Creating Patient Records

CHROME GuidedSMILE patient records are simple but specific.

Poor or incomplete patient records will result in a delayed case.

This page will provide you with all of the information you will need to successfully capture the right patient records.

If you have any questions on the important topic of patient record capture please call us – 800-228-6663.

Single Arch Patient Records

Single Dentate Arch Single Dentate Arch Single Edentulous Arch Single Edentulous Arch
Opposing DENTATE arch Opposing EDENTULOUS arch Opposing DENTATE arch Opposing EDENTULOUS arch
Patient Photos ALL photos req’d ALL photos req’d ALL photos req’d ALL photos req’d
Master Casts / Impressions Capture ALL land areas of both arches • Surgical arch - capture ALL land areas
• Non-surgical arch - capture teeth of opposing dentition
• Capture ALL land areas - non-surgical arch only • Capture impression of opposing denture, teeth only
Bite Registration Full occlusion or CR bite Full occlusion or CR bite Full occlusion or CR bite Full occlusion or CR bite
CBCT Scans Scan OPEN position, denture out of the mouth Scan OPEN position, denture out of the mouth • Scan denture in the mouth, in occlusion, not separated
• Scan denture alone resting on foam, not plastic
• Scan denture in the mouth, in occlusion, not separated
• Scan denture alone resting on foam, not plastic

Double Arch Patient Records

Double Dentate Arches Double Edentulous Arches Dentate & Edentulous Arches
Patient Photos ALL photos req’d ALL photos req’d ALL photos req’d
Master Casts / Impressions Capture ALL land areas n/a Capture ALL land areas - dentate arch only
Bite Registration Full occlusion or CR bite Full occlusion or CR bite Full occlusion or CR bite
CBCT Scans Scan BOTH arches, OPEN position, with any removable prostheses out of the mouth • 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
• Scan BOTH arches with the denture in the mouth, in occlusion, not separated • Scan denture alone resting on foam, not plastic

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CHROME GuidedSMILE Patient Record Videos

Single Arch Cases

Dentate arch, opposing Dentate

Dentate arch, opposing Edentulous

Edentulous arch, opposing Dentate

Edentulous arch, opposing Edentulous

Double Arch Cases

Double Edentulous Arches

Dentate Arch Opposing Edentulous

Simple Patient Records (Webinar Series)

Patient Records Part 1

Patient Records Part 2

Patient Records Part 3

Patient Records Part 4

How to Capture the Necessary CHROME GuidedSMILE Patient Records

1. CHROME GuidedSMILE Photographs

Good CHROME photos

  • Full face full smile
  • Full face exaggerated smile
  • Full face profile
  • Center retracted in occlusion
  • Left retracted in occlusion
  • Right retracted in occlusion

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.