Select Tooth/Teeth
18
17
16
15
14
13
12
11
21
22
23
24
25
26
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28
48
47
46
45
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31
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38
Your Name Your Phone Patient Name Tooth Shade Shade Guide
Restoration Type
CrownBridgeVeneerInlay/OnlayImplantDenture
Fixed Restoration Section
Number of Units
Choose Stage Primary TraySecondary trayTry InFinishRepair
Material of Restoration PFMZirconiaAll ceramicOther
Denture Section
Case Type Full DenturePartialImmediate DentureFlipperNightguardOther
Nightguard type UpperLowerFlexiguard (hard/soft)HardSoft
Arch upperlowerboth
Choose Stage Custom TrayCast Metal FrameworkBase PlateOcclusal RimTry InFinishRepairRelineRebase
Implant Section
Restoration CrownBridgeAll on X
Abudment Type Cement Retained AbudmentScrew Retained
Cement Retained Abudment Type
Custom Titanium AbutmentCustom Zirconia Abutment
Implant Type Implant Diameter
To be included Lab analogImpression copingAbutmentOther
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