Submit a Case

CASE SUBMISSION PROTOCOL Section 1: Required Digital Files Label every file the same way, PatientLastName_FirstName_ScanType, and send the case as one zipped folder. 1.1. Cone Beam Computed Tomography (CBCT) Scans: The CBCT drives the whole plan, so the series has to be clean and free of artifact. Scan 1: Patient Scan (Without Prosthesis) Field of View (FOV): Must include the surgical site and the anatomy that constrains it — the maxillary sinus and nasal floor above, the inferior alveolar canal and mental foramen below. For a single posterior site a small field is enough as long as it reaches those landmarks. For a full arch, the whole arch, and on the mandible the canal where it enters and where it exits. Use the smallest field that captures them. Patient Position: The patient should be biting on cotton rolls to ensure separation of the arches, preventing streak artifacts. Lips should be relaxed. Resolution: Isotropic voxel of 0.3 to 0.4 mm. Anything under a millimeter is workable; going finer than 0.3 mm adds dose and file size without improving the guide. Format: Uncompressed DICOM (Digital Imaging and Communications in Medicine), the whole multi-file series, zipped. Not a viewer package and not a single flattened file. Gantry tilt: Zero. A tilted acquisition distorts the reconstruction and cannot be planned from. Keep the reconstruction settings constant across the series and export one series. Scan 2: Prosthesis Scan (Dual-Scan Protocol) This scan is required for edentulous or partially edentulous cases to capture the desired tooth position and soft tissue contours from an existing denture or a diagnostic wax-up. Procedure: Place six to eight radiopaque fiducial markers, such as gutta-percha points or purpose-made scan markers, on the flange or the intaglio surface of the patient's existing denture or the diagnostic wax-up model. First Scan: Scan the patient wearing the prosthesis (same settings as Scan 1). Second Scan: Scan only the prosthesis by itself, placed on a foam block. Format: Two sets of DICOM files. 1.2. Intraoral or Model Scans (STL Files): Digital scans are strongly preferred over physical impressions for accuracy. For Dentate/Partially Edentulous Patients: Maxillary_Arch.stl: Full arch scan. Mandibular_Arch.stl: Full arch scan. Bite_Registration.stl: Scan of the patient in maximum intercuspation (MIP) or the desired centric relation (CR). Scan_Body.stl (if applicable): For cases involving existing implants or a digitally-driven immediate provisional plan. For Edentulous Patients: Edentulous_Arch.stl: Scan of the edentulous ridge. Denture_Intaglio.stl: Scan of the tissue-fitting surface of the existing denture. Denture_External.stl: Scan of the teeth and flange portion of the denture. Denture_Bite.stl: Scan of the patient's dentures in occlusion. 1.3. Clinical Photography: High-resolution photos are vital for assessing esthetics, phonetics, and smile design. Facial Views: Full face, resting position (lips together). Full face, natural smile. Full face, exaggerated "E" smile (to show maximum incisal display). Profile view, resting position. Intraoral Retracted Views: Anterior view in occlusion. Left and right lateral views in occlusion. Occlusal views of the maxillary and mandibular arches. Section 2: Detailed Prescription & Treatment Plan Information This information must be clearly communicated on the laboratory prescription form. 2.1. Patient Information: Patient Name & Date of Birth. Lab Case ID (if applicable). Date of Surgery. 2.2. Surgical & Prosthetic Plan: Target Arch: Maxilla / Mandible. Implant System: Specify Manufacturer, Type, Diameter, and Length for each planned implant site for example, Nobel Biocare NobelActive, site #7, 4.3 by 11.5 mm. Implant Positions: List the tooth numbers for each implant position for example, #4, #6, #11 and #13. Guide Fixation: Specify the number and desired location of fixation pins for the base guide. Default is typically 3-4 pins. Note any anatomical areas to avoid. Bone Reduction: Specify the required amount of vertical bone reduction in millimeters for example, 3 mm of reduction from the most coronal bone level. Indicate if the reduction is to be flat or if it should follow the natural bone contour. This is critical for determining the restorative space for the final prosthesis FP1 or FP3, for example. Angulation of Distal Implants: Specify desired angulation for distal implants to avoid the sinus or nerve for example, angulate the distal implants to emerge anterior to the maxillary sinus. 2.3. Restorative & Esthetic Parameters: Vertical Dimension of Occlusion (VDO): Confirm if the existing VDO (from denture or scans) is acceptable. If a change is required, specify the desired increase/decrease in millimeters. Esthetic & Occlusal Plane: Midline: Confirm if the current midline is correct or specify the required deviation for example, shift the midline 1 mm to the patient's right. Incisal Edge Position: Specify the desired incisal edge position relative to the upper lip at rest and during smiling. Reference clinical photos. Occlusal Plane/Cant: Note any cant that needs to be corrected. Final Prosthesis Design: Type: Screw-retained / Cement-retained. Material: PMMA (for immediate provisional), Zirconia, etc. Designation: FP1 (replaces only crown) or FP3 (replaces crown and gingival tissue). 2.4. Verification & Approval: Request Virtual Planning Session: Check a box to request a mandatory remote meeting with the lab technician to review and approve the final digital plan before any manufacturing begins. This is the most crucial step to prevent errors. Section 3: Summary Checklist for Submission Before sending, verify the following are included in the case submission folder: CBCT Data (DICOMs): Patient scan without prosthesis. CBCT Data (DICOMs): Dual-scan records (patient with prosthesis AND prosthesis alone), if applicable. STL Files: Maxillary, Mandibular, and Bite Registration scans. Clinical Photographs: Full facial and intraoral series. Completed Lab Prescription Form: All fields in Section 2 are filled out. Contact Information: Best phone number and email for the clinician for the virtual planning session. Section 4: Exporting Files From Your Scanner Every scanner writes an open STL, PLY or OBJ file, and every CBCT unit writes DICOM. You do not need special software to send us a case. TrueGuide Dental also holds an account on every major scanner portal, so you can send cases to us directly instead of exporting files by hand. Look for TrueGuide Dental in the lab list inside your portal, or call (201) 255-4233 and we will send the connection details for your system. iTero: open the case in MyiTero, choose Export, and select the open STL option. Download the upper, the lower and the bite, then upload all three here. 3Shape TRIOS: open the case in TRIOS or Dental Desktop, choose Export, and save the scans as STL or PLY. Include the bite scan. Medit: open the case in Medit Link, choose Export Case File, and save as STL or PLY. Dentsply Sirona Primescan and CEREC: open the case, choose Export, and save the model as STL. Planmeca Emerald: in Romexis, select the case, choose Export, and save as STL. Dexis, Carestream, Shining 3D, Panda, Runyes, Eighteeth Helios, Launca and Straumann SIRIOS: use the Export or Save As command in the scanner software and pick STL, PLY or OBJ. CBCT: export the full DICOM series as a folder, then zip the folder. Do not send a single viewer file or a self-opening EXE, and do not send screenshots of the scan. Name the files PatientLastName_FirstName_ScanType, put everything in one zipped folder, and upload it in the form on this page. If a file is larger than the upload limit, paste a Dropbox or Google Drive link in the field provided. Call (201) 255-4233 if anything in your software does not match these steps and we will walk through it with you.