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

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This video will show the records for a CHROME single arch edentulous surgery against an opposing denture patient. So as with all of our records, all of the different patient situations, we have a checklist and the checklist is found on the CHROME GS page of our website. Scroll down, CHROME patient records. And we’re going to discuss the last one in the column here. Single arch edentulous with an opposing edentulous arch or a denture. So let’s go through the records. The records are very straightforward for an edentulous case, but there is some important things that we like to have for CHROME. So we always want to have the photographs. We always want to have master casts or and bites, and we want to have a CBCT scan. And since it’s edentulous, it’ll be a dual scan and we’ll explain that below. The first thing is the photographs.

We always want a full face, full smile photo. We could also have a profile picture if we have a class two or class three situation for lip support. And then we want retracted in occlusion left, right, and center. So straight on picture, we want to see how these teeth come together. All right, and it’s just these four photographs and perhaps a profile picture. The opposing right, the working side is an edentulous denture, but the opposing is also a denture, but we don’t need a CT scan of it. We don’t need a scan of the entire denture. We just need a scan of the occlusion. So here is that case, and the doctor just simply held the denture in the fingers and scan the occlusion. And that’s really all we need. If you don’t have a digital impression machine, just take a polyvinyl impression of the denture and send it in. Or if you happen to have a denture duplicator, that’s fine too, but we really just need the teeth. Okay, so that’s the opposing.

Now we have photos. We have the, really the only physical record, which is the opposing denture, and then a bite registration, physical bite registration. And that’s important with this case, we don’t want a digital bite, we want a physical bite mailed to us so that we can articulate the case as in here. So we’re going to articulate the case. The opposing is either printed or it’s a stone cast. What we do not need is an impression of the working side. No, we don’t need an impression of the tissue of the denture or anything. All we need is a CT scan of the denture with markers in a dual scan. We’ll talk about the dual scan in just a minute. So the important thing about the working side is that the denture fits very well. No movement. If a reline is needed, then perform a hard reline. Never a soft. A soft does not show up in the CT scan. And we want the teeth positions to be near ideal. That helps. We can do a lot with our software to manipulate teeth and create a new tooth position. But we like to be close. And if you need to do a reline but don’t really want to do a hard reline, you can also use green mousse. You can use blue mousse. Just load the denture up and seat it as if you’re doing a reline impression.

And then the opposing is just, so we talked about a bite, bite model, a bite and a model or a digital works. But we have to have an analog bite. And when you prepare your denture or a scan appliance, but if the patient has a denture, used a denture, put six markers, there’s six markers on here on the tongue side or on the buckles of the teeth. Never the intaglio. Never the occlusal. We want to keep them off the occlusion because we’re going to perform a dual scan technique. Another technique is to use gutta-percha markers. If you don’t have the scan scan flags.

Alright, so now the dual scan. The dual scan is performed with the denture seated of course. And in occlusion, we always want the teeth together. So here’s a scan appliance. Here’s a denture. Teeth are together always, every single time in a scan. And then the patient biting. You don’t have to bite down hard, but you want to bite firmly, fairly firmly. And then put the chin on the chin rests. So the patient should, patient should not have the bite fork or any other thing separate the teeth. Teeth together, reiterated. And the scans that you’ll see are two scans you’ll scan. Once with the patient wearing the denture, you can see the markers are showing up here. The denture, you won’t see the denture, but you will see the radiopaque markers and then the denture alone by itself sitting on a piece of foam. Now maybe you’ll see the denture in your scanner. Maybe you’ll only see a little halo of it, but you’ll see the same six markers down here. When you scan the appliance, make sure nothing is cut off. We must see the full denture. And here again just the markers. And this is three, but there are some markers on the buckle parts of the denture as well. So this is the dual scan.

And then once you have your dual scan complete, 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 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, 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 pop-up arise and it’s taking all the files and it’s putting in a new folder that you’ll notice has a little zipper on it. 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 them into our portal, and then we have the files necessary to get started on the case.

That is the video for an edentulous single arch with an opposing denture.

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