What is the difference between CHROME and the many plastic guides I’ve seen?
There are significant differences between CHROME and Every other guide. Plastic is flexible therefore it has to rest on the bone. This means a large lingual flap with means longer healing time; it means bone must be adjusted for the guide to seat; the teeth usually have to be removed leaving very few good references for the guide; the bone guide fits to sockets of extracted sites, not very accurate; all plastic guides cover the sites so there is little to no irrigation during drilling; metal osteotomy guide hovers above the site for full vision and irrigation – far superior to plastic guides.
What is the difference between CHROME and nSequence?
There are significant differences that make CHROME superior to nSequence. Ours us much less invasive with no lingual bow, offers incredible stability with CR/CO Fixation Base, allows for full visualization during drilling and placing implants, includes 5 parts rather than many, many parts that require training and extended manual, and ours it tooth supported, not bone supported. Other advantages include no metal substructure to restrict implant position changes in surgery, we work with all implant systems with guided kits and MUA’s, much simpler prosthetic conversion with our carrier guide, rather than the gasket floating system.
Who works on CHROME cases?
Team of 26+, including 4 dentists, several CDT’s and many people with years of dental, surgical, CAD technology. The team is very impressive.
How long does a CHROME case take to make?
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: 3 days to plan, 4 days to fabricate
- CHROME: 5 days to plan, 10 days to fabricate with a buffer to discuss records and to schedule an online meeting
Please do not schedule surgery 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 much should I expect to spend on my first case?
Very good question. There a few things to consider, the Full Package, The Fixation Kit, Prosthetic Conversion Kit, spare denture(s), JC Try-In (optional), Chairside support and any work-up items. Email ROE your particular patient scenario and we can do the math together.
What if I want to split the fees with my surgeon (or referral)?
- This is very important because you hate to have to figure out who owes what later. And quite often with these, the surgeon bears very limit lab costs.
- It is best to agree on who pays for what upfront. ROE can provide a spreadsheet that breaks down our suggestion for surgical and restorative fees. We can email you this upon request.
What is the most challenging part of getting a case in my hands?
Generally, it’s the records that’s usually hold a case up because. Chrome works wonderfully, really a great product, but it must start with great records. We have very specific protocols and checklists to help. Except for tough bite, all the rest is general dentistry collecting records.
What diagnostic steps are not included in CHROME?
- If we need to open the bite with our JC Try-In, or other lab fabricated methods.
- If we need to duplicate or create a new denture, create a scan appliance, perform wax-ups… these items are outside the cost of CHROME.
What is included in a CHROME Complete Package?
- The package includes almost everything to complete a CHROME case, from the PreVu smile simulation through day-of-surgery guides and long term temp, the final restoration, and the miniComfort guard.
- The package includes one iJIG, one Printed Try-In, and one final restoration. It includes planning, live online meeting, digital set-ups, and much more. Cases do require our Fixation Kit, which has the pins and drill(s) needed to support the guide.
- We offer a Prosthetic Conversion Kit for blocking out and luting during the conversion.
- The package does not include implants, abutments, temp cylinders or other implant components, chairside support.
The complete CHROME package includes everything for the day of surgery?
The full package includes:
- Pin Guide
- metal Fixation Base
- Carrier Guide
- Nano-Ceramic Prosthetic
- RAPID Appliance
- Implant Report
What is a miniComfort guard?
- This is a patented guard that covers the lower teeth only, except for the molars.
- It has two ‘elements’ that rest under the maxillary canines to keep the teeth separated.
- The idea is that the patient’s biting force is limited due to limited occlusal contact.
- It is a very popular guard for all patients.
What is the Bite Proof product?
- It is a long-term temporary.
- If you really need to verify more than just our chairside JC Try-In, the bite-proof is more like an overlay temporary, more like a snap-on smile.
- You’d actually bond it in place and send a patient home and have them back and equilibrate, workout the bite, workout the occlusion, et cetera. It might even be a week or two or more. And then once satisfied, they are the patient’s new teeth essentially.
- That’s what the Pin Guide will fit when we move forward.
- You would treat those like the patient’s new teeth. We don’t use it very often, but if you have a patient who you’re really concerned about producing a good bite, as they’ve had issues, then this is a possible solution.
How much can you open the bite in the lab?
We limit the bite to opening 3mm’s, sometimes 4 if the original bite is very accurate.
What is the cost of iJIG and Printed Try-In outside of the CHROME package?
Price may vary due to parts. Part prices will vary greatly depending on the implant system. Call ROE to get an accurate price.
What articulators does the lab use?
Our standard is a Stratos. We’re all calibrated. A lot of our doctors bought them from us so that they’re all calibrated. So if I wanted to buy a Stratus from you that’s calibrated what would the fee for that be? About a thousand dollars. We order it. We would buy it with the magnetic mounts and we would calibrate it for you and ship it to you.
What if a patient is edentulous and has not denture?
Well that patient walks in and they’ve got an awful denture, doesn’t fit, teeth are in the wrong place, etc, or they don’t have a denture. Let’s make them a new economy denture to be used as a back-up and a scan appliance. This is a cost outside the full CHROME package.
Do you make back-up dentures for the day of surgery?
- Most doctors order a backup spare denture.
- If this is a single arch case then you would order our 3D printed economy denture.
- If it is a double arch case, then we like to mill both arches from the same PMMA material that is used in the long term temp so that the materials match if one arch does not get completed. The cost of this is double.
- Rationale – you have a double arch surgery with beautiful nano-ceramic temporaries that are going to be loaded. But let’s say the maxilla doesn’t go and you have to load it with a denture. Well, the 3D printed economy denture does not have the same aesthetics as that nano-ceramic. So we can mill those backup dentures so that they are the same material as that nano product.
Does ROE have Ivoclar universal mounting jigs so that if I take a face bow with a Denar, Whip Mix or Hanau facebows?
Yes, we can mount your facebow with our universal Facebow Mount
What is iJIG?
What final restorations are available with CHROME?
We offer three options:
- Full milled, beautifully-stained zirconia,
- Ultra-Nano Trilor (Trilor substructure),
- Ultra-Nano Ti (titanium substructure).
What is Ultra-Nano?
- One solid block of composite is milled for the teeth and is bonded to either an opaqued titanium bar or on a Trilor bar.
- Trilor is a metal-free material, kind of like Kevlar composite.
- They are used by most of our clients, especially in double arch when clanking is a concern between zirconia arches.
What is a JC Try-In?
- JC Try-In is an appliance that we fabricate when a bite needs to be verified. We also use it when we open a bite on the articulator more than 3mm’s.
- It is a printed flipper essentially, that the patient does not usually wear home. It is made for clinical equilibration.
- If the patient is to wear it home we need to know, because we will design it a little bulkier.
- It should be returned equilibrated with a new bite registration, and always analog, never digitally. Capture photographs if the bite is changing much with the JC seated.
What are the normal steps to a final after CHROME surgery?
RAPID appliance or iJIG appointment and then a Printed Try-In and then a final.
Are we allowed to give out a list of doctors who do CHROME with our lab to patients?
ROE Dental Laboratory works only with doctors, dental practices and other dental laboratories. We cannot do any dental work for patients. We do not want to leave you needing help with no recourse though.
If you complete the form below, and provide consent, we will forward your information to a dental practice in your area that does CHROME GuidedSMILE. They will be able to take care of you, help you with your case and start treatment that works for both of you. Please provide your information below.
CHROME patient form link: https://www.roedentallab.com/products/chrome-guidedsmile/chrome-contact/chrome-patient-form/