CHROME Patient Records

The #1 reason for delayed cases is incomplete or poor patient records!

Accurate and detailed patient records are essential to starting a CHROME GuidedSMILE case properly. This page will detail the necessary records for all patient types. Read this page thoroughly and if you have any questions please call us – 800-763-7821.

 

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Single Arch Patient Cases
  • Patient Photos
    Patient Photos
  • Master Casts / Impressions
    Master Casts / Impressions
  • Bite Registration
    Bite Registration
  • CBCT Scans
    CBCT Scans
  • PDF Checklist
    PDF Checklist
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
  • PDF Checklist
    Single Dentate arch with opposing Dentate arch
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
  • PDF Checklist
    Single Dentate arch with opposing Edentulous arch
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
  • PDF Checklist
    Single Edentulous arch with opposing Dentate arch
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
  • PDF Checklist
    Single Edentulous arch with opposing Edentulous arch
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Double Arch Patient Cases

  • Patient Photos
    Patient Photos
  • Master Casts / Impressions
    Master Casts / Impressions
  • Bite Registration
    Bite Registration
  • CBCT Scans
    CBCT Scans
  • PDF Checklist
    PDF Checklist
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
  • PDF Checklist
    Double Dentate arches
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
  • PDF Checklist
    Double Edentulous arches
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
  • PDF Checklist
    Dentate arch with an opposing Edentulous arch
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Videos
Edentulous - Opposing Dentate (Single Arch)
Edentulous - Opposing Edentulous (Single Arch)
Dentate - Opposing Dentate (Single Arch)
Dentate - Opposing Edentulous (Single Arch)
Double Edentulous Arches (Double Arch)
Dentate - Opposing Edentulous (Double Arch)
Double Dentate Arches (Double Arch)
How to Capture the Necessary CHROME Patient Records
1. CHROME 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
Play Video
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
Master casts or impressions that do not meet the required coverage for the patient scenario, have distortion, or have defects such as holes, drags, bubbles, or voids cannot be used. It’s important to carefully review the record checklist for specific requirements and ensure that the master casts or impressions meet these standards to ensure the success of the procedure.

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, we recommend 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.