Day of Surgery

Welcome to the exhilarating "Gameday" experience of CHROME GuidedSMILE, the day of surgery! This section serves as an introduction to the full surgical protocol - a patented, fully guided, and "prosthetic-down" approach to all-on-x procedures. Meticulously designed for forward-thinking dentists, this protocol offers a safer, faster, and more robust immediate solution for treating full arch patients.

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Before you start, we recommend downloading our free Surgical Protocol of CHROME GuidedSMILE EBook to familiarise yourself with the full protocol and to keep as a reference guide.

Throughout this section, we will delve into the core components of the CHROME GuidedSMILE surgical process, providing a step-by-step overview of its application. While the protocol described here is typical for most CHROME GuidedSMILE cases, it is important to recognize that like any complete solution, there may be minor adaptations based on each patient's unique clinical circumstances.

CHROME GuidedSMILE Components

What is the Pin Guide?
  • The Pin Guide is the first step of the CHROME surgical process. It sets the stage of the whole surgery and ensures that the surgery starts accurately.
  • It’s only purpose is to deliver the Fixation Base and maintain its position while the fixation pins are set
  • Dentate Pin Guides seat on the teeth, are verified via occlusal windows and ensure the surgery starts in the correct position
  • With edentulous patients, the pin guide will seat exactly like the denture and verifies the bite and ultimate tooth position
What is the Fixation Base?
  • The Fixation Base is the second step of the CHROME process and sets the foundation for the surgery.
  • All subsequent components clip into the CHROME Locs on the Fixation Base.
  • It is unique in the industry because it is made of CR/CO which means rigidity and stability.
  • The Fixation Base is designed using our patent pending floating guide technology, meaning the guide does not contact bone, rather is supported by divergent pin placement.
  • The Fixation Base’s initial function is bone reduction. The upper edge of the Fixation Base has been carefully created to indicate the level to which the bone needs to  be reduced.
  • The second function of the Fixation Base is to support the components: Osteotomy Guide, Carrier Guide, Nano-Ceramic Prosthetic, and RAPID Appliance.
What is the Osteotomy Guide?
  • The Osteotomy Guide is the third step of the CHROME surgical process.
  • All CHROME cases come with an Osteotomy Guide. It controls the kit’s spoons or drills during osteotomy creation.
  • Our guides control the implant depth, trajectory, and indexing (rotation).
  • It seats into the Fixation Base and is fixed using the proprietary CHROME Locs.
  • CHROME GuidedSMILE works with any implant systems that offers has a fully- or semi-guided kit.  Fully guided kits allow the user to place the implant through the guide. A complete list of guided kits is available on the upload area of our web site. When you upload you case, chose the system.
  • When you have questions around these systems or any others please call us at 800.228.6663

There are two types of Osteotomy Guides:

  • Manufacturer specific implant systems – One will have inserts that correspond with the original equipment manufacturer sleeves.
  • Non-specific implant systems – The second one is an all-purpose guide created by ROE.
What is the Carrier Guide?
  • The Carrier Guide is the fourth step of the CHROME surgical process and is a plastic guide that serves many functions.
  • Once the Osteotomy Guide has been removed the Carrier Guide affixes to the Fixation Base by use of the CHROME Locs.
  • One function of the Carrier Guide is to serve as a tissue gap between the top of the bone reduction to the bottom of the Carrier Guide.
  • It also serves as a key indicator to the direction of the implants, the rotation of the implants, and the direction of the multi-unit abutment screw that attaches the abutment to the implant.
  • Angled implants are identified on the Carrier Guide by way of notches at the osteotomy site.
  • The Carrier Guide remains in the mouth through the prosthetic conversion.
  • The two clear plastic extrusions on the Carrier Guide delivers the prosthetic in the proper position as planned.
  • It also delivers the RAPID Appliance (the second pick-up) in a similar manner.

The RAPID Appliance is very strategic component of CHROME GuidedSMILE. It is an exact duplicate of the surgical prosthetic. It is picked up the day of surgery, held until the time of final conversion and used to send nearly all records to Quoris3D for the final. A unique and time-saving device.

