InPronto - Implants & Guidelines

GENERAL SCANNING GUIDELINES

There are (3) three different scans needed for every implant case regardless of the case type.

Note1: The bite registration needs to be scanned separately and should be taken using PVS putty in centric occlusion. Do not open the bite when you take the bite out. Also, do not use the blue mousse for the bite and instead use standard PVS putty material. The putty material provides better results than blue mousse.

Note2: Please make sure that you place a ”ONE INCH FOAM” on the Chin holder before scanning in order to separate the bite registration, the Impressions, and the dentures. The foam will act as a separating agent to avoid fusion of the scanned objects with the chin holder.

SCANNING PROTOCOLS FOR IMPLANT CASES

1. Pre-Scan

  • Remove all non-fixed dentures, prosthesis, or retainers. Remove all jewelry in the field of the x-ray.
  • Position the patient in the normal fashion, sitting upright or lying down, depending on your machine. Head should be positioned parallel to the x-ray beam and looking straight ahead.
  • Separate the upper and lower arches of the patient with two cotton rolls. One on each side of the mouth.
  • A tongue blade is used to determine the occlusal plane. Tilt the head, so that the occlusal plane is parallel to the x-ray beam.
  • Patient Positioning

    • Maxilla: scan the patient with the maxillary plane as horizontal as possible to the x-ray beam. Use a tongue depressor to determine the plane if necessary.
    • Mandible: scan the patient with the mandibular plane as horizontal as possible to the x-ray beam. Use a tongue depressor to determine the plane if necessary.
    • If both: scan the patient with the mandibular plane as horizontal as possible to the x-ray beam. Use a tongue depressor to determine the plane if necessary.

2. Scan Settings:

  • Use a minimum of 0.3 mm voxel size for the scan. If using a medical CT, use 0.3 mm contiguous axial or helical slices.
  • Save the images in a multifile, non-compressed DICOM 3 format.
  • Use the same scan settings for all scans related to this patient.

3. Field of View:

  • Include the bottom of the mandible, if the area of interest includes the mandible.
  • Include the TMJ, if the area of interest includes the maxilla

4. Scan Instructions:

  • Make the patient as comfortable as possible.
  • Ask the patient not to move or swallow during the exam. Ask to close their eyes, as these may impart motion into the images.
  • Position patient in the usual fashion. For cone beam CT, use chin cup and headrest.
  • Scan the patient.
  • Check the images for motion before sending the patient out.

5. Scan Settings:

  • Place a one inch flat piece of FOAM between the item scanned and the stent holder of the CT. The foam will act to separate the scan data of the object from the stent holder.
  • Place the item to be scanned in the same orientation as its position in the person’s mouth (see figures). We have discovered inaccuracies of the scan data when the item scanned is upside down.
  • Verify the dentures must have radioopaque markers on them (see below).

6. Uploading DICOM Instructions:

  • DICOM data requirements:
    • DICOM 3 data
    • Non-compressed multifile format
  • Upload all of the DICOM data files to the appropriate folder on the Inpronto inSCAN module.