEP-BY-STEP GUIDE

 7 . Upper Denture Borders

8 | exocad DENTURES STEP-BY-STEP GUIDE

 8 . Upper denture borders

9 | exocad DENTURES STEP-BY-STEP GUIDE

 9 . Mandibular Denture Borders
The mandibular arch and all
the anatomical landmarks
must be scanned for proper
retention and stability of the
denture.

10 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
10 . Mandibular Denture Borders

11 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 11 . Mandibular Denture Borders

12 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
12 . Scan Strategy

13 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
13 . Virtual Waxup Bottom
Remember a large part of the
fit is determined by the
virtual waxup bottom step.
This is the model the denture
will fit and not the original
scan. Understanding the
settings for this are essential.

14 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
14 . Virtual waxup bottom settings

Immediate Denture Copy Denture Physical Impression Intraoral Scan

15 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
15 . Selective Pressure
When scanning with an
intraoral scan it is a true
mucostatic impression
because light does not
deform and compress tissue.
We need to add back
pressure to key areas. Many
shapes off posterior palatal
seals exist. The shape I prefer
resembles Kat ears or batman
ears.

16 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
16 . Selective Pressure Maxilla
Red is 200
micrometers
added pressure
on entire
denture border

Blue is 1mm pressure

posterior seal area Blue is 1mm pressure
and green is 0.5mm Hamular notch is 300 posterior seal area
micrometers of pressure and green is 0.5mm

17 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
17 . Selective Pressure Mandible
Border all the way
around the denture
is 200 microns of
pressure

Lingual is 400
micrometers of
pressure

Retromylohyoid fossa
is 300 microns of
tissue pressure

18 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 REMOVABLES

Copy Denture

19 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E < TABLE OF CONTENTS

 1 . Open Dental DB
Open Dental DB.

20 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 2 . Select Client
Select the client.

21 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 3 . Enter Patient Name
Enter Patient Name.

22 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 4 . Select a Tooth in the Working Arch
Select a Tooth in the Working
Arch.

23 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 5 . Select Full Denture
Select Full Denture

24 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 6 . Select the Method of Fabrication
Select the Method of
Fabrication.

25 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 7 . Remove Record Base Selection
Remove Record Base
Selection.

26 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 8 . Select “Yes” to Copy Existing Scanned Denture
Select “Yes” to Copy Existing
Scanned Denture.

27 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 9 . Select “OK”
Select “OK”.

28 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
10 . Select “Save”
Please note that it is
important to have the exact
same amount of teeth
selected as the denture you
are coping has. If you have to
clear a tooth just left-click
and hold the button down on
any blank tooth and drag it
onto a tooth that has a
prescription.

29 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 11 . Find the 360 Denture Scan File
exocad will always indicate
what arch and what file it
wants you to find.

30 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
12 . Find the Antagonist Scan
Please note the antagonist
will come into the exocad
scene at the bite poison that
you scanned. You do not
need to load a bite scan.

31 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
13 . Right-Click and Rotate the Model
Right-Click and Rotate the
Model.

32 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
14 . Rotate to Look Like This
Step one of the wizard is
model orientation. This is an
important step and it is
necessary to rotate the model
until you are perfectly looking
down the occlusal surface
and incisal edges.

33 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
15 . Hit “Next”
Hit “Next”.

34 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
16 . Find any Holes in Your Denture Scan
The second step in the wizard
is the 3D data editor step.
exocad assumes that you
have some mesh errors you
may want to clean up.

35 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
17 . Circle the Hole
To close a hole in the mesh it
is important to circle and
have an orange selection are
around the entire hole.

36 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
18 . Hit “Close Holes”
Hit “Close Holes”.

37 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
19 . Hit “Next”
Hit “Next”.

38 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
20 . exocad Automatically Marks the Boarder
exocad uses AI to try to
automatically find the apex of
the denture border and will
place a green line on the
border. If you have a very bad
scan it may not find this and
you can draw the line
manually.

39 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
21 . Perfect the Denture Border
You may need to edit the
automatic border. To do this
simply click a ball and drag
the line to where you want it.
Make sure that you do not
have any red areas of the
border line.

40 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
22 . Fine-Tune the Boarder Line
You want the line to be the
apex of curve that is the
border of the denture.

41 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
23 . Hit “Next”
Hit “Next”.

42 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
24 . Denture Tooth Selection
Pay attention to the tooth
exocad is asking you to
select. I find it best to select
the central groove of the
posterior tooth and the
middle straight facial of the
anterior. You can try AI auto
segmentation for a more
efficient process.

43 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
25 . Denture Tooth Selection
The active tooth is orange,
that I the one it wants you to
select. Previously marked
teeth are blue and unmarked
teeth are yellow.

44 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
26 . Keep Selecting Teeth
Please note, if a tooth does
not get selected perfectly you
can hit on the correction icon
and simply paint more of an
area or hold shift and paint
an area to remove from the
selection.

45 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
27 . Keep Selecting Teeth
For anterior teeth, I like to
select the straight facial right
in the middle of the tooth.

46 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
28 . Keep Selecting Teeth
Always make sure the orange
tooth is the tooth that you are
selecting.

47 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
29 . Keep Selecting Teeth
Keep Selecting Teeth.

48 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
30 . Edit Mistakes
After all the teeth have been
selected, you may want to go
back to a previous tooth and
edit the selection area of that
tooth. Simply select a tooth
you want to edit.

49 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
31 . Edit Mistakes
Once selected, hit
“correction”. Then you have
the opportunity to paint the
surface to add to the
selection. SHIFT click and
paint to remove from the
selection.

50 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
32 . Edit Mistakes
Here, I am painting more on
the distal marginal ridge of
this premolar.

51 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
33 . Edit Mistakes
Once you are happy with the
yellow painted area, hit
“apply” to have the changes
saved.

52 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
34 . Root Angulation
You will notice all these arrows
coming out of the teeth. These
arrows represent the proposed
long axis of the tooth and
impact the root eminence angle.
As a general rule the arrow
should be coming out of the
central groove of posterior
teeth and out of the incisal edge
of anterior teeth. To move an
arrow click the small ball at the
tip of the arrow and drag it. Be
very careful not to accidentally
click a tooth as it will start the
segmentation process.

53 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
35 . Hit “Next”
Once you are happy with the
tooth selection and the arrow
angulations hit next.

54 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
36 . Tooth Placement
Here you have access to
global movements and chain
mode. An easy way to alter
the Vertical Dimension of a
scanned denture us to click
move all simultaneously
under simple. This allows all
the teeth to be moved at
once. Please note that if you
wanted to change the vertical
dimension of the denture
tooth setup it would have
been best to scan the bite at
the desired open vertical.

55 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
37 . Tooth Placement
You can optionally move the
entire arch. However most
copy dentures will not require
an aggressive amount of edits
to be made. If you find that
you need to make major
changes to the teeth then
other design methods are
better in exocad and I would
avoid the copy denture
workflow.

56 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
38 . Tooth Placement
Chain mode is super powerful
and allows you to efficiently
make global changes to the
arch of teeth.

57 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
39 . Tooth Placement
The way chain mode works is
easy to understand. The teeth
can have a red or green ball.
Red means they are anchored
down, green means they are
free to move. Each movement
impacts all other teeth like
pearls on a string. For
example, if you want to drop
the posterior segment of
teeth, you can lock the front
teeth, unlock all the back
teeth, and simply drag them
down.

58 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
40 . Tooth Placement
Continue.

59 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
41 . Tooth Placement
Now that the anterior 4 teeth
are locked and the posterior
are unclocked, you can easily
move the posterior sextant
where you desire.

60 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
42 . Tooth Placement
Once you are happy with the
tooth position you can hit
“next”. Usually you have to
do no movements in the tooth
placement step and can hit
next right away.

61 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
43 . Free-Forming
Usually, most of the work on
the copy denture module
needs to be done in free-
forming because of the way
the teeth are copied and
because of the condition of
the teeth they typically have
some wear. In this step, we
can add some anatomy back
into the teeth. It would be
amazing if exocad allowed you
to replace the copy teeth with
new library teeth but at the
time of this guide, they do not
allow that.

62 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
44 . Free-Forming
The first thing I typically do in
this step is go to “Free” then
click the smooth tool.

63 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
45 . Free-Forming
Using the default strength and
size to the smooth brush I
typically smooth the teeth in
areas around the CEJ and the
proximal contact areas.

64 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
46 . Free-Form Smoothing
I work my way around the
arch with the smooth tool.

65 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
47 . Free-Forming Anatomic
The anatomic tool allows you
to click and grab an area of a
tooth and move or stretch it. I
use the size “tooth parts” or
“cups” and edit small areas.
Be careful with this tool as it
can really distort teeth fast if
you are not careful.

66 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
48 . Free-Forming Anatomic
Click here.

67 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
49 . Free-Forming Add Anatomy
Under the “Free” tab select
add remove button, then
select a small brush. Drag
your size to small and
strength to high. Hold shift in
the keyboard while you left
click the mouse and it will
carve grooves and tissues into
the teeth. Let go of the shift
on the keyboard and you will
add wax to areas like
transverse ridges.

68 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
50 . Free-Forming Anatomy
Under the adapt tab, you will
see static occlusion and
approximal. You can adapt by
clicking each button or
alternative you can click cut
all intersections at the bottom
to do both adaptations at the
same time. The default
strength is perfect for me.

69 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
51 . Free-Forming Adapt
The color of occlusal contacts
should be blue with “Show
contact areas” as the color
range. Please note if you have
“show interference contacts”
as your default color range
then you want to see no color.

70 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
52 . Free-Forming Adapt
Under the adapt tab, you will
see static occlusion and
approximal. You can adapt by
clicking each button or
alternatively, you can click
cut all intersections at the
bottom to do both
adaptations at the same time.
The default strength is
perfect for me.

71 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
53 . Free-Forming Adapt
The color of occlusal contacts
should be blue with “Show
contact areas” as the color
range. Please note if you have
“show interference contacts”
as your default color range
then you want to see no color.

72 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
54 . Denture Base Bottom
This is the step that
determines the fit of your
copy denture. This is where a
lot of mistakes are made in
design. Think about what you
are trying to do. You are
trying to replicate the fit of
the denture, therefore you do
not want exocad to alter the
model by adding wax and
spacer.

73 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
55 . Denture Base Bottom
Pick your path of insertion of
the denture by rotating the
model. Usually, for the
Maxilla, it is a facial 60-
degree angle. Then hit set
insertion direction from view.

