CHROME 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 throughly and if you have any questions please call us
This page contains information on the following record aspects:
Patients Records Checklist
Click the appropriate patient scenario to see appropriate record requirements.
- Photographs – Full face full smile photo, plus profile photo if Class II or III. Retracted photographs front, left side, right side IN occlusion, see below.
We suggest capturing photos before taking impressions to keep the lips and teeth clean.
- Prepare Denture – Use existing denture as dual scan appliance. If patient does not have existing denture(s), fabricate new dentures to completion.
If existing dentures are far from ideal, and teeth are not in the proper position, fabricate new dentures.
- Denture rules:
- Dentures must fit perfectly to the tissue and exhibit ideal tooth position.
- NO soft relines. Must complete hard reline(s) if fit is not ideal, or reline with Blue Mousse impression material for the dual scan described below.
- Place 6 scan markers on each denture (www.suremark.com) or place 6 random gutta percha markers in the pink area of the labial flanges.
- 3 CBCT Scans – Must follow the Dual Scan Technique
- Scan of the maxillary denture alone resting on foam or similar.
- Scan of the mandibular denture alone resting on foam or similar.
- Scan of BOTH dentures, in the mouth, in occlusion, not separated, and ensure the scan includes the patient from the chin up to the nasal cavity.
- Bite registration – Suggestion: 3 small bites to tripod the bite registration rather than full arch bite.
Step One – Design Ideal Denture or modify existing
You may use the patient’s existing denture if the criteria below can be met. If not, duplicate the denture in clear acrylic and adjust as necessary.
- Teeth are proper size, shape & length
- Occlusion and vertical dimension are properly established
- No metal components
- Sufficient thickness (2.5 – 3mm)
- Buccal flanges of sufficient length for scan markers / support anchor pins
- Excellent fit to soft tissue
- Hard reline only‐no soft reline
- No radio-opaque components or coating (no barium sulfate)
Step Two – Fully Edentulous
Order SureMarks (www.suremark.com) or add gutta percha markers
- 6 gutta percha markers
- Place half lingual and half buccal
- Place on varying horizontal planes
- Place on flange, below gingival plane of the teeth
- Use a #6 or #8 round bur to a depth of 1mm. Keep markers spherical in shape, no larger than illustrated.
- Fill flush with gutta percha
Step Three – Partially Edentulous
Order SureMarks (www.suremark.com) or add gutta percha markers. If the patient is missing many teeth, has metal‐based restorations on most of the teeth, or the bite is being opened more than 2mm, order a Scan Appliance.
- Send models and a bite to DLA with instructions on implant placement and future restorations
- Doctor receives scan appliance, seats and adjusts if there is a rock or ill fit (must fit with NO rock)
- Perform dual scan protocol
Patient CBCT Scan Instructions—Dual Scan Protocol
1st scan appliance in the mouth 2nd scan appliance alone
- Seat appliance(s) and ensure fit with no rocking—if there is a rock, hard reline or adjust until good seating (NO soft relines ever)
- Fully Edentulous scan appliance—important to bite IN OCCLUSION with No space between the opposing! No bite material, no cotton rolls.
- Partially Edentulous scan appliance—important to place bilateral cotton rolls and capture the CT
- Bite with medium pressure and do not move
- Scan appliance by itself sitting on any type of foam or scan table that is NOT plastic. Must sit above plastic scan table!