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

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This video will describe the CHROME records for a single edentulous arch with an opposing dentate arch. The edentulous arch will be the surgery arch. And as with all of our CHROME records for all the different treatment options, the checklists are found on our website under CHROME GS CHROME patient records. And on this page you’ll see a grid for all the different options. And below that, this is single. This is double arch. And then here are the actual checklists that you can print off and use them as you collect your records for each case for a surgery. The records are fairly straightforward, but they are detailed and they’re all very important. So as with all of our cases, we need photographs. We need master cast or bite, and we need a CBCT scan. And because it’s edentulous, we’ll need a dual scan. So let’s quickly go through the photographs.

Just imagine that one of these arches is a denture. And capture the photos with the teeth in occlusion, retracted, left, right, and center. This is how we ensure that we articulate the case properly. We also want these photographs, which is a full phase, full smile, a nice smile, and then an exaggerated smile. So we’re very careful about transition lines. And then if you’re working with a class one, I’m sorry, class two or class three, then maybe a profile picture if you think that would help with our setup. And then we are little picky about the full face pictures. Patients should be looking directly at the camera, not down into the right or et cetera. Other types of photographs that are not dead on looking at the camera and certainly a full smile. And then we do not need any orthodontic occlusal images at all, just teeth and occlusion.

For this particular case, we’ll need an opposing master cast. And if the opposing is going to need a denture for some reason it happens quite often. We want the full land area master cast with the palate, but otherwise we want just a nice master model. No partial impressions and very high quality. It’s very important for articulation. If the opposing arch has a partial or a flipper, then please seat that when you are capturing the records for bite registration and for the photographs, we want to make sure we have the opposing partial in place. Okay, so that’s photos, that’s records as far as intraoral scans or models. And now we have the CBCT scan. So because this is an edentulous arch, then we have to have a dual scan.

And let’s just go through this page real quick. I have an X here because we do not need any physical impressions of the denture arch. All we need is a dual scan of that arch. And you can see there are stickers here. These are radiopaque markers that you can purchase from us, and you’ll stick them on the denture. And you can put them anywhere except the intaglio. You can put ’em on the teeth, on the palate. Obviously don’t put ’em on the occlusion because we need the patient to be able to bite. So place the stickers and you’ll perform what’s called a dual scan. And this image here is just showing what we do with that dual scan. We’ll actually print the denture, we’ll mount it with your bite with the opposing. And so we do use the physical properties of that denture as well. What that means is that we need a denture that fits very well with no movement. If a reline is needed, you can perform a hard reline or you can use a mousse material.

You can use green mousse or blue mousse, and you can load that denture and you can seat it. And that will give us the patient’s tissue and it’ll have a nice fit and it’ll show up on the CT. That’s the most important part of using this blue mousse material. Soft tree lines p vs. Other materials, bite materials, they will not show up and we can’t see ’em, so they look like a void. So always use the mousse. Tooth position should be ideal and put must should be ideal, should be very close to what you want. If it’s a little bit off, we can make changes. We’re very good at redoing setups. And then you must have the markers. If the markers aren’t there, we’ll be calling and asking for another scan, and it must be in occlusion. I’ll show that in just a minute. And we can work with an opposing digital, although we prefer to have analog model shipped in with a physical bite that helps us do our job more accurately.

When you take the CBCT scan, have some repeated notes here, but the denture must be seated fully and it must be in occlusion. I do not separate the arches with cotton rolls or a stick or a bite fork from the scanner. In occlusion, this is a scan appliance. This is a denture. You don’t see the markers here. They’re on the occlusion or they’re on the tongue side, but in occlusion. And that kind of covers that particular part of the records. And then you’ll notice here that this is a, let me just change the title of this, dual scan single arch. And the two scans that you’re going to take are denture by itself and denture in the mouth. So this scan is of the denture just sitting on a piece of foam in the scanner. Make sure you can see the entire denture doesn’t get cut off.

Maybe your scanner has a preview. Or after you take the scan, make sure that it doesn’t have the teeth or any of it cut off. And then the other scan is of the patient wearing the denture, fully seated teeth together. So those are the two scans. This scan here is just simply showing that the markers are going to show up on this scan here. Okay? You may not see the denture, that’s okay. You’ll see the markers, you’ll see the patient. You’ve captured a dual scan. All right, just another image of where the markers are. There’s actually six on this. There’s just one here, one here, one here, and then three on the tongue side. Then you’ll need to export two sets of files. And so you’ll scan the denture by itself and then you’ll scan the denture seated. Name the two folders lower and name them lower patient and lower appliance.

In this case, it’s obviously a lower, but you’re going to have two scans. So you’re going to export both of these and then we want to zip them. But the first thing you’ll do is go inside the file and check, go inside the folder. Let me change the view to a list view. There were 206 scans in this case. So that scan looks good. And then the appliance by itself, there were 211, but they’re multi file, right? Not a single file. These are multi file single scans, and that’s very important. It has to be multi file. And then what you can do here is you can zip the folders. You’ll have to zip them in order to upload. So you can either put these in one master folder, CBCT scan folder, or you can zip them individually, but you’ll right click send to compressed zipped folder.

That is how you zip. And then just click it. And then you’ll see this compressing popup arise, and it’s taking all the files and is putting in a new folder that you’ll notice has a little zipper on it there. So this folder shows up. So this folder and this folder, they’re both named the same, but this one has a zipper. And this is what you will drag and drop into our portal to upload. And you’ll do the same thing with the appliance scan. So you’ll have two zipped folders, drag and drop ’em into our portal. And then we have the files necessary to get started on the case.

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