74 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
56 . Denture Base Bottom
In general, put smoothing to
0mm unless to ensure
complete replication of the
patient anatomy.

75 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
57 . Connectors
Offset 0mm

Angel 30 Degrees

Allows Undercuts 1mm

These settings will ensure

minimum to no modification
of the fit of the denture.

76 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
58 . Denture Base Bottom
The virtual waxup bottom
will look speckled like this.
That is what you want to see.
Tan stone interlaced with blue
is an indication that the two
models are coincident. You
can use the slice plan to
verify if needed. Once happy
hit Next. If you want to edit
the virtual waxup bottom you
can go to freeform and add or
remove wax to areas as
needed.

77 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
59 . Connectors
Connectors are useful to help
keep the teeth together
during printing or milling,
which make easy insertion as
one unit into the denture
base. Furthermore, the
connectors help decrease
shrinkage and warpage when
3D printing and curing.

78 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
60 . Connectors
To better see the connectors
turn off your gingival design
parts by selecting the EYE
icon on the model or holding
control on the keyboard and
clicking the mouse roller ball
button on the object you want
to hide.

79 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
61 . Connectors
Now, we can see the
connector as yellow blobs
between the teeth.

80 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
62 . Connectors
You can alter the shapes and
size and hit “apply” cross
section / shape change” to
apply the changes. I tend to
like the teardrop shape.

81 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
63 . Connectors
Each connector is able to be
moved by left-clicking it and
dragging. You want to make
sure that you do not have
black triangles coronal to the
connector.

82 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
64 . Connectors
Here, we can see a black
triangle coronal to the
connector. You want to click
and drag it down towards the
occlusal surface.

83 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
65 . Free-Forming Denture Base
Usually, minimal tissue
sculpting is needed. I
typically go to “Free”, then
“Smooth/ Flatten”.

84 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
66 . Free-Forming Denture Base
Smooth the denture base. If
needed you can festoon. Look
for a festooning handout to
better explain how to festoon
a denture. Once happy with
the tissue hit “Next”.

85 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
67 . Adapt Denture Base to Teeth
Under teeth minimum,
thickness is 1mm.

86 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
68 . Adapt Denture Base to Teeth
The tooth pocket gap should
be set to 200 micrometers to
ensure passive fit. If milling
make sure to scroll down and
hit anticipate milling. Once
happy hit “next”.

87 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
69 . Posterior Palatal Seal
Too add the posterior palatal
seal in the merge and save
section you should see a
freeform restoration icon.

88 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
70 . Posterior Palatal Seal
Once you select Free-form
restorations you have to then
hit next to enter the freeform
merged part module.

89 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
71 . Posterior Palatal Seal
It may ask you if you want to
free-form the merged gingiva
or the merged teeth. Make
sure to select gingiva.

90 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
72 . Posterior Palatal Seal
Unselect the check box for
the color scale and unselect
keep bottom and boundary
fixed.

91 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
73 . Posterior Palatal Seal
Hit the “Free” button to enter
the Add/Remove tool.

92 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
74 . Posterior Palatal Seal
To be able to see how much
pressure we are adding in the
posterior seal area we need
to alter the visualize distance
scale. Hit the small chevron
to show more options.

93 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
75 . Posterior Palatal Seal
Switch from show contact
areas to distance to scan
data.

94 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
76 . Posterior Palatal Seal
Select “Nearest Point
Distance”.

95 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
77 . Posterior Palatal Seal
Change the distance scal
value where the minimum is
0.01mm and the maximum is
1.5mm.

96 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
78 . Posterior Palatal Seal
Change the size of the add
tool to make it a little smaller.

97 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
79 . Posterior Palatal Seal
Add to the seal area to the
pressure you desire and the
shape that you desire. I like
1.5mm pressure (blue) to be
the maximum amount.

98 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
80 . Posterior Palatal Seal
Once you are satisfied, hit
“next” and it will take you back
to the merge and save screen.
The design is now complete.
The files will be stored in the
project folder or can be
exported from here. The proper
tooth file is called the merged
part. The proper denture base
file is called denture base
adapted. To export them, turn
one on and everything else off.
then right-click the screen and
hit save scene as-STL - visible
objects only-default orientation.

99 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 REMOVABLES

Renewed Copy Denture

100 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E < TABLE OF CONTENTS

 1 . Open Dental DB
Open Dental DB

101 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 2 . Select Client
Select the client.

102 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 3 . Typically “Default Client” is Used
The client in exocad is tied to
all the settings in exocad.
Changing clients will change
the settings. Any settings that
are changed are remembered
and tied to the client.

103 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 4 . Put the Patient Name
Add the patient name here.

104 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 5 . Select a Tooth in the Working Arch
Select a Tooth in the Working
Arch

105 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 6 . Select Partial Denture
Although we are doing a
complete denture we are
going to select partial
denture. Then we will select
flexible denture under type.

106 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 7 . Select Pre-Op Model
You want to make sure to
select pre-op model for this
technique because this will be
essential when designing the
case. Essentially by selecting
this you will be able to load
the scanned denture twice.
Once as the upper jaw and
again as the pre-op.

107 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 8 . Select Remaining Teeth
While holding shift on your
keyboard select the most
distal tooth on the
contralateral side of the arch.
This will copy the
prescription across the arch.

108 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 9 . Select Connectors
Make sure to selct the
connectors for each tooth
because this is a split file
design.

109 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
10 . Select Connectors
I prefer to have the entire
arch connected for easy
bonding of the teeth to the
denture base. However some
people like to do this in
sextants. If so then you will
have 3 sections to bond to
the base. If that is the case
just make sure to leave the
connector bubble blank distal
to the cuspids.

110 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 11 . Select Any Tooth on the Lower
Select any tooth on the
opposing arch and then select
antagonist. If doing a dual
arch case then you will copy
the prescriptions from the
upper onto the lower rather
than selecting an antagonist.

111 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
12 . Save
You must save your finalized
prescription before designing.

112 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
13 . Design
Now, you can select design.

113 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
14 . Load Your Files
Load the 360 degree denture
scan twice. Once as the
upper jaw and again as the
Pre-Op. Then, load the
antagonist.

114 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
15 . Turn Off Color
Once the files are loaded,
turn off the color by selecting
the color button. This will
make differentiating the
preop scan and the upper jaw
scan easier. The upper jaw
will be yellow stone and the
prep will be teal.

115 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
16 . Enter Expert Mode
Expert mode will allow us to
do the virtual pour technique.

116 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
17 . Select Upper Scan
Turn off the pre-op model
and make sure only the upper
scan is visible. Then right-
click the denture and hit “edit
mesh”.

117 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
18 . Data Editor
In 3D Data editor make sure
to select the second bubble:
“Select Only Surface”. This is
the setting we need to pour
this denture up.

118 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
19 . Draw Circle
Draw a circle around the
entire denture from the
occlusal view like shown.

119 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
20 . Select Surface
The occlusal view will now
appear orange.

120 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
21 . Rotate to the Sides
Rotate the denture ever so
slightly to the side and repeat
the process. Draw a large
circle around the denture and
select the visible surface by
closing the circle. This needs
to be repeated looking at
various surfaces but never
being able to see the fitting
surface of the denture.

121 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
22 . Check Intaglio
Make sure you do not have
any orange on the fitting
surface of the denture. It is
ok to have some on the very
aped of the border as long as
it is facial to the apex of the
border. If you have orange on
the intaglio surface make sure
you had the second option
selected “select only
surface”. You can remove
orange by holding shift on
your keyboard down while
circling an area.

122 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
23 . Delete Cameo Surface
Once the majority of the
outer surface is selected
orange and none of the fitting
surface is orange, hit the
“delete” button to remove te
cameo surface.

123 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
24 . Delete Floaters
You will notice floaters and
little specs of material left
over from the cameo surface.
We need to remove these as
well. The next step shows you
how.

124 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
25 . Click Surface
Now, go to the third option,
“select by click on surface”.

125 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
26 . Click the Palate
Click the palate and you will
notice the entire denture is
highlighted orange, but not
the little floaters.

126 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
27 . Invert
Now, click invert and the
floaters will all be selected
orange, and not the actual
denture.

127 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
28 . Delete Floaters
Now, you have to delete
floaters.

128 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
29 . Invert Triangles
This part is confusing. You
now have to right click the
denture and hit “Show
Triangle Orientation” and
you will see the ridge is red
like shown here. That is
actually inside-out. We need
to flip the triangles and invert
the normals. To do this right
click again and hit “invert
triangles.”

129 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
30 . Hit “OK”
(Please note that all these
steps could be avoided by
using the copy denture
feature to virtually pour up
the denture and then export
those files into this style of
prescription for a renewed
copy denture.)

130 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
31 . Back to the Wizard
Click on the magic wand
button to go back into the
wizard.

131 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
32 . Orientate Model
Orientate the model so that
you are looking down the
edentulous ridges from an
occlusal view.

Then, hit “Next”.

132 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
33 . Correct Pre-Op Scan
The software is asking if your
pre-op denture is in the
proper position in relation to
the lower arch and the newly
poured up scan that you just
completed. It should be
perfect so no need to do
anything here. Just hit
“Next”.

133 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
34 . Virtual Waxup Bottom
This is the most important
step for determining denture
fit. Make sure to rotate to the
ideal path of insertion.
Usually a facial 45 degree
insertion for maxillary arch.
Then hit “set insertion
direction from view.”

134 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
35 . Change Bottom Properties
It is important to replicate the
denture bottom and not have
exocad smooth things and
add wax which will
dramatically loosen the fit.

135 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
36 . Bottom Properties
0 mm offset and 0%
smoothing. Think about this.
Why would you go through all
the trouble to reline a denture
and have great suction only to
have exocad add spacer and
smooth everything?

136 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
37 . Block Out Undercuts
Change the block out
undercuts settings to allow
undercuts all the way to
.05mm and select the block
out angle to -30 degrees.
Essentially you do not want
blockout anywhere on the
virtual blackout model unless
it is extreme.

137 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
38 . Apply Settings
Hit apply and look at the
model. You should see this
mottled leopard pattern
where you have stone and
blue material interlaced
together. This is indicating
that the new virtual wax-up
bottom is identical to the
original poured denture
model. Please note that you
can hit freeform and add or
remove wax if needed. Once
happy hit “Next”.

