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This video tutorial from exocad shows you how to use the "Virtual Waxup", "Virtual Gingiva", "Cutback Library" and "Multi-level Cutback" feature.

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These four new features are demonstrated on one single demo sample called

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"Screw retained implant Bridge with virtual gingiva design".

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Starting with exocad version 2016, for some restoration types there are a new options available.

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Let's have a look at the reduced waxup restoration type.

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For all waxup restoration types you will find the new dropdown field "Scan waxup?".

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When choosing "Yes", you have to scan a waxup or import a waxup scan as usual.

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Selecting the option "No, design waxup digitally" results in a different workflow where you design a virtual waxup first.

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Furthermore you will find another new dropdown field for all waxup and crown restoration types called "Virtual gingiva design mode"

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You can choose between three different options.

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"No" means that a virtual gingiva can only be designed in expert mode.

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The default mode "Optional" means that you will be prompted in the wizard to decide.

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"Mandatory" means that the gingiva design dialog will appear automatically.

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Let's choose "Optional" as this allows us to make this decision later.

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The same options are also available for pontics.

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Please note that you can design one virtual gingiva for the whole restoration or separate gingivas for single teeth.

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Separate gingivas on single teeth can only be designed in expert mode by selecting the tooth first.

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Let's proceed with the design.

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If not required, you can skip the emergence profile step and proceed to the next step,

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which is the tooth placement.

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Make sure that you use the correct tooth library. Only exocad's "generic" library includes the cutback libraries.

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Why not use the "Chain Mode" for the tooth placement?

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You will find more information about the chain mode in a separate video tutorial.

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It is a very nice tool to design full arch setups.

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To save time, let's do a quick setup by using the chain mode.

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It might not look perfect, but as the chain mode is not the subject of this tutorial, perfect tooth placement is not important.

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Certainly you know that very often on this kind of implant restorations, the implants are situated between two teeth.

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You can see this right here.

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Well, that's a perfect case for the virtual waxup feature.

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It supports all kinds of designs, no matter the implant positions.

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Proceed to the next step.

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We can skip the "Generate Abutment Bottoms" step, too, as we did not define any emergence profile border at the beginning.

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In the first free-forming step, there is one important thing to know in case you decide later to use one of the cutback libraries.

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If you pull parts from the anatomical tooth or if you add material, this change will not be applied to the cutback design later.

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On the contrary, removing material or pushing parts into the design is possible and will be applied to the cutback design.

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This will become more clear later in this tutorial when you see the result.

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Just keep in mind that we have added material on tooth 16 and removed material on tooth 26.

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You can adapt the pontics to the gingiva and the approximal contacts,

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but if you choose to do a virtual waxup, that is not really essential

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as approximal intersections will be deleted automatically and the basal area on the entire virtual waxup will be adapted to the gingiva later.

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Now you are prompted if you'd like to do a gingiva design or not. That's because we have selected "Optional" in the DentalDB at the beginning.

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Let's start without gingiva, just to demonstrate only the "Virtual waxup" feature.

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I will show the virtual gingiva later in this tutorial.

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Proceed to the "Shrinking" step.

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Starting with exocad version 2016, there are two new features available in the "Shrinking" dialog:

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The "Cutback Design Library" and the "Multi-level Cutback" feature.

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In this first sample case I'd like to start with the
"Multi-level Cutback" feature.

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Let's play with it a little.

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Choose for example a low value for the shrinking depth,

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and choose 25 percent less shrink on the lingual side to the anteriors.

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Click "Apply" to start shrinking with the selected parameters.

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The "Multi-level Cutback" feature will thus allow us to shrink again the shrunk restoration,

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with an unlimited number of shrinking operations.

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This opens up a multitude of new ways to design a reduced restoration.

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Here you can see that the anteriors have only been shrunk very slightly on the lingual side.

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This helps us to keep the core shape of the anteriors.

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Now we could, for example, perform an additional global shrinking with a value of 0.5 mm on the entire tooth.

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To do this, define your parameters for the second operation.

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Click "Multi-level Cutback",

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and check "Re-shrink reduced shape".

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Then click "Apply" to start the additional operation.

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The advantage here is that the second shrinking operation will smooth the area between the less shrunk lingual side and the buccal side.

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As I already mentioned, this opens up many ways in the shrinking step and certainly every user will find their own different ways and other reasons to use it.

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You could even choose "Exclude selected parts" and mark areas to be excluded from a first, second, or third shrinking operation.

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Before we proceed to the next step, I'd like to show you the "Advanced parameters".

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Here you can change the minimum thickness.

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Changing the "Bottom shrink depth" allows you to specify a different shrink depth for the bottom.

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Proceed to the next step.

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The second free-forming step allows you to free-form the reduced parts,

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or to adapt the restoration to the antagonist, the gingiva, and the adjacent teeth.

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The free-forming step will be explained in detail in a separate video tutorial.

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To save time, we skip this step as a perfect design is not the subject of this tutorial.

