if you need more geometry so that you can work at a higher resolution you can subdivide.
if the flow of the geometry is making it difficult to sculpt the shapes that you want you can use zremesh or sculptris or dynamesh. Sculptris and dynamesh or more suitable for while you are working in zbrush and just "shaping the clay", whereas zremesher attempts to make a game style topology (all quads, equidistant and flowing with the contours of the model).
So usually people are using zremesher as part of a retopology process. it might do all the work for you or just some of it and then you do some manual fixing afterwards.
to understand what each of these things does turn on the wireframe view when running the tool and you'll see what is happening. I think the default hotkey for that is either shift+F or ctrl+F.
In order to know what tools to use you have to know what is being made, why it is being made, where you are at now, etc.
Zremesher would take forever on subdivided mesh like several mil one. And usually you never get it right from first attempt. Still it's a simple way to get even quads before subdividing. It does it slightly more clever than Dynamesh. So yeah > Import or free sculpt with sculptris and booleans in mid res >zremesh> export> fix edge flow and UNWRAP >back import > subdivide and sculpt details.
btw 3dmax does have a nice remesher too. Zremesher wouldn't cope well with sharp things like sword blade . Probably not the best one currently but still pretty nice with detecting hard edges with "detect edges" button on. Blender re-mesher is still quite a lot behind.
https://exoside.com/ this oNE is same as Zremesher basically but a bit more convenient imo
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