CHROME Patient Records

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The #1 reason for delayed cases is incomplete or poor patient records!

Accurate and detailed patient records are essential to starting a CHROME GuidedSMILE case properly. This page will detail the necessary records for all patient types. Read this page thoroughly and if you have any questions please call us – 800-763-7821.

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Single Arch Patient Cases

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Double Arch Patient Cases

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Videos

Edentulous – Opp Dentate (Single)
Edentulous – Opp Edentulous (Single)
Dentate – Opp Dentate (Single)
Dentate – Opp Edentulous (Single)
Double Edentulous Arches (Double)
Dentate – Opp Edentulous (Double)
Double Dentate Arches (Double)

How to Capture the Necessary CHROME Patient Records

1. CHROME Photographs

Good CHROME photos

  • Full face full smile
  • Full face exaggerated smile
  • Full face profile
  • Center retracted in occlusion
  • Left retracted in occlusion
  • Right retracted in occlusion
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2. Master Casts / Impressions

Good master casts/impressions

  • Capture full palate
  • Capture most/all of the surrounding labial & lingual tissues, the vibrating line, the full roll
  • Are free of noticable holes, skips, voids, or bubbles

Helpful Guidelines

  • Most CHROME cases use a backup denture; please capture as much anatomy as you would for an immediate full denture.
  • It can be challenging to reach the entire vestibule with an IO scanner, but please try to capture as much of the palate as possible.
  • If there is distortion, please retake the impression. It is best to catch inaccuracies at the office.

Bad master casts/impressions
Master casts or impressions that do not meet the required coverage for the patient scenario, have distortion, or have defects such as holes, drags, bubbles, or voids cannot be used. It’s important to carefully review the record checklist for specific requirements and ensure that the master casts or impressions meet these standards to ensure the success of the procedure.

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3. Bite Registration

Good bite registrations

  • Capture full occlusion or CR bite.
  • Taken with the patient in a closed bite, in natural occlusion.
  • Taken with the patient’s prosthesis in mouth, if applicable.

Helpful Guidelines

  • Use enough material to capture the occlusion, but not too much as to open the bite.
  • Neuromuscular bites are accepted as well; these are often the best, most accurate bites.
  • If the patient is missing posterior stops, we recommend bite blocks or a JC Try-In. A JC Try-In appliance will stabilize the bite and help establish occlusion.


Bad bite registrations

We cannot use bite registrations that:

  • Only capture a narrow centric occlusion.
  • Used too much material, which separated the bite.
  • Were not captured with teeth in natural occlusion.
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Scanning Videos
4. CBCT Scans
Dentate

Good dentate CBCT scans

  • Capture both arches.
  • Taken with the patient in an OPEN position.
  • Taken with the patient’s denture(s) out of the mouth, if applicable.

Helpful Guidelines

  • Have the patient bite on cotton rolls or the bite fork.
  • Place cotton rolls between cheeks and teeth for a better image.
  • If the field of view only allows one arch, send two individual scans of each arch.
  • Export DICOM files (.dcm) from the CBCT into a patient folder- this should contain 200-400 individual .dcm files. Zip the patient folder and upload with Rx

Bad dentate CBCT scans:

We cannot use dentate CBCT scans that:

  • Captured the patient in a closed position.
  • Captured the patient with their denture(s) in the mouth.
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Edentulous

Good edentulous CBCT scans:

  • Follow a dual scan protocol.
  • Use the patient’s well-fitting denture or scan appliance in the mouth during the scan.
  • Capture a scan of the patient with their denture(s) in the mouth, in occlusion, not separated.
  • Capture a scan of the denture(s) alone resting on foam.

Helpful Guidelines

  • If the patient has a good denture: Prepare by placing 6 scan markers (www.suremark.com)
    or 6 gutta-percha markers randomly in the pink area of the labial flanges.
  • If the patient has a poor denture: Either fabricate a new denture, perform a hard reline, or
    place blue mousse inside the denture to stabilize it. Soft relines are NOT acceptable.
  • If the patient does not have a denture: A new denture or scan appliance must be fabricated.
  • The scan must include the patient from the chin up to the nasal cavity.
  • Do not scan the patient alone without their denture.
  • Export DICOM files (.dcm) from the CBCT into a patient folder- this should contain 200-400 individual .dcm files. Zip the patient folder and upload with Rx.

Bad edentulous CBCT scans

We cannot use edentulous CBCT scans that:

  • Captured the patient without their denture in the mouth.
  • Captured the patient with their denture not fully seated against the tissue.
  • Used a poorly-fitting denture for the scan.
  • Used a denture with a soft reline for the scan.
  • Captured the extraoral denture scan not on foam, but plastic or metal.
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