Is there a surgical guide decision tree for record collecting for dental impants?

Getting started with ROE’s surgical guides

160K+ surgical guides designed & 500K+ implants planned = 18 years of experience. Talk to us about your case.

Step 1 – Understand the records you need for CT planning

Step 2 – Export and send us your DICOM

Step 3 – Upload your case

Step 4 – Sign our Master Surgical Agreement

From here ROE will:

Design the surgical guide
Conduct an online meeting with you for design approval and sign-off
Create and mail you your surgical guide

ROE make this process simple as a result of over a decade and a half of surgical guide experience.

Now Skip the Online meeting and receive a video

Our planning dentists and implant specialists send video plans with a voice-over explaining the details about your case so that you can review and approve, or reply with changes. Our clients love these videos. The 1/2 price savings, the convenience, and the quality are a step above the competition.

See the example on the right.

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, this decision tree will walk you through the steps of collecting records.

Identifying the patient's current status via the questions below
Patient's Current Condition*
Amount of metal in the patient's mouth*
Digital Records Steps
What to send to the lab:
1. Maxillary and Mandibular master cast and a bite registration
  - if restoring 1 or 2 implants and vertical space is not in question, opposing and bite are not needed*
  - if restoring anterior teeth or 3-4 adjacent implants, send study model if available
2. DICOM (Multi File, RAW, uncompressed - a folder with 80 - 300 files with extension .dcm)
*when including immediate restorations, opposing and bite are required
Digital Records Steps
What to send to the lab:
1. Maxillary and Mandibular master cast and a bite registration
  - if restoring 1 or 2 implants and vertical space is not in question, opposing and bite may not be needed*
  - if restoring anterior teeth or 3-4 adjacent implants, send study model if available
2. Submit a CT Order Form requesting a Scan Appliance
*when including immediate restorations, opposing and bite are required
Doctor receives Scan Appliance and captures 2 CT scans
Steps: Dual Scan Technique
1. Scan 1 - Scan the Appliance alone sitting on 2 cotton rolls
2. Scan 2 - Scan the patient with Scan Appliance seated completely with no rock,, IN FULL OCCLUSION, not open on a bite stick or cotton rolls.
3. Upload both sets of DICOM (RAW, uncompressed set of single .dcm files) (place in separate folders labeled PT and APPL inside a master folder with the patient name, zip and upload to through our online portal.
Notes about Specific 3D Scanners
- Sirona Galiloes & XG3D owners must purchase the Scan Cylinder from Sirona Part #6299759 and change KV to 70 and MA to 10 for the scan appliance scan. Place the scan appliance inside the scan cylinder on the provided piece of foam and scan.
- Planmeca owners must change the KV to 70 and MA to 10 for the scan appliance scan.
- Kodak 9000 owners must change both scan settings. Patient scan set KV to 75 and MA to 10. Scan Appliance Stitched scan KV t0 80 and MA to 2.
Digital Records Steps
What to send to the lab:
1. Maxillary and Mandibular master cast and a bite registration, study model if available
2. CT Order Form requesting a Scan Appliance
Doctor receives Scan Appliance and captures 2 CT scans
Steps: Dual Scan Technique
1. Scan 1 - Scan the Appliance alone sitting on 2 cotton rolls
2. Scan 2 - Scan the patient with Scan Appliance seated completely with no rock, biting on cotton rolls
3. Upload both sets of DICOM (RAW, uncompressed set of single .dcm files) (place in separate folders labeled PT and APPL inside a master folder with the patient name, zip and upload to through our online portal.
Notes about Specific 3D Scanners
- Sirona Galiloes & XG3D owners must purchase the Scan Cylinder from Sirona Part #6299759 and change KV to 70 and MA to 10 for the scan appliance scan. Place the scan appliance inside the scan cylinder on the provided piece of foam and scan.