138 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
39 . Set Teeth
This is the stage where you
can go to expert mode and hit
tools-smile creator and Start
setting teeth using smile
creator if you have a photo
both retracted and smile with
the old denture in place. Look
for the handout titled
“Denture design with Smile
Creator” for a step by step.
Here however I am doing a
denture setup without any
photos. Click gingival
position of tooth 3 as shown.

139 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
40 . Set Teeth
Turn your preop denture to
50 % transparent by sliding
the bar next to the eye icon
on the top left object browser
next to Pre-op. Then left click
the tissue of the poured
model under the distal most
tooth of the pre-op denture.

140 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
41 . Select Second Dot
Before clicking a second dot,
change to Gingival position of
tooth 14 as shown.

141 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
42 . Select Contralateral Dot
Now click the crest of the
ridge of the poured model
looking through the pre-op
model where tooth 14 was
positioned. Please note I am
designing a first molar
denture, if you have second
molars then you always select
distal most tooth.

142 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
43 . Hit Next
Hit “Next”. The arch will look
bad as it always does.

143 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
44 . Tooth Placement: Simple
This can be overwhelming
because the arch always
looks terrible at this stage. I
like to click on the button
“SIMPLE” then hit the last
check box “Move all
simultaneously” then click
the arch of teeth and drag
them. Use control to rotate
them and then move them
close to the original position
of the pre-op denture.

144 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
45 . Tooth Placement: Simple
It can be difficult when first
learning to manipulate the
entire arch. Take your time.
Click to drag, control and left
click to rotate, shift and left
click to scale the arch. I focus
mostly on the two central
incisors and getting them in
alignment with the pre-op
denture.

145 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
46 . Tooth Placement: Simple
Make sure to rotate the scene
and look from multiple
different views. Here you can
see I am getting my new
denture teeth incisal edges
very close to the old denture
incisal edges.

146 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
47 . Chain Mode
Once the teeth are close you
are are now ready for Chain
Mode. Click “Chain” icon.
Now you will see red and
green balls. Make all the balls
green make sure to look at
the distal most teeth as these
will need to be turned from
red to green. Red means
locked. Green means free.

147 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
48 . Chain Mode
Then lock the two front teeth
by clicking green to red on
the two central incisors.

148 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
49 . Lock the Laterals
Lock the lateral incisors.

149 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
50 . Move the Quadrant by Distal Tooth
Now notice the front 4 teeth
are red balls and the rest of
the teeth are all green balls.
Now position the quadrant by
clicking the distal most tooth
and moving and dragging it to
be coincident with the pre-op
denture.

150 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
51 . Fine-Tune in Simple
Now you can fine tune
individual teeth by clicking
simple. Make sure to
UNCLICK the move all
simultaneously button. Now
individual teeth can be
positioned. To move a tooth
just left click a tooth. To scale
hold shift and drag while
holding left click and to
rotate hold control and left
click.

151 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
52 . Preliminary Occlusion
Under the “Advanced” tab we
have very powerful tools.

152 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
53 . Instant Anatomic Morphing
Now, select the eye icon
under the advanced tab.

153 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
54 . Select the Morph Icon
Select the tooth arrow icon in
the center.

154 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
55 . Blue is Good
Assuming you have “contact
areas” selected in your
occlusion heat map settings
and not “interference
contacts” you will have nice
blue contacts. You can also
further move and stretch and
rotate individual teeth but
now it will automatically
equilibrate the teeth as you
move them.

155 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
56 . Next
Once you are happy with the
overall tool position and
occlusion, hit next.

156 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
57 . Cut All Intersections
In this tab we should not have to
spend a lot of time because most
of the design is done in the
previous tab. Too many new users
spend way too much time in “Free
From” and they make things look
very bad. All we really need to do
is hit “Cut all Intersections” This
will cut the pontics to make sure
they do not penetrate the tissue,
it will cut any static occlusion
interferences. It will fine tune
proximal contacts. NOTE- if you
want dynamic occlusion look for
the handout on mounting in the
articulator.

157 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
58 . Next
Hit “Next”.

158 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
59 . Skip This
At first glance this might
seem intriguing. It is asking if
you want to adapt your new
design to the old denture.
This is not the workflow for
doing this. You would have
used the copy denture
workflow if you wanted
maintain the original denture
tooth setup. So hit next to
skip this step.

159 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
60 . Surface Properties
This is the step where we
draw our denture base
margin. Set the base
thickness to 2-2.5mm
depending on the resin you
are printing with. High impact
resin can be 2mm thick.
Other resins need to be 2.5
or sometimes even 3mm
thick. Look and manufacture
recommended thicknesses of
the resin you are 3D printing
with.

160 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
61 . Draw Border
I start in the Hamular notch
area and left click. It is
important when you are
marking your border to stay
away from the edge of the
model because it will cause
failure to adapt base errors
later on. If you keep having
this issue you can run the
model through model creator
before designing and use the
solid model next time you
design.

161 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
62 . Continue Marking the Border
Continue to mark the border.

162 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
63 . Finalize
Double click on the first ball
that you placed to finalize the
border. Please note that each
green ball is editable and
moveable. Also note that
even after the tissue is
created you can still move the
lasso line by clicking a green
ball and dragging it then
hitting apply to regenerate
the tissue. Once happy hit
NEXT.

163 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
64 . Festoon the Denture
It is too complicated to teach
festooning in a handout. It is
best to watch the videos and
follow along for this.

Once happy, hit next.

164 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
65 . Connectors
Default settings for connector
is fine. People get all worked
up over connector settings for
no reason. It’s a denture not a
fixed bridge. We only need the
connectors to hold the arch
together for bonding of the the
teeth. Each yellow blob is a
connector. They can be clicked
and moved. Make sure you do
not have a black triangle under
the connector as shown here.
Make sure you do not have any
red connectors. If you do move
it until it turns yellow.

165 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
66 . Fine-Tune Connectors
Here I moved the connector
corona to eliminate the black
triangle space which may
cause a failure of the pocket
to adapt later on.

166 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
67 . Hide Anterior Connectors
To hide anterior connectors
drag them a little palatal.

167 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
68 . Next
Once happy with the
connectors, hit “Next”.

168 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
69 . Adapt Pockets
Change minimum thickness
under pocket to 1mm.

169 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
70 . Gap Settings
Change pocket gap to 0.2mm.
If milling, make sure to scroll
down and select anticipate
milling and select the tool
size.

170 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
71 . Finalize Denture
Hit next to create final
denture parts. The final parts
are the “Merged Part” and the
“Denture base adapted”.

171 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
72 . Final Parts
The denture base adapted is
the final tissue part needed to
mill or print.

172 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
73 . Final Parts
The “merged parts” is your
final teeth that you need to
mill or print.

173 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
74 . Palatal Seal
If a palatial seal is desired
you need to add it to the final
adapted base. Click Free-
form restorations and then hit
“next”.

174 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
75 . Unselect Options
Unselect “Keep Bottom and
Boundary Fixed” and
unselect the color bar.

175 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
76 . Show Distances
Go up to the top of the screen
to the show distance color
bar. Hit the tiny chevron icon
as shown.

176 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
77 . Distances to Scan Data
Switch the Show contact
areas to Distance to Scan
data.

177 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
78 . Change Color
Change color scale to .01 on
the minimum and 1.5mm on
maximum.

178 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
79 . Free
Click “Free and then add to
your border”.

179 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
80 . Add Your Pressure
Many different philosophies
exist on what size, depth and
shape of the seal needs to be.
It honestly deepens on the
patient and palatal
classification. In general I will
have blue spots (1.5mm) in
areas and then fade it to
green and yellow to red which
is 200 microns of pressure.
This is an exacting way to see
exactly how much pressure is
put on the tissue. .

180 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
81 . Hit “Next”
Once happy with the seal, hit
“next”.

181 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
82 . You are Done!
You are now done with your
denture design. The CAD files
are stored in the project
folder already. You can also
export the files here. If you
do so turn only one file on at
a time. Right click the black
area of the screen-save
screen as-STL-Visible objects
only-default orientation.

182 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 REMOVABLES

Merge IOS to Denture and Photos

183 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E < TABLE OF CONTENTS

 1 . Organize and Align Your Scans
The first step is to
organize and align your
scans. Here I have a
denture that I scanned
360 degrees out of the
mouth. Placed it back to
scan the bite. It is aligned
to the opposing. I have an
IOS I made of the
edentulous arch not
aligned to anything.

184 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 2 . Enter Expert Mode
I have some housekeeping
to do before I can get
started with the design. I
have to align my meshes.
My favorite thing to do in
exocad.

185 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 3 . Tools
Click the “Tools” button.

186 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 4 . Align Meshes
Click the “Align Meshes”
button.

187 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 5 . Click “Manually”
Click the “Manually” tab.

188 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 6 . Drag the Model
Click and drag the
misaligned model. Avoid
touching any models that
are already aligned. In this
case, I need to click my
maxillary IOS scan and
move it. To rotate the
entire scene right-click.

189 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 7 . Drag the Model
Drag the model.

190 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 8 . Drag the Model
Drag the model.

191 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 9 . Rotate
Now I need to route the IOS
scan to be in the same
position as the aligned scans.
Hold ctrl and right-click the
scan to rotate.

192 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
10 . Rotate
Now, I need to route the IOS
scan to be in the same
position as the aligned scans.
Hold ctrl and right-click the
scan to rotate.

193 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 11 . Rotate
Now I need to route the IOS
scan to be in the same
position as the aligned scans.
Hold ctrl and right-click the
scan to rotate.

194 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 12 . Rotate
You want to view the maxilla
from the top. It will look like
the IOS is inside out.

195 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 13 . Click “Automatically”
Click “Automatically”.

196 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 14 . Find Common Points
Always start on the mesh you
want to be moved. I want my
IOS scan to be moved to try a
denture scan, which is
already aligned to the bite
and lower.

197 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 15 . Find Common Points
Find the identical spot on the
denture scan and click.

198 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 16 . Repeat
Repeat always starting in the
IOS scan of the edentulous
arch and moving to the
denture scan. 5 points is
ideal.

199 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 17 . Matching: Exclude Selected Parts
Click “Matching: Exclude
Selected Parts”.

200 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 18 . Brush Size
Click “brush size”.

201 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 19 . Paint the Areas that are in Common
Paint the areas that are in
common.

202 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
20 . Click “Invert”
Click “Invert”.

203 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 21 . Check
The software will only use
what you painted and
inverted to calculate the
match.

