Overview: This article provides step-by-step instructions for scanning an existing traditional denture to create a tissue-supported surgical guide for implant placement.
Use this workflow when performing the following clinical tasks:
- Fabricating a surgical guide for implant placement on an edentulous patient so that their existing complete traditional denture can be converted into an implant-supported overdenture post-surgery.
- Fabricating a surgical guide for implant placement on an edentulous patient so that a new implant-supported overdenture can be fabricated.
Prerequisites
-
The patient has an existing denture: The patient requires surgical implant placement so their traditional denture can be converted to an implant-supported overdenture.
- Obtain six 2mm x-ray markers (such as Suremark VF-20 Stickers).
-
The patient does not have an existing denture: A radiographic (surgical) stent can be fabricated which will be used in place of a full denture during CBCT and intraoral scan capture.
- Dual arch intraoral scans should be captured first in a diagnostic case setup.
- These intraoral scans must be downloaded and attached to the tissue-supported surgical guide case during case setup.
- Submit the order, and Dandy sends you a radiographic/surgical stent.
- The workflow is the same process except that the radiographic/surgical stent is scanned in place of an existing complete denture.
Prepare the Denture for Scanning
Proper marker placement is essential for scan accuracy:
Apply six 2mm x-ray markers to the surface of a dry, relined, well-fitting denture.
Place three markers on the facial/buccal surface and three markers on the palatal surface.
Vary marker placement across different axial planes to improve scan stitching.
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:
Create a new order for a tissue-supported guide within the Dandy Chairside portal.
Skip the initial CBCT upload step to submit the order for processing.
Open the submitted order and select Capture New Scans from the Quick Order Actions menu on the right-hand side.
Capture the 360-Degree Denture Scan
Use the Trios scanner to document the denture geometry:
Initiate a 360-degree Trios scan of the denture with all markers attached.
Follow the specific scan sequence: Intaglio → Border → Occlusal → Cameo → Bite.
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:
Verify the x-ray markers are still attached to the denture.
Place the denture in the patient's mouth.
Instruct the patient to bite on cotton rolls or a posterior bite registration to eliminate air gaps between the denture and soft tissue.
Set the CBCT parameters to a field of view between 6cm and 8cm with a voxel size of 0.3 to 0.4.
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:
Export the completed CBCT scans in DICOM format.
Compress all DICOM files into a single zipped folder.
Navigate to the case in the Dandy portal.
Drag and drop the zipped folder into the designated CBCT upload box.