Patient Records
Patient Records Checklists
Single Arch
- Single Dentate arch with opposing Dentate arch
- Single Dentate arch with opposing Edentulous arch
- Single Edentulous arch with opposing Dentate arch
- Single Edentulous arch with opposing Edentulous arch
Double Arch
- Double Dentate arches
- Double Edentulous arches
- Dentate arch with an opposing Edentulous arch
Patient Records Overview
Single Arch Patient Cases
Single Dentate Arch | Single Dentate Arch | Single Edentulous Arch | Single Edentulous Arch | |
---|---|---|---|---|
Single Dentate arch with opposing Dentate arch | Single Dentate arch with opposing Edentulous arch | Single Edentulous arch with opposing Dentate arch | Single Edentulous arch with 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 |
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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 |
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Double Arch Patient Cases
Double Dentate Arches | Double Edentulous Arches | Dentate & Edentulous Arches | |
---|---|---|---|
Double Dentate arches | Double Dentate arches | Dentate arch with an opposing Edentulous arch | |
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 |
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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
- Centre 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, 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.
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.
Capturing CHROME Records