Guided Surgery

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What types of surgical guides does ROE fabricate?

There are three main types of surgical guides:

  1. Tooth Supported– Guide that fits over teeth (needs models and CT scan)
  2. Tissue Supported– **Edentulous patients only**
    • Need a dual scan with well-fitting dentures. If dentures do not fit well, use blue mousse as a soft reline.
    • If the patient does not have dentures, we can make some or do a bone supported guide.
  3. Bone Supported– Just need a CT scan

How long do guides take to fabricate?

Once we have all the accurate records

  • 3 days to pre-plan
  • 1 event of planning (determined by doctor’s schedule)
  • 4 days to fabricate
  • 1-2 days shipping

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What scan markers do you recommend?

We recommend SureMark markers. We sell them for $50/ pack of 6. They are not considered reusable but could be removed

Notes: Scan markers are points of reference, they make the scan appliance or denture register and merge with the patient scan.

Actions to take: Use the material code SHSMSM. This is a set of 6 markers

What format do doctors send a CT scan in?

.DCM or Dicom is the format we use 99% of the time. This is sent to us in a folder with 200+ .dcm files.  We can also use Simplant. (.spr).
**Scans cannot be older than 6 months**

Galileous Sirona note:  We can export scans through this program, however, we cannot export plans.

Can doctors order sleeves for surgical guides?

You can order sleeves on our web site. You can chose what system(s) you need and quantities.

How do doctors scan a denture with a lot of metal?

With a metal base in the denture, it will make the scan scatter. You can try to add SureMarks to the teeth away from the metal and perform a dual scan and let’s see if it works. But, if we cannot register the case, we’ll have to make a duplicate denture and then you can perform a dual scan.

What is a BSB file?

BSB is a BlueSky Bio Plan which is the implant planning program we use to plan cases.


Doctor needs a drill report. How to send it?

We can email the doctor the drill report. Please email your request. If you are in need urgently, please call the lab and ask for the Guided Surgery department

Need a Fixation Kit or Prosthetic Conversion Kit

Sure, email and we can sell you what you need. If this is for a specific patient, please include the patient’s name. The pins and drills are ala-cart based on the actual case. If you need extra pins and drills, just itemize them in your email.

How to create online accounts for different doctors that work in the same office?

Online accounts just need a unique email address. If the doctor has their own account but is located at the same address, we can set up the existing account online with this new email address. If the new account has not been added yet, please visit our web site and make a new account.

Doctor wants to send you a guided surgery case/CHROME case. How long do they take?

The timeline of these cases is broken up into 2 phases – planning and production, with an online meeting for approval scheduled in between. We don’t start these cases until we have ALL of the CORRECT records – that is when the timeline begins.

Simple guides: 4 days to plan, 4 days to fabricate

CHROME: 5 days to plan, 10 days to fabricate

However, we ask that you do not schedule a surgery, or lock in a return date until the online meeting is complete. If we run into problems during the planning phase, the case can get held up, and we don’t want to disappoint you or the patient!

How can I get my CT scans to you?

Always upload your cases through our web site. At the top of the homepage, you’ll see upload. You can include .stl’s and photos if needed. CT scan must be sent as a zipped file.

What CBCT Cone-Beam scanners do you work with?

We work with all cone beam scanners. We just need the ‘raw dicom’ from the scanner. We need multi-file dicom, which should be a set of files that end in .dcm. Just export them into a folder and then zip the folder and upload it via our web portal. If you are having trouble:

Web page to help with exporting dicom:

Misc Notes on CT Scanning:

  • If there is a breakage point in a scan we will require a new one.
  • Chrome FTX – No holes in prosthetic (Maybe on lingual)
  • Chrome Natural – No pink, provider adjusts tissue
  • Double arch temp materials– double arch milled PMMA single printed
  • iJIG – used for new tissue position, mounting purposes, refine aesthetics to transfer position of implants to prosthetic. Give questions regarding an i-jig to tech reps–restorative product.
  • Mental Foramen – holes in the jaw that help mark the end of the nerve.
  • Sleeves attached to the provider’s drill to ensure the drill is stable on surgical guides
  • Vlad can help with angulation corrections of the abutment.

Where should photos be sent for CT customers?

Actions to take: It can be sent to but must include patient name and doctor name.

Why do you need my scan appliance sent back to you when you have the models?

We do not need the scan appliance returned unless:

a. the scan appliance is a JC Try-In, a is a bite positioning appliance used in full arch reconstruction.

b. The doctor’s office did not scan the appliance by itself for the dual scan, and cannot have the patient back in the office. The appliance can be sent to ROE for ROE to scan in our CBCT scanner on site.


Is the flap is laid before putting in the metal bar (Fixation Base)?

Always on dentate cases. Edentulous cases with no bone reduction do not need this type of flap. Edentulous with bone reduction may need the flap.

Is there any reline needed under the flat immediate prosthesis?

Never, should meet the tissue, but some gap is ok through healing. Don’t want pressure on the ridge, sutures etc. Down the road on maxillary if the patient has passing air issue then can add to meet the tissue.

What is the pink silicone bite used for in CHROME guided surgery?

You can use it to float in your guide if you are having orientation issues. This bite was made on the articulatory by opening the bite 2-3 millimeters

Can I use Stella or Voco acrylic resin during my guided surgery?

You can use either. We recommend Stellar DC Acrylic because it is available in Pink and White, it is dual-cure, and can be tacked in only 6 seconds, and full cure by light in 20 seconds. Voco is self-cure only and requires an adhesive.

How many production days are iJIGs and Printed Try-Ins?

An iJIG and the subsequent Printed Try-In take 7 days in the lab. We send a 3D Preview to your email for your approval. This can add time to the overall case production, waiting for a response, approval, or changes.

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