  • The RAPID Appliance serves multiple strategic functions.
  • Just like the surgical long-term temp is picked up on the day of surgery, the RAPID is also picked up on a second set of temporary cylinders and is held until it is time to transition into the final prosthesis.
  • OPTION ONE – The surgical prosthesis is relined and sent to Quoris3D with the opposing and bite registration. Once the surgical prosthesis is removed, you will seat the RAPID appliance, equilibrate and send the patient home in the RAPID.
  • OPTION TWO – Remove the surgical prosthesis and seat the RAPID Appliance. Once seated, equilibrate, reline, and send the RAPID to Quoris3D with the opposing and bite registration.
  • From this record, we can produce either a printed prototype for final, or final restoration. There is no simpler method of converting to final.
  • The RAPID provides us with everything needed to make the final:
  • Initially it is picked up during surgery.
  • Once the surgical prosthetic is picked up, another set of temporary cylinders are inserted onto the multi-unit abutments and then the RAPID Appliance is picked up.
Why is the CHROME provisional special?
  • The CHROME provisional is the printed, immediate load, long-term prosthetic that is delivered during the day of surgery. It is esthetic, patient-pleasing appliance.
  • It is a natural-looking, beautiful, strong provisional.
  • Easy to adjust. Accepts composite, bonding agents, acrylic and VOCO, Stellar, Duralay, GC pattern resin luting materials.
  • It is designed from a smile simulation using proprietary tooth libraries.
  • It is designed for long-term post-surgical patient use.
  • Provides the perfect prototype for the final restoration

Prosthetic Conversion

CHROME sets the standard for efficient chairside prosthetic conversion, setting up the case for a simplified final restorative protocol

Chairside prosthesis conversion with CHROME is a straightforward process. Using standard tools and applying knowledge of simple conversion techniques, the doctor, the staff, and or a dental technician can quickly process the surgical pick-up into a lovely prosthesis ready for seating in just 15 minutes.

Items needed for conversion:

  • Titanium copings – 2/implant site
  • Stellar flowable acrylic (Voco and a few other non-shrinkage materials are ideal)
  • Small composite / endo tips for small areas (optional)
  • Lab Handpiece with a selection of aggressive and fine burs, polishing wheels, polishing paste
  • Glaze and Light cure (optional but will help after adjustment)
  • Compressed air

Quoris3D Provides chairside support. We have a fee for this service. Our goal is to deliver a beautiful prosthesis ready for seating, while at the same time, teach the staff to complete the conversion so the savings can be seen immediately over other full arch processes.

C2F (patent pending) is the CHROME philosophy of Small Hole Technology. C2F means delivering immediate prosthetics during a CHROME surgery with 2.5mm holes, rather than the typical industry-standard larger holes. Small Hole Technology dramatically improves the performance of CHROME prosthetics by maintaining the principal structure of the manufactured material, preserving the ideally designed occlusion, providing an extra-oral method of equilibration, creating a master cast on the day of surgery, delivering a beautifully crafted prosthetic without resin filled holes and faked-in occlusion, and providing the patient with what appears to be a final prosthetic. C2F is helping CHROME lead full arch guided procedures.

C2F Protocol

C2F is a very simple but technique sensitive process. The parts are ordered from Quoris3D and will accompany the GuidedSMILE case. However, we highly recommend requesting our chairside service for the firsts case to teach doctor and staff the nuances of the systems.


SurgiMAT takes guided surgery to a new level. The SurgiMAT is a patient-specific, wall poster that provides the doctor and team the relevant information to complete a CHROME GuidedSMILE surgery.

The SurgiMAT comes in two parts:

Provides the information necessary to guide the team through a CHROME surgery without the need to stop and leaf through a multipage surgery report. This 47 ¼”, glossy, full color poster delivers vital information at-a-glance from anywhere in the surgical suite.

The information is read from left to right and leads through the surgery in this direction.

SurgiMAT contains:

  1. Key notes from the live meeting, drill and pin lengths, guided kit to be utilized;
  2. Drill and pin cross-sections;
  3. Panoramic view of implants;
  4. Implant information and tooling, showing visual cross-sections, drill depths and tooling;
  5. Pin length and occlusal view;
  6. Bone reduction labial view;
  7. Osteotomy guide view;
  8. Abutment/screw access view;
  9. Carrier guide / temp cylinder alignment view;
  10. Torque reference QR code

This part of the SurgiMAT is placed on the countertop in the operatory. It is designed for the team to organize all of the implants, MUA’s and temp cylinders for easy access during surgery. Notice each image includes specific information such as abutment angle, implant size, and implant site. The SurgiMAT is one of the many features that sets CHROME apart from the other systems.

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