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The next step is the "Connectors" step.

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This step will be explained in a separate video tutorial,

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so I'll just make some small adjustments on the connectors.

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This is not how I'm used to doing a design,

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but it's a perfect example to demonstrate that the virtual waxup supports any kind of design,

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especially between tooth 22 and 23.

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The software generates a virtual waxup, no matter how the design looks,

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and where the implants are situated or where pontics and reduced crowns have been defined in the DentalDB.

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Note that this step may take some time, as several operations need to be computed.

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Once the virtual waxup base has been generated, you can click "Next" to proceed.

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In this free-forming step, you can perform free-forming as you are used to doing on merged restorations

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where smoothing and melting in the areas between elements is possible, too.

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Proceed to the last step,

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which is the screw hole design.

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By default, the screw holes are activated and snapped to the anatomy.

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Certainly you can switch them off.

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But keeping them activated might be an advantage, as with the freedom in virtual waxup, you can possibly create very thin areas around the screw holes.

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You can decide where you want the screw holes to be snapped to, either to the anatomy, or to the framework.

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The framework option provides at least a certain protection against sharp and thin edges,

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as it can be used to create a minimum border thickness around the screw holes.

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Let's finish and have a look at the result.

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Here you can see how the screw hole design creates a nice border around the screw holes.

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Difficult implant positions between teeth are no 
problem for the software.

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Let's go back and have a look at the virtual gingiva and cutback libraries.

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Let's restart the same case in the dialog where you are prompted to decide if you'd like to do a gingiva.

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This time, we will choose to do a virtual gingiva.

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You can change the gingiva's bottom properties.

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"Offset" creates a gap between the jaw scan and the gingiva bottom.

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"Smoothing" fills out edgy cavities.

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"Milling diameter" adds a tool radius compensation for the tool used to mill the gingiva area.

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If the checkbox "Include gingiva scan" is activated, the additional scan will be included in blocking out.

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If it is not checked, only the jaw scan will be blocked out.

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Before you start blocking out, you can choose an insertion direction, which is by default the average of the different implant angulations.

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On cement-retained restorations, it is by default the insertion direction of the bridge/crowns.

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You can also set the view parallel to the insertion direction.

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Set the insertion from view.

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To verify, set the view from the insertion direction.

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Then click "Apply" to start blocking out.

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The light-blue mesh displays the blocked-out surface.

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You can still change the parameters and apply again by clicking "Update".

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You can also clear and reset the settings.

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Use "Free-forming" if you desire to manually block out certain areas.

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Here you can add and remove material, as you are used to doing it in free-forming.

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Note that removing material is only possible on blocked out undercuts and might recreate undercuts.

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The depth of the undercuts will be visualized with a color scale.

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When you are done, proceed to the next step.

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The wizard will prompt you to draw the gingiva margin line.

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It is exactly the same margin draw mode as for the margin line of crowns and copings.

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Add as many points as required to design the border of your gingiva area.

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Finish drawing the margin line with a double-click.

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You can still do corrections on the margin line.

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Add points with the left-mouse button and remove points with left- and the right-mouse button.

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Apply again to recompute the changes.

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The gingiva design shape can be influenced using several parameters.

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You can change the thickness of the base,

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the cervical border thickness around the teeth,

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and smoothing of the surface.

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You must confirm each adjustment of parameters or margin with "Apply".

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As you can see here, different parameters will result in a different design.

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But I will recompute the gingiva with the default settings,

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as these give really good results.

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You can also use the "Clear" button to clear the margin and restart from scratch.

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When you are done, proceed to the next step.

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The gingiva free-forming tool differs slightly from the known free-forming tool for crowns and bridges.

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The "Anatomical" free-forming mode only provides two different options.

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The default "small region" option allows you to move smaller parts of the gingiva,

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whereas "huge region" allows you to move major areas.

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When moving bigger areas, bottom and boundaries are fixed by default.

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If you uncheck this option,

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the boundaries and bottom will also be moved.

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The desired thickness of the gingiva will be maintained only when morphing parts of the gingiva.

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As you can see here, a thickness of 1 mm will only be regenerated in the morphed area.

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Note that only changing this thickness value will not recompute the entire gingiva thickness.

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Furthermore, the thickness can be visualized with an adjustable color scale.

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Now, click on the "Free" tab to access the virtual wax knife.

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This tool behaves exactly the same as in the known free-forming mode

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where you can add, remove, or smooth material with different brush types adjustable in size and strength.

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This tool can be used for the final touches.

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Now, proceed to the next step.

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In the first part of this tutorial I already introduced two features in the shrinking dialog.

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Now I want to show you the "Cutback design library" 
feature.

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In this tutorial I only want to talk about the cutback libraries.

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"Retentions" and "thimble" will be shown in a separate tutorial.

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There are two different cutback libraries:

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"facial-ridges"

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and "incisal-ridges".

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Let's start with facial ridges.

