CHROME Patient Records

CHROME GuidedSMILE records are very specific. This page is designed to help you navigate the process.
Incomplete, poor quality or mistaken records will delay your patient's surgery. This page will detail the necessary records for all patient scenario.

Read this page thoroughly and if you have any questions please call us – 800-228-6663.

CHROME Patient Records Summary

Single Arch Patient Cases

  • Patient Photos

    Patient Photos
  • Master Casts / Impressions

    Master Casts / Impressions
  • Bite Registration

    Bite Registration
  • CBCT Scans

    CBCT Scans
Single Dentate
Arch
Opposing DENTATE arch
  • Patient Photos

    ALL photos req’d
  • Master Casts / Impressions

    Capture ALL land areas of both arches
  • Bite Registration

    Full occlusion or
    CR bite
  • CBCT Scans

    Scan OPEN position, denture out of the mouth
Single Dentate
Arch
Opposing EDENTULOUS arch
  • Patient Photos

    ALL photos req’d
  • Master Casts / Impressions

    • Surgical arch - capture ALL land areas
    • Non-surgical arch - capture teeth of opposing dentition
  • Bite Registration

    Full occlusion or
    CR bite
  • CBCT Scans

    Scan OPEN position, denture out of the mouth
Single Edentulous
Arch
Opposing DENTATE arch
  • Patient Photos

    ALL photos req’d
  • Master Casts / Impressions

    • Capture ALL land areas - non-surgical arch only
  • Bite Registration

    Full occlusion or
    CR bite
  • CBCT Scans

    • Scan denture in the mouth, in occlusion, not separated
    • Scan denture alone resting on foam, not plastic
Single Edentulous
Arch
Opposing EDENTULOUS arch
  • Patient Photos

    ALL photos req’d
  • Master Casts / Impressions

    • Capture impression of opposing denture, teeth only
  • Bite Registration

    Full occlusion or
    CR bite
  • CBCT Scans

    • Scan denture in the mouth, in occlusion, not separated
    • Scan denture alone resting on foam, not plastic

Double Arch Patient Cases

  • Patient Photos

    Patient Photos
  • Master Casts / Impressions

    Master Casts / Impressions
  • Bite Registration

    Bite Registration
  • CBCT Scans

    CBCT Scans
Double Dentate
Arches
  • Patient Photos

    ALL photos req’d
  • Master Casts / Impressions

    Capture ALL land areas
  • Bite Registration

    Full occlusion or CR bite
  • CBCT Scans

    • Scan BOTH arches, OPEN position, with anyremovable prostheses out of the mouth
Double Edentulous
Arches
  • Patient Photos

    ALL photos req’d
  • Master Casts / Impressions

    n/a
  • Bite Registration

    Full occlusion or CR bite
  • CBCT Scans

    • Scan BOTH dentures in the mouth, in occlusion, not separated
    • Scan maxillary denture alone resting on foam, not plastic
    • Scan mandibular denture alone resting on foam, not plastic
Dentate & Edentulous
Arches
  • Patient Photos

    ALL photos req’d
  • Master Casts / Impressions

    • Capture ALL land areas - dentate arch only
  • Bite Registration

    Full occlusion or CR bite
  • CBCT Scans

    • Scan BOTH arches with the denture in the mouth,in occlusion, not separated• Scan denture alone resting on foam, not plastic

How to Capture the Necessary CHROME Patient Records

1. CHROME Photographs

Good CHROME photos

  1. Full face full smile
  2. Full face exaggerated smile
  3. Full face profile
  4. Center retracted in occlusion
  5. Left retracted in occlusion
  6. Right retracted in occlusion

Helpful Guidelines

  • Patient face should be level with the camera, not at an angle.
  • Patient should be standing looking directly at the camera.
  • Patient should wear any existing prostheses in the photos.
  • Capture photos before taking impressions to keep the lips and teeth clean.

Poor CHROME photos

Poor images can result in your case being delayed as we wait for new photographs.

Poor photos include those that have poor light, have the patient sitting/reclined in the chair, have the teeth out of occlusion, or if the photos are out of focus.

2. Master Casts / Impressions

Good master casts/impressions

  • Capture full palate
  • Capture most/all of the surrounding labial & lingual tissues, the vibrating line, the full roll
  • Are free of noticable holes, skips, voids, or bubbles

Helpful Guidelines

  • Most CHROME cases use a backup denture; please capture as much anatomy as you would for an immediate full denture.
  • It can be challenging to reach the entire vestibule with an IO scanner, but please try to capture as much of the palate as possible.
  • If there is distortion, please retake the impression. It is best to catch inaccuracies at the office.

Bad master casts/impressions

We cannot use master casts or impressions that do not meet the desired coverage per patient scenario (see record checklist for details), have distortion, or have noticeable holes, drags, bubbles, and voids.

3. Bite Registration

Good bite registrations

  • Capture full occlusion or CR bite.
  • Taken with the patient in a closed bite, in natural occlusion.
  • Taken with the patient's prosthesis in mouth, if applicable.

Helpful Guidelines

  • Use enough material to capture the occlusion, but not too much as to open the bite.
  • Neuromuscular bites are accepted as well; these are often the best, most accurate bites.
  • If the patient is missing posterior stops, ROE recommends bite blocks or a JC Try-In. A JC Try-In appliance will stabilize the bite and help establish occlusion.

Bad bite registrations

We cannot use bite registrations that:

  • Only capture a narrow centric occlusion.
  • Used too much material, which separated the bite.
  • Were not captured with teeth in natural occlusion.

Scanning Videos

4. CBCT Scans

Dentate

Good dentate CBCT scans

  • Capture both arches.
  • Taken with the patient in an OPEN position.
  • Taken with the patient's denture(s) out of the mouth, if applicable.

Helpful Guidelines

  • Have the patient bite on cotton rolls or the bite fork.
  • Place cotton rolls between cheeks and teeth for a better image.
  • If the field of view only allows one arch, send two individual scans of each arch.
  • Export DICOM files (.dcm) from the CBCT into a patient folder- this should contain 200-400 individual .dcm files. Zip the patient folder and upload with Rx.

Bad dentate CBCT scans:

We cannot use dentate CBCT scans that:

  • Captured the patient in a closed position.
  • Captured the patient with their denture(s) in the mouth.

Edentulous

Good edentulous CBCT scans:

  • Follow a dual scan protocol.
  • Use the patient's well-fitting denture or scan appliance in the mouth during the scan.
  • Capture a scan of the patient with their denture(s) in the mouth, in occlusion, not separated.
  • Capture a scan of the denture(s) alone resting on foam.

Helpful Guidelines

  • If the patient has a good denture: Prepare by placing 6 scan markers (www.suremark.com)
    or 6 gutta-percha markers randomly in the pink area of the labial flanges.
  • If the patient has a poor denture: Either fabricate a new denture, perform a hard reline, or
    place blue mousse inside the denture to stabilize it. Soft relines are NOT acceptable.
  • If the patient does not have a denture: A new denture or scan appliance must be fabricated.
  • The scan must include the patient from the chin up to the nasal cavity.
  • Do not scan the patient alone without their denture.
  • Export DICOM files (.dcm) from the CBCT into a patient folder- this should contain 200-400 individual .dcm files. Zip the patient folder and upload with Rx.

Bad edentulous CBCT scans

We cannot use edentulous CBCT scans that:

  • Captured the patient without their denture in the mouth.
  • Captured the patient with their denture not fully seated against the tissue.
  • Used a poorly-fitting denture for the scan.
  • Used a denture with a soft reline for the scan.
  • Captured the extraoral denture scan not on foam, but plastic or metal.
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