204 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
22 . Click “Perform Alignment”
Click “perform alignment”.

205 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
23 . Best Fit Matching
Click “Best Fit Matching”.

206 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
24 . Matching Exclude Parts: Unselect
Uncheck the “Matching:
Exclude Parts” box.

207 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
25 . Show Distance
Select the “show distance”
box.

208 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
26 . Evaluate Accuracy
You want to see a mottled
look to the colors spread
through the arch.

209 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
27 . Click “OK”
Click “OK”.

210 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
28 . Check the Scans
Now the IOS of the
edentulous arch is perfectly
aligned to the old denture
which was aligned to the bite
and lower from the IOS
scanner.

211 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
29 . Click “Wizard”
Click “Wizard”.

212 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
30 . Orientation
Set your model orientation.

213 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 31 . Pane
Click “pane”.

214 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
32 . Rotate
Rotate to be looking straight
down the arches from the
occlusal view and hit “next”.

215 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
33 . Click “Next”
We skip this and hit “next”.

216 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
34 . Set Insertion
Rotate to the path ion
insertion of the denture and
hit set from view.

217 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
35 . Click “Bottom Properties”
Click “Bottom Properties”.

218 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
36 . Click “0”
Offset and smoothing need to
be 0 for IOS scan.

219 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
37 . Change Smoothing
Change the smoothing
percentage.

220 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
38 . Click “Block Out Undercuts”
The fit of a digital denture is
determined a lot by these
virtual waxup bottom
settings. The software's
default settings add way too
much smoothing, spacer, and
block out wax. We need to
edit this.

221 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
39 . Click “Bottom Properties”
Click “Bottom Properties”
dropdown.

222 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
40 . Click “Bottom Properties”
Click “Bottom Properties”.

223 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 41 . Click “Custom”
Click “Custom”.

224 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
42 . Click “-30 Angle”
Click “-30 Angle”.

225 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
43 . Click “Allow 0.5mm”
Click “Allow 0.5mm”.

226 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
44 . Allow 0.5mm
I rather have too much
retention to my denture than
no retention.

227 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
45 . Click “Apply”
Click “Apply”.

228 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
46 . Check Virtual Waxup Bottom
Exocad makes a new blue
model. This is the model the
denture fits to.

229 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
47 . Click “Next”
Click “Next”.

230 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
48 . Click “Expert”
Click “Expert” mode.

231 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
49 . Click Tools
Click Tools.

232 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
50 . Click “Smile Creator”
Click “Smile Creator”.

233 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 51 . Click “Load Retracted”
Click “Load Retracted”.

234 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
52 . Find Retracted Photo
Find retraced photo.

235 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
53 . Rotate Model
Rotate the IOS so it is about
the same angle as the denture
in the photo. Do not left-click
because you may drop
marker dots in the wrong
spot. If you do drag them to
the proper spots as shown
next.

236 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
54 . Click “Left Cupid”
Click CEJ of the patient’s left
cuspid.

237 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
55 . Find a Spot
Click the same exact spot on
the IOS scan of the denture.
Note that you can drag and
move the balls after placing
them.

238 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
56 . Click Right Cuspid
This time, pick the cusp tip.

239 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
57 . Click Right Cuspid
Click the right cuspid.

240 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
58 . Click “Next”
Click the “next” button.

241 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
59 . Right-Click to Rotate
First, rotate the model by
right-clicking the midline and
dragging.

242 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
60 . Rotate
Rotate now.

243 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 61 . Refine Dots
Click the center of a dot and
drag it to refine.

244 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
62 . Refine Dots
Refine the dots.

245 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
63 . Repeat
Repeat.

246 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
64 . Repeat
Continue to repeat.

247 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
65 . Repeat
Continue to repeat.

248 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
66 . Change View
You can change the way the
IOS looks. This may help.
Right-click the model.

249 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
67 . Click “Outline”
Select the “outline” button.

250 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
68 . Toggle on and Off Outline
Toggle on and Off Outline.

251 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
69 . Toggle on and Off Outline to See
Toggle on and Off Outline to
See.

252 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
70 . Click “Next”
Click “Next”.

253 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 71 . Click “Load Smile Photo”
Click “load smile photo”.

254 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
72 . Find Smile Photo
Find your smile photo.

255 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
73 . Auto Alignment
The smile and retracted
photo will be automatically
aligned. If they are not it is
because you made bad
photos. The head can’t move
and the camera can’t move
between the shots.

256 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
74 . Clear Teeth
The teeth should look clear
and crisp no ghosting.

257 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
75 . Bad Example
This is an example of a bad
alignment. Retake photos or
try to align them by dragging
the dots.

258 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
76 . Drag Dots if Needed
Drag the dots if it is needed.

259 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
77 . Drag Dots if Needed
Drag the dots if needed.

260 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
78 . Next
Hit the “Next” button.

261 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
79 . Outline Lips
Outline the lips.

262 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
80 . Follow the Lip Line
Follow the lip line.

263 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 81 . Click “Next”
Click “Next”.

264 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
82 . Refine Pupil Spot
Refine the pupil spot.

265 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
83 . Next
Click “Next”.

266 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
84 . Position Facial Midline
Position the facial midline.

267 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
85 . Position Proportion Gauge
Position the proportion
gauge.

268 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
86 . Move the Incisal Edge Position
Move the incisal edge
position.

269 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
87 . Click “Next”
Click “Next”.

270 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
88 . Next
Keep clicking “next” to finish
the smile design.

271 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
89 . Wizard
Click “wizard”.

272 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
90 . Chain
Click the “Chain” tab.

273 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 91 . Lock 8 and 9
Lock number 8 and 9.

274 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
92 . Lock 8 and 9
Lock number 8 and 9.

275 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
93 . Lock Laterals
Lock the laterals too.

276 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
94 . Lock Laterals
Lock the laterals too.

277 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
95 . Unlock Posterior Teeth
Unlock the posterior teeth.

278 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
96 . Unlock Posterior Teeth
Unlock the posterior teeth.

279 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
97 . Position Teeth
Position the teeth.

280 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
98 . Position Teeth
Position the teeth.

281 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
99 . Position Teeth
Position the teeth.

282 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
100 . Position Teeth
Position the teeth.

283 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
101 . Click “Advanced”
Click “Advanced”.

284 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
102 . Click “Apply to All”
Click instant anatomy
morphing and then apply to
all.

285 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
103 . Smile Window and Refine
Click “Smile Window and
Refine”.

286 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
104 . Show Helpers
Click “Show Helpers”.

287 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
105 . Refine Tooth Set Up

288 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
106 . Check Other Tutorials
Check other tutorials in this
manual to finish the design
and make the tissue base.

289 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
107 . Done!
Your design is complete.

290 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 REMOVABLES

Using Face Scans

291 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E < TABLE OF CONTENTS

 1 . Expert Mode
To bring in a face scan, go to
expert mode.

292 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 2 . Click “Expert Mode”
Click “Expert Mode”.

293 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 3 . Tools
Click “Tools”.

294 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 4 . Click “Add/Remove Mesh”
Under tools, if you are in
expert mode a window will
pop up. Hit “Add Remove
Mesh”

295 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 5 . Face Scan
Under mesh type find face
scan.

296 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 6 . Load
Click the “Load” button.

297 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 7 . Find Your Retracted Scan
Find your retracted scan.

298 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 8 . No
Click “No”

299 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 9 . Orientate
This can be tricky. You have
to position the face scan and
move it to the same
orientation as the jaw scan.

300 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
10 . Rotate Entire Scene
Right-click and drag the
mouse to rotate the entire
scene so the models are
facing you as shown. Please
note the face scan will be at
some random position. Ignore
it.

301 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 11 . Move the Face
Left-click the face and drag
it. Hold control and left-click
to rotate it.

302 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 12 . Move the Face
You want the face scan
looking the same direction as
the models in the scene.

303 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 13 . Position the Face
Check from multiple angles to
ensure the face is in the same
plane.

304 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 14 . Position the Face
Position the face.

305 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 15 . Proper Alignment
Be sure to get proper
alignment.

306 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 16 . Click “Align Meshes”
Not that the face scan is in
the proper position for
alignment we can click align
meshes.

307 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 17 . Find Common Points
Obviously you need
something to match the face
scan to the IOS scans. Here I
scanned the old denture. It
could also be a record base
or the MOD stray or an old
relined denture. Pick your
FIRST point on the face scan.
Usually, I pick the patient’s
left side cuspid.

308 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 18 . Pick Common Points
Your second point should be
the same exact spot on the
IOS scan.

309 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 19 . Keep Finding Points
Your second point is on the
face. Usually the lateral
incisor.

310 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
20 . Find Common Points
Find the same exact spot on
the IOS.

311 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 21 . Repeat
Repeat with a dozen or more
spots. Notice the arrows are
pointed to the IOS.

312 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
22 . Matching: Exclude Selected Parts
Click “Matching: Exclude
Selected Parts”.

313 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
23 . Brush Size
Click “Brush Size”.

314 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
24 . Pain Common Areas
Pain the common areas.

315 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
25 . Pain Common Areas
Paint common areas on the
face and IOS. Usually, the
teeth on both are painted.

316 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
26 . Click “Invert Markings”
Click “Invert Markings”.

317 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
27 . Click “Perform Alignment”
Click “Perform Alignment”.

318 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
28 . Click “Best Fit Matching”
Click “Best Fit Matching”.

319 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
29 . Close the Brush Tool
Close the brush tool.

320 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
30 . Click “OK”
Click “OK”.

321 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 31 . Load Additional Face Scan
Load additional face scan.

322 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
32 . Find Smile Scan
Find the smile scan.

323 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
33 . No
Click “No”.

324 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
34 . Move the Smile
Do not click or move the
already merged face scan or
any models. Just move the
new smile face scan.

325 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
35 . Rotate
Rotate the new scan by
holding control and left-
clicking it.

326 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
36 . Ideal Placement
Now that they are properly
positioned you can click align
meshes.

327 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
37 . Find Common Face Points
Click first on the smile face
scan. Usually, some spots on
the forehead and corners of
the eyes are good starring
points. Any common areas
that did not move between
the scans.

328 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
38 . Click Common Points
The corner of the eye is a
good spot. Always click first
on the smile face scan and
second on the already merged
to the IOS retracted face
scan.

329 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
39 . Click Common Points
Click the common points.

