The “Alternative Dual Scan Protocol” is recommended if you are using the Sirona CBCT unit for fully edentulous cases, or the patient’s denture has metal sub-structures. Using this technique, a duplicate clear denture will be required.
Scenario #1: PREFFERED
1. Duplicate the patient’s hard-relined, well-fitting denture into a clear acrylic denture (NO Barium or Biocryl X).
2. On the clear acrylic duplicate denture, place 6 x-ray markers:
- Place 3 markers on the facial/buccal surface and an additional 3 markers on the lingual surface
- Place the markers on varying axial planes
- Example: if you place a marker on the buccal area of #2-3, then place your next marker on the lingual area of #4-5 area, the next marker on the facial of #8-9 area and so on
*Do not place the markers on the intaglio surface of the denture*
![image1](https://implantcleanup.wpengine.com/wp-content/uploads/2016/09/image1-300x225.jpg)
![image2](https://implantcleanup.wpengine.com/wp-content/uploads/2016/09/image2-300x225.jpg)
![](https://implantcleanup.wpengine.com/wp-content/uploads/2016/09/image3-e1479854400719-225x300.jpg)
3. Pre-Scan Patient Instructions:
- Use a bite registration for separation, secure fit, and to eliminate rocking
- Confirm fit by asking the patient “Is the denture fitting correctly?”
- Breathe through your nose, close your eyes, and place the tongue at the back of the mouth
4. Capture CBCT of the patient WEARING the denture with the x-ray markers.
Vital Anatomy to be captured:
- Superior: Mid Sinus / below orbit
- Inferior: Capture 1-3 mm of mandible dentition
CBCT General Settings: Maxl 6cm
- 8cm, 0.3 – 0.4 Voxel
5. When scanning a patient following Dual Scan Protocol:
- Review the scan carefully to be sure there is no “Black Air Space” between the denture and the soft tissue of the patient
6. Export and Upload CBCT Scan
- Export the CBCT scan in a multi-file DICOM format to the desktop
- Right-click on the folder, go to “Send To”, and select “Compressed (Zipped) Folder”
- Upload the zipped/compressed folder to Implant Concierge
7. Ship the duplicate denture with the x-ray markers STILL ATTACHED, to Implant Concierge.
More information on exporting the DICOM files form you specific CBCT machine can be found under the “Exporting DICOM” section.
If the Doctor has already scanned the patient wearing a radio-opaque denture…
1. Ship the denture to Implant Concierge
2. Ship the Master Cast to Implant Concierge