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Surgical Guide Decision Tree

Whether you are restoring a single implant-supported crown, a bridge, hybrid, overdenture, or GuidedSMILE or guided All-ON-4 type case, the decision tree below will walk you through the steps of collecting records.

Important CBCT Scanning Tips

Dentate – Always separate the arches with cotton rolls, bite stick or CT equipment bite fork for the scans. NEVER in occlusion! If the patient has MOSTLY metal-based restorations, send models to ROE for scan appliance fabrication!

Mostly Edentulous – If the bite cannot be determined 100%, order bite blocks, a set-up, then a scan appliance.

Full Edentulous – MUST be in occlusion. DO NOT Separate Arches with anything! Must use a scan appliance* – can be the patients’ existing denture(s) with markers, if the fit is excellent, the teeth are close to acceptable position, and NO soft relines.

* Please allow ROE to fabricate scan appliances when they are required. Ideal design, thickness, radiopaque marker position and size are critical for a successful outcome. An exception would be adding radiopaque markers to an existing denture.

Scan Appliance Full Arch – The Scan Appliance for the fully edentulous patient is a denture, or a clear duplicate of a denture. It is imperative that the fit is excellent and that the teeth are close to an accepted position. Place 6 SureMarks (/) randomly on the tongue side of the denture, or Gutta Percha dots using a #5 bur 1mm deep. Scan the appliance in the mouth, fully seated, IN OCCLUSION. Then scan the appliance ALONE in the CBCT scanner sitting on foam or cotton rolls, not on a plastic scan table.

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