330 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
40 . Repeat
Notice that the arrows are
pointing to the retracted face
scan, indicating the newly
imported smile face scan is
going to be moved to the
retracted face scan.

331 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 41 . Repeat
5 or more spots is the ideal
amount.

332 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
42 . Repeat
Continue to repeat.

333 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
43 . Matching: Exclude Selected Parts
Click “Matching: Exclude
Selected Parts”.

334 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
44 . Click “Brush Size”
Click the “Brush Size” button.

335 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
45 . Paint the Common Areas
Paint the common areas on
both face scans that have not
dramatically moved between
smile and retracted.

336 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
46 . Click “Invert Markings”
Click the “invert markings”
button.

337 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
47 . Click “Perform Alignment”
Click “perform alignment”.

338 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
48 . Click “Best Fit Matching”
Click the “best fit matching”
button.

339 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
49 . Matching: Exclude Selected Parts
Click “Matching: Exclude
Selected Parts”.

340 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
50 . Show Distance
Click “show distance”.

341 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 51 . Evaluate Match
Evaluate the match.

342 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
52 . Click “OK”
Click the “OK” button.

343 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
53 . Right-Click Face
Right-click the face.

344 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
54 . Click “Edit Face Scan”
Edit the face scan.

345 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
55 . Hide Retracted Face
Hide the retracted face.

346 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
56 . Hide Retracted Face
Hide the retracted face.

347 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
57 . Circle Face Scan Smile
Draw a line around the inner
lips to circle the teeth from
the face scan. Get close to
completing the circle but do
not completely close the
circle.

348 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
58 . Delete
Click “delete”

349 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
59 . OK
Click “OK”.

350 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
60 . All Done
Now you should be able to
see the preop teeth and any
teeth you design through the
smile face scan as designing.

351 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 61 . Back to Wizard
Back to Wizard.

352 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
62 . Set Orientation
Rotate the model to the ideal
path of insertion of the
denture and hit next.

353 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
63 . Rotate
Rotate the model.

354 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
64 . Next
Click “Next”.

355 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
65 . Next
Ignore this step.

356 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
66 . Skip Smile Creator
You can use smile creator but
I usually skip it. One trick is
to make two screen captures
with the retracted and smile
face scan to use in the smile
creator module. At this time I
do not like using face scan in
smile creator.

357 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
67 . Design Tissue
Click “Design Virtual
Gingiva”.

358 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
68 . Rotate and Set from View
Set the dial path of insertion
of the denture. Understand
that the fit is determined by
this rotation so it is
important.

359 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
69 . Click “Set from View”
Click “Set from View”.

360 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
70 . Click “Apply”
Click “Apply”.

361 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 71 . Bottom Properties
Click “Bottom Properties”.

362 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
72 . Adjust Fit
For physical impressions or
washed dentures, I often
make offset to 0 and make
smoothing 0.

363 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
73 . Change Settings
Change the settings.

364 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
74 . Block Out Undercuts
Click “Block out undercuts”.

365 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
75 . -30 For Angle
Click “-30 for angle”.

366 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
76 . Allow Undercuts 0.5mm
Click “Allow undercuts
0.5mm”.

367 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
77 . Click “Next”
Click “Next”.

368 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
78 . Set Teeth Following Wizard
Se the teeth following wizard.

369 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
79 . Click “Molar Positions”
I like to use the preoperative
denture as a reference, even
if moving teeth after.

370 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
80 . Place Teeth
It is common for the anteriors
to be at a bad angle as
shown. This will be corrected
next.

371 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 81 . Click “Simple”
Click the simple tab.

372 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
82 . Click “Move All”
Click “Move All”.

373 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
83 . Move and Rotate the Entire Arch
This can be tricky. Use
control to rotate, shift to
scale, and click to translate.

374 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
84 . Move and Rotate the Entire Arch
Focus on the incisal edge of 8
and 9.

375 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
85 . Chain Mode
Once the arch is close
especially focused on 8 and 9
click chain mode. I like to
lock 8 and 9 by clicking the
green balls to red. Then
unlock the posteriors and
move them in place. This may
take some time and practice.

376 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
86 . Click “Advanced”
Once complete with chain
mode click advanced.

377 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
87 . Click “Apply All”
Notice the teeth with the
arrow are selected orange,
then hit the text box apply all
to equilibrate the teeth,

378 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
88 . Move Individual Teeth
Move the individual teeth.

379 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
89 . Move Individual Teeth
Move the individual teeth.

380 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
90 . Turn on the Face Scan Smile
Turn on the face scan smile.

381 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 91 . Click “Simple”
Click “Simple”.

382 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
92 . Click “Move All Simultaneously”
Click “Move All
Simultaneously”.

383 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
93 . Move the Arch of Teeth
Now with the face in view,
move the entire arch of teeth.

384 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
94 . Move the Arch of Teeth
Now with the face in view,
move the entire arch of teeth.

385 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
95 . Move the Arch of Teeth
Now with the face in view,
move the entire arch of teeth.

386 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
96 . Move the Arch of Teeth
Now with the face in view,
move the entire arch of teeth.

387 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
97 . Move the Arch of Teeth
Now with the face in view,
move the entire arch of teeth.

388 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
98 . Move the Arch of Teeth
Now with the face in view,
move the entire arch of teeth.

389 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 99. Compare Against Preop Denture
In this case, the midline was
extremely off on the old
denture as seen here so we
moved it dramatically with
the new tooth setup.

390 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
100 . Finalize Esthetics
Proceed on with denture
design as outlined in the
other sections of this manual.

391 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 REMOVABLES

MOD Denture Record System

392 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E < TABLE OF CONTENTS

 1 . Open Dental DB
Open Dental DB.

393 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 2 . Choose Client
Choose client.

394 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 3 . Add Patient Name
Add in the patient name.

395 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 4 . Click Distal Most Tooth
Click the distal most tooth in
the arch.

396 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 5 . Click “Partial Denture”
Select Parital Denture.

397 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 6 . Click "Flexible denture"
Click "Flexible denture”.

398 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 7 . Click Preop
For the MOD denture record
system you can select preop
to bring in the record bite
scan as a preop scan. This
will aid in face alignment if
you have a photograph.

399 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 8 . Click “OK”
Click “OK”

400 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 9 . Hold Shift and Click Contralateral
By holding shift on the
keyboard and selecting the
opposite side distal most
tooth you will copy the
prescription to all teeth in the
arch

401 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
10 . Click Connectors
If doing a dual arch case you
can copy the prescription
over to the lower arch
however you do not need to
have a preop model in the
prescription for the lower.

402 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 11 . All Teeth Should Have Connectors
Begin to click the conenctors
so that all of the teeth have
them.

403 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
12 . Copy to Lower Arch
If doing a dual arch case you
can copy the prescription
over to the lower arch
however you do not need to
have a preop model in the
prescription for the lower.

404 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
13 . Save
After you have selected all of
the conenctors on the lower.
Hit Save.

405 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
14 . Design
Click the design tab.

406 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
15 . Load the IOS Soft Tissue Scan
Load the IOS tissue scan of
the jaw that it prompts you to
load first. Typically the
maxillary.

407 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
16 . Load the Preop
Load the MOD tray scan as
the preop Scan. Then load
the antagonist next.

408 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
17 . Align Files
Depending on the scanner
you may not have your IOS
scans aligned to your tray
scan. And even if you did you
may not trust the alignment.

409 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
18 . Enter Expert Mode and Select Tools
Once you enter Expert Mode,
select “tools”.

410 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
19 . Click “Manually”
Select the Manually tab.

411 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
20 . Manually Move the Upper Scan
Move the upper jaw scan and
rotate it so you are looking
down at the scan from the
top. The scan will appear
inside out. Also rotate the
tray scan to the same position
and make them side by side
as shown. This can be tricky.
Control and left click the
object to rotate only it. Left
Click to drag. Right click to
rotate the entire scene.

412 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
21 . Click “Automatic”
Now click automatically and
select common points
between the two models.
Start on the IOS scan and left
click a distinct spot.

413 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
22 . Click “Point on Tray"
Click the same exact spot on
the tray scan that you
originally selected on the
IOS maxillary scan.

414 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
23 . Find More Common Points
Find 4 to 8 common points.
Preferentially spread out.
Always select first the IOS
maxilla then the tray scan.
Notice the arrows show the
IOS maxillary is going to be
moved to the tray.

415 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
24 . Click “Matching: Exclude Selected”
Check the check box for
matching exclude selected
parts.

416 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
25 . Click the “Brush Size” and Make Large
Click the “Brush Size” and
Make Large.

417 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
26 . Paint Only the Attached Tissues
Paint the attached tissues of
the IOS maxillary scan as
shown in blue. Paint the very
same area on the tray scan as
well.

418 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
27 . Click Invert Markings
Click invert markings will
reverse the selection so the
software will only consider
the surface you painted in the
calculation for the alignment.
All the areas dark blue will
not be considered. This way
the movable tissues do not
throw off the alignment.

419 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
28 . Click “Perform Alignment”
Click “Perform Alignment”.

420 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
29 . Click “Best Fit Matching”
Best fit match looks at
millions of datapoints and
finds the closest match
between the two separate
files and aligns them.

421 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
30 . Evaluate
The maxillary IOS will now be
moved to and aligned with the
tray scan as shown. To see
how accurate this alignment
is you have to uncheck
exclude selected parts then
check show distances.

422 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
31 . Uncheck “Exclude Selected Parts”
Uncheck “Exclude Selected
Parts”.

423 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
32 . Click “Show Distance”
Click “Show Distance”.

424 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
33 . Evaluate Heat Map
Look at the heat map. Any
color other than pink is good
and shows an acceptable
match. You ideally want to
see these colors on both
sides of the arch. Pink just
means greater than 200
microns of error but this does
not necessarily man those
areas are not accurate in the
IOS scan. Remember the
putty will compress the
tissues a lot so don’t expect
perfect matches everywhere.

425 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
34 . Click “OK”
We have to exit by hitting OK.
Even though the lower has
not been aligned.

426 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
35 . Back to Tools
Now we repeat everything for
the lower arch.

427 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
36 . Click “Align Meshes”
Click on the “Align Meshes”
button.

428 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
37 . Click “Manually”
If you need to move the lower
arch make sure you do NOT
move the tray or the upper
arch you just aligned
previously. Therefore do not
LEFT click anything that you
already aligned.

429 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
38 . Look Down from the Bottom
Rotate both so that you are
looking down from the
bottom mandibular arch. The
IOS scan of the mandible will
look inside out.

