since 1926


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GuidedSMILE was developed for dentists who desire a preplanned, predictable guided All-On-4 (5,6,7) style surgery. This amazing service delivers anchored bite verification, anchored bone reduction, anchored site drilling and finally very accurate anchored provisionalization. We offer this service from merely a CT scan and traditional records. The process, the product, the surgery is straightforward, and can include chairside assistance!

GuidedSMILE ROE Dental Laboratory

GuidedSMILE is a 4-Guide System

1 Pin guide - sets anchor pins


Pin Guide is fully seated on the patient's existing dentition. Once verified via the two occlusal windows, the horizontal sites are drilled and anchored. Anchor pins are fully seated, verified and the guide is removed.

GuidedSMILE Pin GuideEdentulous Pin Guide is a digital duplicate of the patient's existing denture. This tissue-supported guide is inserted, patient closes, and the anchor sites are drilled, anchored, verified, and the guide is removed.

2 Bone Reduction

Once teeth are removed and tissue is flapped, the Bone Reduction Guide is inserted, anchored, and bone is levelled to the meet the labial and lingual frame of the guide. This guide floats above the bone, and therefore should not be impinged by undercut.


GuidedSMILE Bone Reduction Guide

3 Osteotomy Guide

This guide is rigidly fixed with the pins, yet floats around the bone. Standard protocols are followed to drill sites and place implants.

GuidedSMILE Osteotomy Guide


Superior to conventional denture pick-up systems, this anchored GuidedSMILE nano-ceramic provisional transfers the CO/CR as determined by pre-surgical records. Implant abutment positions, anchor sites, tooth position, smile, and tissue space are all pre-set.

GuidedSMILE PMMA Guide

5 PMMA (optional RAPID Appliance) - comes with purchase of final restorations

RAPID Appliance is ROE's special pick-up device, a clear duplicate of the PMMA. This allows the doctor to capture a second record to hold until final conversion. Once the patient is ready for the final, perform a pick-up impression, with tray adhesive on the tissue side, using medium PVS. Send this pick-up to ROE and we will


GuidedSMILE Osteotomy Preparation Options

Option 1 - GuidedSMILE-FG - Fully Guided (as seen above) - accommodates fully guided kit from most manufacturers, accommodates ROE's sleeve-in-sleeve system, and allows some implants lines to be placed through the guide.

GuidedSMILE ROE Dental Laboratory

Option 2 - GuidedSMILE-PG - Pilot Guide - allows accurate placement of pilot drilling with subsequent non-guided sequencing.

GuidedSMILE ROE Dental Laboratory

Option 3 - GuidedSMILE-FH - Free-Hand - includes a location reference on the bone reduction frame to optimize implant location for PMMA pick-up, and a removeable reference inset to provide a maximum range for site preparation. Left image: notice the round divot references indicating implant general location. Right image: boundary insert used to ensure location of implants is within PMMA parameters.

GuidedSMILE ROE Dental Laboratory


GuidedSMILE Work-Up Protocol, Documents and Links:

Step 1:

a. Complete our on-line Rx to provide ROE with complete case information: upload DICOM / Photograph (full face, full natural smile) as 'Documents' through this Rx web page: LINK web site portal

b. Send master casts, bite registration (CO and/or CR), and/or digital impressions, study casts – print UPS label here.

c. Send MSGA - Master Surgical Guide Agreement with first case (required to begin)

- Required - GuidedSMILE Work Authorization required for all cases (on line or White Paper)
- Optional - Esthetic & Funct'l Checklist include please if ROE is significantly changing tooth arrangement, or a new denture set-up is needed.

Step 2: Meet ROE on line for implant and guide planning (allow 5 days after receiving all materials) Link

Step 3: Sign and return the TPA Treatment Plan Report – via fax or scan and email

Step 4: Receive the GSI Surgical Information Form to order parts and review surgery – via email

Step 5: Receive guide (ROE will ship within 10 days of the signed TPA Treatment Plan Report)

Notes on preparring for and capturing the CT Scan.

If your patient is dentate, follow the above steps, and capture a CT scan with the patient opened biting on cotton rolls.

If patient is edentulous, and the existing denture fits well and the tooth arrangement is accepted, convert into a scan appliance (instructions page 6). Perform a dual scan using the protocol in our manual. If edentulous patients needs to establish tooth position and vertical, begin conventional denture steps to create a scan appliance.

We are always available to discuss your case. Call 800 228 6663 and ask for the CT Department and reference GuidedSMILE.


GuidedSMILE Surgical Steps - Click through PowerPoint:

Published on Apr 20, 2017 This slideshow is provided as a guide only, and not as a complete 'how-to' for guided surgical procedures with GuidedSMILE. Please use this video in conjunction with our web video below, clinical experience and training, and our chairside assistance upon request.

GuidedSMILE Surgical Steps - Video

Published on Apr 20, 2017 This slideshow is provided as a guide only, and not as a complete 'how-to' for guided surgical procedures with GuidedSMILE. Please use this video in conjunction with our slideshow above, clinical experience and training, and our chairside assistance upon request.


GuidedSMILE photographs

Edentulous Patient

Pin Guide

GuidedSMILE edentulous

Bone Reduction Guide

GuidedSMILE Bone Reduction

Osteotomy Guide

GuidedSMILE Osteotomy Guide

PMMA Guide - Shown: 1-Piece, when vertical space does not allow the standard 2-piece

GuidedSMILE PMMA Guide


Digital Impression:

digital impressions guidedsmile

ROE accepts all digital impressions. Here are your options:

3Shape - must use 3Shape Communicate - ROE's email is to open a connection

Cadent iTero - must use Cadent's portal, just search for ROE to add connection

E4D - either use the Model Export function in Romexis to export files to the desktop and upload through our portal along with your DICOM, or use DDX (not dependable)

Sirona - either export a DXD file to your desktop and upload through our portal for ROE to convert, or us Cerec Connect to upload to ROE

3M TDS - must us 3M's portal

Carestream 3500, 3600 - export .stl to desktop and upload to our portal, or use DDX (not dependable)