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These will "reduce" the tooth with ridges on the facial side where the incisal edge remains untouched.

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The "incisal-ridges" affect the facial and incisal side.

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As you may remember, we have added material on tooth 16 and removed material on tooth 26 during free-forming at the beginning of this tutorial.

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Now you can see that the cutback libraries are not able to adjust automatically to the shape with the added material.

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But the cutback libraries will be cropped automatically where we removed material

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when you click "Apply".

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Here you can see how tooth 26 is cropped.

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Let's compare both teeth again.

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For tooth 16, the free-forming changes are not applied.

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Tooth 26 has been cropped correctly.

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That's why I recommend not to use free-forming on anatomical teeth, or to remove material only.

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Again, you can use all the known free-forming options.

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If you want to work with cutback libraries, the best way is just to do the tooth placement and to do fine-tweaking using free-forming here in this step.

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Before you proceed to the next step you can decide if you want to reduce the gingiva.

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This additional step is only available in expert mode.

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Click "Shrink Gingiva Design Part" in the expert frame.

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Then enter the desired depth of shrinking.

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By default, the option "Auto select gingiva" is active.

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This option automatically excludes the frame's lingual part and the frame's intersecting parts with the teeth from being shrunk.

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Let's hide a tooth to show this excluded part in the tooth area.

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Of course you can deactivate this option and/or clear all brushed areas to shrink the entire ginigva,

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if you want to brush areas manually.

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Remember, the brush size can be adjusted using Shift and the mouse wheel.

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Brush with the left-mouse button and toggle the brush with Shift and the left-mouse button.

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If you activate "Auto select gingiva" again, only the intersections between teeth and gingiva will be brushed automatically.

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Click "Select all around" to get back to the initial default situation where the lingual part of the frame and it's intersecting areas with the teeth are brushed.

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You can adjust the thickness of the blue border surrounding the teeth by changing the "Vestibular height" value.

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There are two additional options in the "Preserve area around teeth" dialog:

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"Always exclude parts inside teeth" means that areas inside the intersection between teeth and gingiva will never be reduced, even if they are not brushed.

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"Preserve gingiva around teeth" means that shrinking will try to avoid going inside the tooth surface, even if this area is not brushed.

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In this case, some teeth intersect with the basal area of the gingiva.

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That's the reason why this areas are also brushed automatically.

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This can be corrected manually,

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or can be avoided with a correct tooth placement or adaptation.

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As in the tooth shrinking step, the "Shrink Gingiva" feature also provides "Multi-level Cutback",

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and advanced parameters.

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I already explained those features earlier.

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Click "Apply" to start the gingiva shrinking process.

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Then click "OK" to close the dialog.

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Note that in expert mode you are even allowed to still change the position of the cutback teeth.

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This can be used to do some fine-tweaking if required.

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But this should better be done before you shrink the gingiva, because now the gingiva design in the tooth areas does not surround them any more.

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Let's undo and close that step.

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If required, you can again free-form the gingiva right here in expert mode, even if the gingiva has already been shrunk.

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Let's restart the wizard.

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We are now back in the free-forming dialog, which I already have explained before.

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00:25:03,100 --> 00:25:06,700
Proceed to the next step, which will be the connectors step.

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00:25:07,400 --> 00:25:13,500
I am sure most of you are already familiar with this step, that's why I won't explain in detail.

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The connectors step will be explained in a separate video tutorial.

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00:25:18,300 --> 00:25:24,700
I just want to explain the two cross sections shapes that might be useful for this kind of restoration.

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The "tooth to tooth" connector shape joins tooth shapes directly by using the existing tooth geometry.

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00:25:34,700 --> 00:25:40,300
By default, this connector shape ignores the minimum cross section area.

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00:25:40,300 --> 00:25:50,933


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You can also delete all connectors, as for this virtual waxup with gingiva all the teeth are connected by the gingiva.

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Proceeed to the next step, the creation of the "virtual waxup".

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Note that this step might take some time, as several operations need to be computed.

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When the virtual waxup has been generated, you can click "Next" to proceed.

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334
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In this free-forming step you can free-form the merged restorations as usual.

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Smoothing and melting in areas between elements is possible, too.

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338
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This can also be used to adapt the whole frame to the gingiva again, if required.

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00:27:22,000 --> 00:27:40,100


340
00:27:40,100 --> 00:27:43,433
Proceed to the next step,

341
00:27:43,433 --> 00:27:44,733


342
00:27:44,733 --> 00:27:47,199
which is the screw hole design.

343
00:27:47,200 --> 00:27:47,233


344
00:27:47,233 --> 00:27:53,099
I already explained the advantages of the screw hole design in the first part of this tutorial.

345
00:27:53,100 --> 00:27:55,100


346
00:27:55,100 --> 00:27:59,433
This time I will switch them off to show you the difference.

347
00:27:59,433 --> 00:28:02,033
Proceed to the last step.

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Thank you for watching this video.