430 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
39 . Click “Automatically”
Find common points. Start
always on the IOS of the
mandibular arch and click.
Then click the same spot on
the tray.

431 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
40 . Find Common Spots
Find common points. Always
start on the IOS of the
mandibular arch and click.
Then, click the same spot on
the tray.

432 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
41 . Spread Out Spots
5 or more spots are ideal with
more being better. Spread
them out. Notice the direction
of the arrows. They should
point to the tray.

433 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
42 . Click “Matching: Exclude Selected”
Check the “Matching:
Exclude Selected” box.

434 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
43 . Click “Brush Size”
Increase the brush size.

435 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
44 . Paint the Attached Tissues
Paint the attached tissues and
any teeth surfaces scanned in
the IOS.

436 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
45 . Paint the Tray
Paint the same surfaces on
the tray.

437 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
46 . Click “Invert Markings”
Select the “Invert Markings”
button.

438 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
47 . Click “Perform Alignment”
Select the “Perform
Alignment” button.

439 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
48 . Click “Best Fit Matching”
Select the “Best Fit Matching”
button.

440 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
49 . Click “Matching: Exclude Selected”
Uncheck the check box now
under matching exclude
selected parts so we can see
the colors.

441 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
50 . Click “Show Distance”
Check the “Show Distnace”
box.

442 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
51 . Evaluate the Accuracy
Evaluate the accuracy of your
design.

Then click “OK” if you are

satisfied.

443 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
52 . Click “Wizard”
We now will enter back into
Wizard Mode.

444 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
53 . Set Model Orientation
Rotate your model so that you
are looking straight down the
ridge.

445 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
54 . Skip Preparative Alignment
You aligned the models to the
tray, so you want to skip this
step and just hit “next”.

446 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
55 . Set Insertion
Rotate the model to look
perfectly done the ridge at
the path of insertion. Usually
facial 45 degrees for maxilla.

447 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
56 . Click “Set Insertion Direction from View”
Click the “Set Insertion
Direction from View” button.

448 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
57 . Click “Bottom Properties”
Click the “Bottom Properties”
button.

449 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
58 . Set the Offset and Smoothing to 0
Move the slider to set the
offset to 0.

Move the slider to set the

smoothing to 0.

450 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
59 . Click “Block Out Undercuts”
Click the “blockout
undercuts” button.

451 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
60 . Adjust Angle to -30
Move the slider to adjust the
angle to be -30.

452 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
61 . Allow Undercuts to 0.5mm
Move the slider to allow
undercuts to 0.5mm.

453 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
62 . Click “Apply” and “Next”
Click apply to look at the
virtual waxup bottom. It
should look speckled like a
leopard pattern indicating the
software did not add a bunch
of spacer, wax and
smoothing to the model. This
ensures the best fit for IOS.

454 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
63 . Repeat for the Lower Arch
Repeat the same steps for the
lower arch.

455 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
64 . Evaluate
Evaluate virtual waxup
bottom. Here I have a few
teeth and I am making a
lower partial denture so the
setting change. I leave them
default I will click
“FREEFORM” and remove
wax on the teeth manually.

456 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
65 . Freeform Wax
Click on the “Add/Remove”
tool.

457 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
66 . Remove Wax on Clasp Areas
Only melt waz from the teeth
at the clasp areas for a RPD.

458 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
67 . Repeat
Repeat this process for each
clasped tooth.

459 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
68 . Engage Undercuts
Remove blackout wax in
retromylohyoid fossa.

460 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
69 . Next
Click the “Next” button.

461 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
70 . Click “Expert Mode”
If you have photos go to
expert mode-tools-smile
creator to set teeth based on
the smile.

462 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
71 . Load a Retracted Image
Load a retracted image of the
patient with the tray in place
fully seated

463 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
72 . Rotate the Tray to Match
Right click to rotate the tray
on the left to match the angle
it appears in the photo. Do
not left click or you may
accidentally drop marker
points.

464 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
73 . Click a Distinct Point
Click a point on the tray near
the cuspid position on the
patient’s Left side.

465 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
74 . Dot Alignment
Find the same spot on the
IOS scan of the tray and click
to place a dot.

466 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
75 . Refine the Dots
The dots should be in the
exact same spot. You can
click the center of the dot
and drag it if needed. They
should also be the same
color.

467 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
76 . Click the Right Dot
Click a distinct dot on the
patient’s right side photo.

468 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
77 . Dot Alignment
Click the same exact dot on
on the IOS of the tray for the
right side.

469 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
78 . Click “Next”
Click the “Next” button and
proceed.

470 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
79 . Refine
Two movements to refine.

1) Right click the center of

the model and rotate the IOS

2) Click the balls and gently

drag them to refine.

3) Repeat

471 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
80 . Refine
Continue to Refine

472 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
81 . Right-Click to Rotate
Right-click to rotate while
refining.

473 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
82 . Click “Load Smile Image”
Click “load smile image”.

474 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
83 . Click on Your Smile Image
Click “load smile image”.

475 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
84 . Auto Alignment
The software will
automatically align the two
photos. If the patient had
head movement or the
camera moved they will never
align.

476 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
85 . Draw Lips Line
Although the patient lip line
here is not accurate, just
draw the best you can and
then hit “next”.

477 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
86 . Refine Pupil
Refine the pupil selection
here.

478 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
87 . Refine Pupil
Refine the pupil selection
here.

479 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
88 . Click “Next”
Select the “Next” button.

480 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
89 . Next Steps
See the smile design tutorials
in the manual for how to use
the smile design.

481 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
90 . Continue with Wizard
Once you are done with the
smile design module, return
to the wizard to finish the
design following the other
tutorial in this manual. You
are done.

482 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 REMOVABLES

Digital Denture Rebase

483 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E < TABLE OF CONTENTS

 1 . Find the Original Denture Design
Find the original denture
design.

484 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 2 . Click Design
Click the “design” button.

485 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 3 . Load Scene
Find the Original Denture
Design.

486 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 4 . Click Design
Click your design.

487 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 5 . Click Here
We have to enter expert
mode and erase a few files.

488 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 6 . Delete Adapted Tissue
We need to delete a few files.
Click the denture and go to
the bottom of the screen and
find the trash can.

489 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 7 . Denture Base Adapted
We have to delete the
adapted denture base. This
will allow us to design a new
one.

490 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 8 . Click “OK”
Click “OK” here.

491 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 9 . Repeat
Click the trash icon again.

492 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
10 . Virtual Waxup Bottom
Select “Virtual Waxup
Bottom” here.

493 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 11 . Click “OK”
Click “OK” here.

494 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
12 . Tools
Select the tools button.

495 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
13 . Add/Remove Mesh
Add/Remove mesh.

496 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
14 . Extra Jaw Scan
Select “Extra Jaw Scan”.

497 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
15 . Load
Hit the load button.

498 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
16 . Find New Impression Scan
Find your new impression
scan.

499 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
17 . Click “No”
Find and load the new
impression. This can be a
scan of a relined denture, a
soft tissue scan like this, or a
scan of an impression. It will
NOT be aligned. This is ok.

500 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
18 . Click “OK”
Click the “OK” button.

501 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
19 . Wizard
Select wizard mode.

502 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
20 . Align New to Old
In wizard it will ask you to
align the new impression to
the old one used for the
original design.

503 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
21 . Click Common Points
If you need more than one
point hold control on
keyboard while you click.

504 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
22 . Find Common Spots
Find common spots.

505 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
23 . Click “Next”
Click the “Next” button.

506 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
24 . Click “Replace the Whole Scan Data”
Click the “Replace the Whole
Scan Data” button.

507 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
25 . Set Insertion
You should not need to
change this as it will be
identical to the first denture.
If you need to rotate and hit
set from new. Make sure to
edit your bottom properties
based on my other tutorials in
this manual.

508 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
26 . Click “Next”
Click the “Next” button.

509 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
27 . Adapt Pockets
1mm under teeth

0.2 mm Gap

Hit “Next”

510 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
28 . New Fit
The software will keep all
your festooning and tooth
setup and just refit the tissue
to the new scan.

511 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
29 . All Done
You are now done.

512 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
30 . New Denture
Now the denture fits the new
scan.

513 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
31 . All Done!
Your digital denture rebase is
finalized.

514 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 REMOVABLES

Immediate Denture

N AT U RA L T E E T H

515 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E < TABLE OF CONTENTS

 1 . Using Natural Teeth
In this example we will
virtually extract teeth and tell
exocad we want to use them
as the library teeth to wax the
case.

516 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 2 . Select Client
Select the client. Remember
all settings are tied to the
client.

517 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 3 . Enter the Patient Name
Select the client. Remember
all settings are tied to the
client.

518 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 4 . Select Distal-Most Tooth
This patient has natural
second molars so I am
selecting a second molar.

519 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 5 . Anatomic Pontic
All my immediate dentures
are monolithic. Monolithic
dentures are stronger, can be
thinner compared to split file
dentures. The disadvantage is
you need to stain the tissue
pink using products like Anax
Gum.

520 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 6 . Virtual Extraction
Select 3D print as material,
select virtual extraction as
yes for every tooth the
patient has that you want to
extract. Hit ok when done.

521 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 7 . Copy Prescription
Hold shift on the keyboard
and then select the distal
most contralateral tooth.

522 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 8 . Eliminate Connectors
Remove the connectors
because monolithic dentures
should not receive
connectors. In this color
scheme the green dots will be
clicked to be clear.

523 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 9 . Copy Mirror
Select any teeth in the
prescription that are different
such as those teeth that are
already missing. You would
unselect virtual extraction
and also have the option to
select copy mirror if you
wanted to mirror image
another tooth in that space.
Click ok when done.

524 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
10 . Orientation
Step one is to rotate the scan
to a perfect occlusal
orientation. And hit next.

525 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 11 . Skip
Skip the smile creator step
because we are literally
copying the patient teeth.

526 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 12 . Extraction
The trick to extracting teeth in
the extraction module is to
select the appropriate location
on the tooth and select the
proper indication: no copy
means tooth is extracted and
gone. Virtual preop means
tooth is extracted but visible
as a preop. You will be
required to wax using library
teeth. Direct copy means
tooth will be extracted and
used for design without
needing a library tooth. Here
we use direct copy.

527 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 13 . Extraction
Once direct copy is selected
now click the tooth indicated
in the wizard. If it is a
posterior tooth the central
groove perfectly in the
occlusal surface for best
success.

