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From R17 onwards, you may use Tetrahedrons / Patch Conforming Method only to create a tetrahedral mesh, whatever its complexity. In previous versions, Patch Independent Method was an alternative to mesh more complex geometries, when manual or Virtual Topology cleanup were not an acceptable or practical solution to prepare the mesh. But the main shortcomings of the Patch Independent method remain its lack of topology control (no mesh on surfaces) and its relatively poor RAM efficiency (leading to a slower mesh generation). In latest versions, the cleanup capabilities have been improved in Workbench Meshing (for both local and global controls, for example with defeaturing). Therefore, these capabilities can be used in combination with the Patch Conforming method to perform tetra meshes, even if the geometry is not cleaned enough after import.