Chairside Fully Edentulous CBCT Workflow

The following workflow is for capturing a CBCT on an edentulous patient.

Have you already completed your scans? Follow the instructions here to export and upload your CBCT. 

Potential use cases for this workflow include:

Best Practices 

1: Confirm the denture fits the patient. 

  • In cases of poor retention, reline the denture with PVS material before scanning. Only use enough PVS materials to fill gaps with minimal overflow. 

2: Instruct patients to breathe through their nose, close their eyes, and place their tongue at the back of the mouth. 

3: Review the scan carefully to ensure there is no “Black Air Space” between the denture and the patient's soft tissue.

  • Use a bite registration (or cotton rolls) for separation, secure fit, and to eliminate rocking.

Denture Setup 

1: Place six x-ray markers (2 mm in diameter) around the surface of a dry, relined, well-fitting denture with no metal substructure. Metal will render the scan unusable. We recommend opaque markers such as Suremark VF-20 Stickers

  • Three markers on the facial/buccal surface 
  • Three markers on the palatal surface

2: Place the markers on varying axial planes. 

  • For example, if a marker is placed on the buccal area of #28-29, the next marker should be placed on the lingual area of #26-27, and the next marker should be placed on the facial area of #24-25. 

3: DO NOT place markers on the intaglio surface. 

4: Follow the steps below to set up the order in the Dandy portal and scan the denture
BEFORE taking your CBCT (This will avoid movement of markers between scans)

Placement Visualizations

Order Set up 

  • Set up the order for a tissue-supported guide
  • Skip the CBCT upload and submit the order.
  • View the order, and on the right-hand side, under "Quick Order Actions," choose "Capture New Scans."

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Denture Scan

Capture a 360° Trios scan of the denture with X-ray markers in place.

  • Begin scanning on the occlusal sweep across the arch, capturing the entire outer (cameo) surface.
  • Roll over to the tissue side of the denture, capturing the entire intaglio surface and borders of the denture.
  • Evaluate the 360° scan for gaps or voids along the border indicating possible stitching error.

Note: If the patient goes to an outside clinic for their CBCT and does not have a Trios, a denture scan can be done in a CBCT scanner with the radiation levels turned low enough to capture acrylic.

CBCT Scan

Capture a dual-arch CBCT of the patient wearing dentures with x-ray markers still in place.

  • Reline the denture or do a light body wash to create a well-adapted fit that will be copied for the surgical guide
  • Have the patient bite on cotton rolls or bite registration in the posterior to ensure no air gap exists between the denture and tissue
  • Capture the entire working arch
  • CBCT General Settings: 6cm-8cm, 0.3-0.4 Voxel

Export and Upload CBCT Scans

Once your scans are complete, follow the instructions to Export and upload CBCT scans

  • Add these scans to the case in the Dandy portal by dragging and dropping the zipped CBCT
    in dicom format into the CBCT box 

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