528 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 14 . Evaluate
Check to see if exocad has a
perfect tooth extracted and
copied. I am going to turn off
the color model to see better.

529 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 15 . Evaluate
Hit “F” on the keyboard to
remove the tooth and
evaluate the socket.

530 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
16 . Evaluate
You can change the
angulation of the extraction
socket by clicking the head of
the arrow and moving the
arrow.

531 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 17 . Evaluate
Select the depth of the
extraction socket. 2mm is a
safer value for immediate
dentures.

532 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 18 . Hit “Next”
Next, move on to the next
tooth. Please keep track here.
The teeth that are in the
wizard extraction tool are
based on the prescription. If
something is off and it does
not show your tooth it means
your prescription is wrong.
you could always go to expert
mode, right-click the model,
and hit extract.

533 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 19 . Repeat Extractions
Repeat the previous steps.
Click the direct copy again
then click center of the tooth.
Then hit next.

534 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
20 . Repeat Extractions
Repeat the previous steps.
Click the direct copy again
then click center of the tooth.
Then hit next.

535 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 21 . Repeat Extractions
Repeat the previous steps.
Click the direct copy again
then click center of the tooth.
Then hit next.

536 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
22 . Repeat Extractions
Repeat the previous steps.
Click the direct copy again
then click center of the tooth.
Then hit next.

537 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
23 . Repeat Extractions
For anterior teeth I like to
click the center of the facial.

538 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
24 . Evaluate
In this case exocad combined
two teeth when I clicked the
cupid it also selected the
lateral. We need to correct
this.

539 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
25 . Correct
Hit correct.

540 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
26 . Correct
Hold shift and paint the tooth
that was accidentally selected
removing all the yellow from
the tooth.

541 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
27 . Correct
Check all surface and remove
all the yellow.

542 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
28 . Apply
Hit apply to lock in the
changes and serenader the
extraction.

543 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
29 . Next
Hit next to move on to the
next tooth.

544 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
30 . Repeat
Keep working around the arch
and repeat. Hit next after the
last tooth.

545 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 31 . Copy Mirror
I selected copy mirror for
tooth 8 in the prescription
because tooth 8 is already
missing. so now I am getting
asked to copy mirror. Make
sure your teeth are visible
and then click the center of
the tooth you want to mirror.

546 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
32 . Copy Mirror
After clicking the tooth you
want to mirror then roll the
mouse over to the edentulous
space.

547 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
33 . Copy Mirror
Click the ridge to place the
tooth, then further fine tune
the placement by using left
click to drag, control left click
to rotate and shift left click to
scale.

548 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
34 . Copy Mirror
Hit next when happy with
position of the tooth.

549 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
35 . Auto Articulator
My exocad is set to go into
auto-articulation when I hit
next. To turn this feature on
go to tools-settings-add on
module-auto articulation.

550 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
36 . Static Occlusion First
Turn off your dynamic
occlusion to focus on static.
If you do not have a dynamic
here you did not have
articulator or auto
articulation on.

551 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
37 . Static Occlusion First
Go to adapt.

552 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
38 . Static Occlusion First
Hit static occlusion. 100
microns is ideal strength.
With show distances on as
the color gauge then this will
be a blue color.

553 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
39 . Static Occlusion First
All the static occlusion will
now be blue.

554 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
40 . Smooth Extraction Sockets
Before we cut the pontics to
the tissue using the basal
button we need to smooth the
model.

555 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 41 . Smooth Extraction Sockets
Enter Expert Mode.

556 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
42 . Smooth Extraction Sockets
Click the model then go to
free-form scan data.

557 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
43 . Smooth Extraction Sockets
Go to free- smooth/flatten
and then hold shift in the
keyboard and left-click the
rough areas.

558 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
44 . Smooth Extraction Sockets
Go to free- smooth/flatten
and then hold shift in the
keyboard and left-click the
rough areas.

559 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
45 . Smooth Extraction Sockets
Click ok when done.

560 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
46 . Back to Wizard
Back to wizard to finish the
adapting.

561 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
47 . Adapt
Free- Adapt- Basal. 0 is the
perfect value.

562 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
48 . Adapt
Make sure the pontics are no
longer poking through the
tissue.

563 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
49 . Adapt
Click approximal to have nice
contacts with nice
embrasures. Not as important
for a monolithic denture but I
still do it.

564 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
50 . Adapt
Focus on dynamic. Hit the
little chevron on the dynamic
icon.

565 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 51 . Adapt
Hit exclude selected parts.

566 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
52 . Adapt
Paint small dots on your
static occlusion marks and
the incisal edges of all
interior tech.

567 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
53 . Adapt
Click the dynamic occlusion
button now.

568 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
54 . Adapt
Click the dynamic occlusion
button now.

569 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
55 . Adapt
Smooth using free- smooth to
make the anatomy more
natural where it did
aggressive cuts.

570 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
56 . Adapt
Hit “next”.

571 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
57 . Design Virtual Gingiva
Select design virtual gingiva
and hit “next”.

572 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
58 . Path of Insertion
Rotate the model to the same
orientation as the denture will
be inserted. Usually a slight
facial occlusal view as shown
here and then hit “Set from
view” to change the
angulation of the blackout
model. Make sure your
setting s are aligned with the
settings chapter.

573 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
59 . Settings
Your virtual waxup bottom
settings should match this.
Then hit next

574 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
60 . Settings
Hit “next” to move on.
Exocad will create a new
model called the virtual
waxup bottom, that is the
model the denture will fit to.

575 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 61 . Single Gingiva
Hit “yes”.

576 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
62 . Draw Denture Border
Start in the hamular notch
and start marking the denture
borders.

577 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
63 . Draw Denture Border
Avoid marking the border line
too close to the edge of the
model because this can cause
a failure to merge and adapt
the tissue later.

578 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
64 . Draw Denture Border
Look where the muscle fibers
are attaching to the ridge and
place the margin at this
location.

579 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
65 . Draw Denture Border
Look where the muscle fibers
are attaching to the ridge and
place the margin at this
location.

580 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
66 . Draw Denture Border
Double click first dot to
render the tissue.

581 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
67 . Draw Denture Border
Set thickness to 1.5mm and
hit apply. Edit the border line
as needed by dragging the
green dots and hit “apply”.
Hit “next” when ready.

582 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
68 . Freeform Tissue
Anatomic small region is good
for pulling papillas into the
proper location.

583 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
69 . Freeform Tissue
Free add/remove and
smooth/flatten to finish the
tissue sculpting. I do not do
much anatomy for monolithic
dentures because they will
get painted with pink resin.
Hit “next” when done.

584 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
70 . Palatal Seal
We are all done. You should
have a solid denture now. We
only need to add the seal.

585 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 71 . Freeform
Click “Free-Form”.

586 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
72 . Freeform
Hit “Next”.

587 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
73 . Distance to Scan Data
The nearest point distance
checked.

588 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
74 . Distance to Scan Data
Change scale 0.01-1mm.

589 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
75 . Distance to Scan Data
Add tool to add the palatal
seal and border seal.

590 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
76 . Next
Hit “next” to save.

591 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
77 . Done
You are all done and ready
for printing.

592 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 REMOVABLES

Immediate Denture

LIBRARY TEETH

593 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E < TABLE OF CONTENTS

 1 . Using Library Teeth
In most instances the patient
does not want to use their old
teeth for the denture design.
In this instance I will show
you a faster tooth extraction
method that is more manual
and then smile creator to set
the arch of teeth.

594 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 2 . Select Client
Select the client. Remember
all settings are tied to the
client.

595 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 3 . Enter the Patient Name
Enter the patient name in the
text box.

596 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 4 . Select Distal-Most Tooth
This patient has natural
second molars so I am
selecting a second molar.

597 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 5 . Anatomic Pontic
All my immediate dentures
are monolithic. Monolithic
dentures are stronger, can be
thinner compared to split file
dentures. The disadvantage is
you need to stain the tissue
pink using products like Anax
Gum.

598 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 6 . No Virtual Extraction
We are not going to use the
wizard for extractions so do
not select virtual extractions.

599 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 7 . Select Pre-Op
Select preop so we can load
the working arch twice.

600 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 8 . Select Virtual Gingiva
Select virtual gingiva and hit
“OK”.

601 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 9 . Copy Prescription
Hold shift on the keyboard
and then select the distal
most contralateral tooth.

602 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 10 . Eliminate Connectors
Remove the connectors
because monolithic dentures
should not receive
connectors. In this color
scheme the green dots will be
clicked to be clear.

603 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 11 . Expert Mode
Load your scans. Remember
because we used preop in the
dental DB persecution we
need to load the working arch
twice. Turn the color off so
we can easily distinguish
between working arch and
preop. And then go to expert
mode.

604 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 12 . Edit Mesh
Turn off the antagonist and
preop and then right click the
working arch and hit edit
mesh. We are going to
manually extract the teeth.

605 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 13 . Extract Sextants
Looking straight down the
occlusal view click and circle
the teeth in sections of 4 -6
teeth at a time.

606 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 14 . Extract Sextants
Make sure you have only the
teeth in orange and no other
areas. Remember this is on
“select through” which means
you need to be carful on the
angle you select. Also hold
shift and circle to remove the
section areas to fine tune the
selection.

607 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 15 . Extract Sextants
Fine tune the mesh selection
by holding shift and
circumscribe selection areas
that may have extended too
far on the tissue.

608 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 16 . Extract Sextants
Fine tune the mesh selection
by holding shift and
circumscribe selection areas
that may have extended too
far on the tissue.

609 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 17 . Extract Sextants
It may be necessary to select
one tooth at a time.

610 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 18 . Extract Sextants
It may be necessary to select
one tooth at a time.

611 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 19 . Extract Sextants
Evaluate from all angles.

612 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
20 . Extract Sextants
Evaluate from all angles.

613 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 21 . Extract Sextants
Now hit delete on the menu
bar.

614 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 22 . Extract Sextants
Now we need to close the
hole. Do a big circle around
the hole. You need a
continuous band of orange
around the entire hole.

615 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
23 . Extract Sextants
Now hit close holes.

616 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
24 . Extract Sextants
Now hit none to clear the
section area.

617 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
25 . Extract Sextants
You should have a beautiful
closed hole. If not your
messed top your selection
area.

618 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
26 . Extract Sextants
Repeat on other teeth.

619 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
27 . Extract Sextants
Repeat on other teeth.

