Chairside Tissue-Supported Surgical Guide Case Setup

Overview: This article provides step-by-step instructions for scanning an existing traditional denture to create a tissue-supported surgical guide for implant placement.

Prerequisites

Before starting the workflow, ensure the following requirements are met:

  • The patient must have an existing complete denture that is not implant-supported.

  • Confirm the denture contains no metal substructure, as metal will interfere with the scan quality.

  • Obtain six 2mm x-ray markers (e.g., Suremark VF-20 Stickers).

  • If the denture has poor retention, reline the denture with PVS material to ensure stability before scanning.

Prepare the Denture for Scanning

Proper marker placement is essential for scan accuracy:

  1. Apply six 2mm x-ray markers to the surface of a dry, relined, well-fitting denture.

  2. Place three markers on the facial/buccal surface and three markers on the palatal surface.

  3. Vary marker placement across different axial planes to improve scan stitching.

  4. Do not place x-ray markers on the intaglio surface of the denture.


 

Set Up the Case in Dandy Chairside

Follow these steps to initiate the order in the software:

  1. Create a new order for a tissue-supported guide within the Dandy Chairside portal.

  2. Skip the initial CBCT upload step to submit the order for processing.

  3. Open the submitted order and select Capture New Scans from the Quick Order Actions menu on the right-hand side.

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Capture the 360-Degree Denture Scan

Use the Trios scanner to document the denture geometry:

  1. Initiate a 360-degree Trios scan of the denture with all markers attached.

  2. Follow the specific scan sequence: Intaglio → Border → Occlusal → Cameo → Bite.

  3. Check the 360-degree scan for gaps or voids along the borders to prevent stitching errors.

Capture the Dual-Arch CBCT Scan

The CBCT scan must capture the patient wearing the prepared denture:

  1. Verify the x-ray markers are still attached to the denture.

  2. Place the denture in the patient's mouth.

  3. Instruct the patient to bite on cotton rolls or a posterior bite registration to eliminate air gaps between the denture and soft tissue.

  4. Set the CBCT parameters to a field of view between 6cm and 8cm with a voxel size of 0.3 to 0.4.

  5. Capture the scan, ensuring the entire working arch is visible.

Upload the CBCT Files

Finalize the case by submitting the digital files to the portal:

  1. Export the completed CBCT scans in DICOM format.

  2. Compress all DICOM files into a single zipped folder.

  3. Navigate to the case in the Dandy portal.

  4. Drag and drop the zipped folder into the designated CBCT upload box.

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