Case type · Diagnostics

Scan review and rescue.

The expensive version of a bad scan is the one nobody checked. Design proceeds, the appliance is made, and the problem surfaces at the fit appointment — a fortnight after it could have been fixed with a five-minute re-scan.

Case typeScan reviewRe-scan specifiedSame day

Intraoral scan field showing an incomplete palatal vault capture — **A vault that stops at the gingival margin.** There is nothing here to seat a framework on, and no amount of design work creates the missing surface.

What this is

Every case that arrives is checked before design starts. Not as a courtesy — as the first step of the work, because designing on a record that cannot support the appliance is worse than not starting.

Where a record will not do the job, you get told the same day, with a specification of exactly what to re-capture. Not "please rescan", which wastes another appointment. Which region, to what extent, and why.

What gets checked

Coverage

Does the scan actually contain the anatomy the appliance needs? A palatal expander needs the vault to its full depth. A framework needs the tissue it will rest on. The most common failure is a scan that is perfectly adequate for a crown and useless for an appliance, because it was taken as though it were for a crown.

Completeness of the arch

Full arch means to the distal of the last erupted tooth. A scan that stops at the second molar constrains anchorage planning in ways that are not obvious until the plan needs that tooth.

Surface quality where it matters

Noise on a buccal surface nobody uses is irrelevant. Noise on the fitting surface of a planned framework is not. We look at the surfaces the design depends on rather than at the scan as a whole.

The bite

Whether it is present, whether it is in the position the case notes describe, and whether both arches actually agree with it. Bite records disagree with their own scans more often than people expect.

Radiographic registration

Where the case merges scan with CBCT, whether there are enough clean, well-distributed surfaces to register against — and whether scatter has degraded the ones the merge needs.

A re-scan on day one costs a short appointment. A re-scan after an appliance has been made costs the appliance, the appointment, and the conversation.

What you get back

If the scan is fine, nothing — the case just runs. If it is not:

What is missing or unusable, shown rather than described
Why it matters for this appliance, specifically
What to capture on the re-scan, in enough detail to brief whoever is holding the wand
Whether any part of the case can proceed meanwhile

Why we do not just work around it

Because working around a missing surface means inventing it, and an invented surface fits the patient the way an invented surface fits a patient. The design would look complete and would not seat.

It is also worth saying that a rejected scan is not a criticism of whoever took it. Scanning for an appliance is a different job from scanning for a restoration, and most scanner training covers the second one.

Common causes, in order

Vault not captured, on any case involving the palate
Arch stopped short of the terminal molar
Bite recorded in a different position from the one described
Scatter degrading the surfaces a CBCT merge needs
Soft tissue captured mid-movement, so the surface is a blur of two positions

More on this: the record errors that cost the most.

Timeline

Same working day. It happens before the case enters the design queue, not after it.

Planning and design support only. Diagnosis, treatment planning and the clinical decision remain entirely with the treating clinician.

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