620 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
28 . Extract Sextants
Carefully select only the
teeth.

621 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
29 . Extract Sextants
Delete.

622 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
30 . Extract Sextants
Circle the entire hole.

623 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 31 . Extract Sextants
Close holes.

624 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
32 . Extract Sextants
Click “OK”.

625 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
33 . Jump Back to Wizard
Wizard mode.

626 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
34 . Orientation
Step one is to rotate the scan
to a perfect occlusal
orientation. And hit next.

627 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
35 . Start Smile Creator
We will use smile creator to
set the library teeth.

628 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
36 . Load Retreated Image
Hit load a retracted image
and navigate to the photo of
the patient with retractors.

629 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 37 . Load Retreated Image
Rotate the model with the
preoperative on at the same
angle the photo is made. If
you accidentally left click you
will drop alignment dots. If
you do drag them to the
appropriate locations in the
next slide.

630 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
38 . Align
Left click the photo CEJ of
patient right cupid. If you
need to move the dot click it
and drag it to fine tune.

631 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
39 . Align
Left click cusp tip of patient
left cuspid. If patient is
missing these teeth use the
closest teeth to the cuspids.
If you need to move the dot
click it and drag it to fine
tune.

632 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
40 . Align
Click same spot on preop
scan CEJ of right cuspid. If
you need to move the dot
click it and drag it to fine
tune.

633 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 41 . Align
Click same spot on preop
scan cusp top of left cuspid.
If you need to move the dot
click it and drag it to fine
tune.

634 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
42 . Next
Click same spot on preop
scan cusp top of left cuspid.
If you need to move the dot
click it and drag it to fine
tune.

635 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
43 . Fine-Tune Alignment
This frustrates people. New
AI tools make this easier but
it is still in beta so I will show
the manual way. I like to right
click the midline and hold
the right click and drag the
mouse to alter the pitch and
angle of the 3D scan in the
photo. Split the difference in
errors on the left and the
right.

636 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
44 . Fine-Tune Alignment
This frustrates people. New
AI tools make this easier but
it is still in beta so I will show
the manual way. I like to right
click the midline and hold
the right click and drag the
mouse to alter the pitch and
angle of the 3D scan in the
photo. Split the difference in
errors on the left and the
right.

637 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
45 . Fine-Tune Alignment
Once the angle is fine tuned
left click the center of a ball
and drag to fine tune
merging.

638 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
46 . Fine-Tune Alignment
Repeat on the contralateral
side.

639 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
47 . Fine-Tune Alignment
Go back to the midline and
right-click and drag to further
refine. Then click the dots
again and repeat the entire
process until everything is
perfect.

640 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
48 . Hit “Next”
Hit “next” when done.

641 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
49 . Load Smile
We now need to load a smile
photo. It is important where
making photos that the
camera and the patient head
does not move.

642 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
50 . Load Smile
Exocad will automatically
align the smile and retracted
photo. If you did a bad job
with the photos they will
never align as it is impossible
to align separate 2D photos
made at different angles. A
good alignment is indicated
by clarity in the anterior 6
teeth. Hit “next”.

643 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 51 . Mark the Lip
Mark the lip and hit next.

644 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 52 . Pupils
Drag the dots to mark the
center of the pupils and hit
next.

645 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
53 . Select Facial Midline
Drag the dot from the vertical
midline bar to desired
midline. Exocad will
automatically place this in the
middle of the pupils.

646 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
54 . 100-65-50
Change the proportion gauge
to 100-65-50.

647 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 55 . Move Proportion Gauge
Move the proportion gauge
see the vertical midline bar is
in line with the facial midline
bar. The horizontal bar on
the promotion gauge is placed
where the desired incisal
edge of the centrals.

648 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
56 . Move Proportion Gauge
Shrink the cuspid line to the
desired distal of the cupid
location. If the patient is
missing cupids then use the
alar region of the nose as a
reference.

649 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 57 . Move Smile Arc
Drag the blue smile arch to
desired location.

650 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
58 . Hit “Next”
We are now ready to load the
teeth. Hit next.

651 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
59 . Evaluate
Notice how the teeth come in
at the perfect location based
on the proportion gauge. You
may need to alter the
proclination of the teeth by
hitting the rocker bar here.

652 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
60 . Evaluate
Notice how the teeth come in
at the perfect location based
on the proportion gauge. You
may need to alter the
proclination of the teeth by
hitting the rocker bar here.

653 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 61 . Evaluate
Hit the tooth measurement
icon

654 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
62 . Evaluate
Click the central incisor and
evaluate the size. The ideal
size is around 10 to 11 mm
long and 8 to 9mm wide.

655 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
63 . Evaluate
Alter the length by clicking
the blue dot above the square
bounding box and dragging
the cervical. Notice how the
box is around all the teeth. If
not, it means that you clicked
somewhere and need to draw
a box around all the teeth by
left-clicking your mouse and
drawing a big box.

656 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
64 . Evaluate
Continue to fine tune always
moving the entire arch of
teeth if needed. I do not
move individual teeth in this
module. Hit next when done.

657 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
65 . Skip
Hit next to skip this. I do not
use this feature.

658 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
66 . Skip
Hit done to skip this. I do not
use this PDF report.

659 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
67 . Tooth Placement
Hit chain mode in tooth
placement tab.

660 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
68 . Chain Mode
Lock the central incisors by
hitting the green dot to turn it
red.

661 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
69 . Chain
Unlock the molars by clicking
the red dots to green on the
distal-most dot.

662 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
70 . Move Molars
Now click the distal most
molars and drag to the
desired location and then
lock it by turning the green
dot red. I can be helpful to
turn on the preop.

663 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 71 . Move Premolars
With the molars locked now
drag the premolars to be
near as possible to ideal
location. Then local the
premolars.

664 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 72 . Move Cupids
With the premolars locked
drag the cuspids to ideal
locations.

665 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
 73 . Advanced
We now are ready to fine tune
individual teeth and set the
initial occlusion. Click the
advanced tab.

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 74 . Advanced
Click these three buttons:

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 75 . Advanced
Move individual teeth as
needed to fine tune. Control
left click will rotate. Control
shift and left click will
stretch. Shift left click will
scale. Clicking and dragging
will move. Notice how
occlusion is automatically
equilibrated as moving the
teeth.

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 76 . Hit “Next”
Next to move onto the next
tooth. I have exocad set to
auto articulate between tooth
placement and freeform. To
set this up got to tools,
settings, add on module, auto
articulation. This mounts the
case automatically and does
dynamic movements.

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 77 . Static Occlusion First
Turn off dynamic occlusion
and focus on static occlusion
first. Use the add remove tool
to fine tune location of
contacts in static occlusion.

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 78 . Static Occlusion Adaptation
Click adapt and then static
occlusion. Set to positive 100
microns. This will be a true
blue contact if you have show
distances for your color
scale.

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79 . Approximal Adaptation
Click adapt approximal. Zero
is perfect.

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80 . Basal Adaptation
Click adapt basal. 0 is a
perfect value for this. This
cuts the pontics to the exact
tissue location.

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 81 . Dynamic Adaptation
Turn on dynamic to see
dynamic marks. We need to
adapt dynamically, but
protect our incisal edges and
static marks.

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82 . Dynamic Adaptation
Click the little chevron by the
dynamic button.

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83 . Dynamic Adaptation
Click exclude selected parts.

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84 . Dynamic Adaptation
Now paint all your static
contacts and paint the very
tips of the incisal edges of the
anterior teeth. This will make
sure exocad does not distort
these areas when we do the
auto cut.

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85 . Dynamic Adaptation
Now hit the dynamic button
to auto cut. Strength is
usually set to 0.2 or near that
value.

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86 . Dynamic Adaptation
Go to free- smooth and
smooth any areas that the
dynamic cut left rough as it
transitioned to your
protected painted zones.

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 87 . Next
Click “Next”.

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88 . Skip
exocad will always ask you if
you want to copy the preop
model any time you have a
preop model loaded in the
case. Skip this just hit “next”.

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89 . Virtual Waxup Bottom
This step determines the fit
of the immediate denture.
Rotate the model to the ideal
path of insertion. One that
minimizes block out. Then hit
set insertion from view.

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90 . Virtual Waxup Bottom
Change your settings and hit
next

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 91 . Virtual Waxup Bottom
Yes, design one gingiva.

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92 . Gingival Margin
Draw your denture border.
Avoid being too close to the
edge of the model as this will
create a failure later on.

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93 . Gingival Margin
Draw your denture border.
Avoid being too close to the
edge of the model as this will
create a failure later on. Look
where the muscle fibers
attach to the ridge.

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94 . Gingival Margin
Draw your denture border.
Avoid being too close to the
edge of the model as this will
create a failure later on. Look
where the muscle fibers
attach to the ridge.

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95 . Gingival Margin
Draw your denture border.
Avoid being too close to the
edge of the model as this will
create a failure later on.
Look where the muscle fibers
attach to the ridge. Double
click the first staring ball to
generate tissue.

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96 . Gingival Margin
You can edit the margin line if
needed by dragging the green
balls and hitting apply to
make changes. Change
thickness to 1.5mm and hit
next.

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97 . Gingival Free-Form
Use small region to stretch
papilla in any black triangle
areas.

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98 . Gingival Free-Form
Use small region to stretch
papilla in any black triangle
areas.

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99 . Gingival Free-Form
Use the Free- add remove to
festoon denture as needed.

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100 . Gingival Free-Form.
Use the Free- add remove to
festoon denture as needed.
Use tru smile to visualize
festooning. Then hit next.

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101 . Almost Done
We now have a solid
monolithic denture and we
have to edit the palate seal.

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102 . Free-Form
Click “Free-Form”.

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103 . Free-Form
Click “next”.

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104 . Distance to Scan Data
Distance to scan data as the
visualization.

697 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
105 . Change Scale
Change the scale to 0.1-1mm
or close to that as the max
and minimum.

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106 . Free
Click free- add.

699 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
107 . Add Pressure
Draw the posterior palatal
seal area.

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108 . Add Pressure
Draw the posterior palatal
seal area.

701 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
109 . Next to Save
Hit next to save.

702 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E
110 . Next to Save
You are done. The final
tenure can be found in the
project folder. Alternatively,
you can click the screen and
hit save scene as- STL-
Visible objects only-default
orientation.

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704 | e x o c a d D E N T U R E S S T E P - B Y - S T E P G U I D E