CHROME Records for single arch case: Dentate surgical arch, with opposing Dentate

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This video will explain the CHROME records for a single arch dentate surgery with an opposing dentate arch. As with all of our CHROME surgeries, we offer records for the particular treatment option. In this case, it’ll be a single dentate surgery. So the surgery will be just on one arch, but the patient has an opposing, has opposing natural dentition. So the records are very straightforward. The records are photographs, very particular photographs, master cast, and a bite registration or a scan if you have a digital impression scanner and a CBCT scan. Those are the only three records necessary. There are details that are very important with each of these records and let’s go through them in this quick video.

The photographs, we would like a full face, full smile photo. Please have the patient smile with their normal smile so that we can see how the teeth interact with the lips. We’d also like to see an exaggerated smile, not not retracted, but just exaggerated so that we do not have any issues with the transition line between the prosthetic and the gums. We would also like a profile picture. This one is really optional and it’s if the patient has class two, class three, has some issues that we’re going to try to change with tooth position, and then we always have to have retracted pictures in occlusion, Center. Left right. These are a little out of focus. We’d like to see them more in focus, but in order to case analyze, we want to make sure that we have the correct bite registration on the articulator. And this is how we do it. We confirm it with the photographs. We do not need occlusal records. We do not need any ortho photographs, and certainly we don’t want photos where a patient has a more of a sedate smile. Or you can see in this picture the nose is tipped down. The patient’s looking a little bit to his right. We want the photo straight on. Try to get the lens right in the middle of the nose, and a big smile for that photograph.

The master casts. The master casts are very important. They are what help us set the stage for case analysis and for the surgery to make sure the pin guide fits. So please always capture the full anatomy, all the landmarks, we can’t use any quadrant impressions and impressions that don’t include land areas. And then of course, just make sure that they are pristine, don’t have bubbles and voids, that type of thing. If you have digital impressions, please use that scanner. If your scanner will capture a full pallet and we’ll scan the vestibule, use your iOS. If that is a challenge, then please capture alginates or P vs. If it’s alginates, pour them up yourself, send them in. But you can see on these samples here that all the land areas are captured. Here’s just a little example of an STL file that was sent in recently, and all of the land areas, you can see the full vestibule, the full roll on a single arch or on CHROME the pin guide often goes down into the vestibule and we don’t want to have to guess how deep the vestibule is. And we also on the maxillary, want to make sure you capture the full pallet so that if you want to order a backup denture, we can fabricate one that is just right for the case. So all the land areas. If the patient has a partial or a flipper that is helping to maintain the bite or is giving us an idea of where the anterior teeth should be, then capture a study model with the partial seated and then a scan or an impression without the partial. So two different impressions for partial patients. If the opposing dentate arch has a partial, then just one impression of that so that we have the opposing full dentition to get the bite. And then the CBCT scan that you capture is without the appliances in the mouth. Very important. They need to be out. Those are the physical records.

And then the CBCT scan. Now if you have a full field of view scan where you scan the entire head, send it in, that’s fine. If you have a smaller field of view, then you can see the maxillary will include some of the lower teeth all the way up to the sinus. And the mandibular will have all the teeth. You could even include some of the opposing teeth all the way down to the chin. Those are our fields of view. Also, notice that the teeth are separated in a dentate patient. We never want them together. We cannot separate these, and we must have them separate in order to bring in the models to register the models. So teeth open, and if this means the patient is biting on cotton rolls or if they’re biting on some other type of video lucent material, that’s fine. But most CT scanners have a bite fork. The patient can just bite on the bite fork and then stay open.

And lastly you’ll need to export the DICOM from the CBCT scanner. And once you export the file, you’ll export it to a folder that you can find. And in this case, there’s a patient Cook, found the folder, and then we’ll need to create a zipped. And to create a zip folder, you’ll right click on the folder that’s been exported. Well first go inside the video, inside the folder and double check to make sure that you have multi file. You can see there’s 511 files here. And we’re looking at this in a list view. There’s other ways to look at this at this. There could be a detailed view, there could be a thumbnail view, even a large thumbnail view, but you’ll see that it’s multi file, many different files. That’s really important as opposed to just one file. So go back up to the master folder that you exported and then we’ll zip.

So you right click on the folder. Here we go. Right click drop down to send two compressed zipped folder. And all systems will say the same thing, all computers. And then yet now you’ll see that it’s compressing, well, it’s creating another folder, but inside that folder, it’s going to compress each one of these files. You can see it’s going through one at a time. You can’t see the folder yet, but when this is finished, you’ll see a folder right next to the original folder, patient Cook with a little zipper on it, and we’ll do a little fast forwarding here to get to the end. All right, 511 folder files, DCM files inside the folder, and then here it is. So now this is a second folder. This is a zipped folder that you will use to drag and drop into our portal so that you’re sending us a CBCT scan. And those are the CHROME records for a single arch dentate with an opposing dentate.


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