- Planmeca owners must change the KV to 70 and MA to 10 for the scan appliance scan.
- Kodak 9000 owners must change both scan settings. Patient scan set KV to 75 and MA to 10. Scan Appliance Stitched scan KV t0 80 and MA to 2.
Patient is fully endentulous. Please choose existing condition*
Digital Records Steps
Denture must be prepared for scanning.
- Option 1: Call and order Radiopaque Markers from ROE. Place six in sticky wax on the tongue side randomly.
- Option 2: Place 6 Gutta Percha points on the tongue side of the denture randomly in the pink area using #5 or similar bur to create a 1mm dimple.
Doctor receives Scan Appliance and captures 2 CT scans
Steps: Dual Scan Technique
Notes about Specific 3D Scanners
Digital Records Steps
Phase 1: Remove soft liner and complete a hard reline. Ensure denture seats with no rock.
Phase 2: Denture must be prepared for scanning.
- Option 1: Call and order Radiopaque Markers from ROE. Place six in sticky wax on the tongue side randomly.
- Option 2: Place 6 Gutta Percha points on the tongue side of the denture randomly in the pink area using #5 or similar bur to create a 1mm dimple.
Doctor receives Scan Appliance and captures 2 CT scans
Steps: Dual Scan Technique
Notes about Specific 3D Scanners
Digital Records Steps
Phase 1: Work with ROE to fabricate a new denture
- Option 1 - If a new denture is to be used as the final prosthesis, fabricate denture to completion to also be used as the scan appliance. Go to options below.
- Option 2 - ROE fabricates a duplicate clear denture ready for scanning
If using a different laboratory for denture fabrication, complete one of the two options below to transform it into a scan appliance.
- Option 1: Call and order Radiopaque Markers from ROE. Place six in sticky wax on the tongue side randomly.
- Option 2: Place 6 Gutta Percha points on the tongue side of the denture randomly in the pink area using #5 or similar bur to create a 1mm dimple.
Doctor receives Scan Appliance and captures 2 CT scans
Phase 2: Dual Scan Technique
Notes about Specific 3D Scanners
Digital Records Steps
Questions:
- Are you reducing bone? We suggest our CombiGuide for this type of surgery.
- Are you fabricating an immediate prosthesis? Send models and the final bite for ROE to fabricate.
- Does the patient have the labial bone to allow for a hybrid? We can discuss this from mounted casts.
- Does the patient have the vertical space to support a hybrid? If not try our Pretteau Bridge (TLZ-IB)
- Does the patient's smile line hide the transition from hybrid plastic to nature tissue? Send photographs with the models so we can help you determine.
We are very happy to discuss all these questions and more. Call any time.
When ready to proceed:
If requesting the surgical guide only (and bone reduction guide)
1) Send/Upload DICOM only (Multi File, RAW, uncompressed - a folder with 80 - 300 files with extension .dcm)
If requesting surgical guide and prosthesis:
1. Maxillary and Mandibular master casts and a bite registration
2. DICOM (Multi File, RAW, uncompressed - a folder with 80 - 300 files with extension .dcm)
3. Denture Esthetic Form completed
4. 4) Photographs (upload with your DICOM)
ROE can support you with all your implant guiding and restorative needs. We've been aiding doctors since 2004 and have completed many thousands of case.

IMPORTANT CBCT SCANNING TIPS – MUST READ:

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 determine 100%, order bite blocks, a set-up, then a scan appliance.

Fully 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. 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 (www.suremark.com/) 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.

Getting started with ROE’s surgical guides

160K+ surgical guides designed & 500K+ implants planned = 18 years of experience. Talk to us about your case.

Now Skip the Online meeting and receive a video

Surgical Guide Decision Tree

Identifying the patient's current status via the questions below

Digital Records Steps

Digital Records Steps

Digital Records Steps

Digital Records Steps

Digital Records Steps

Digital Records Steps

Digital Records Steps

Scan Appliance Full Arch

ROE Dental Lab Locations