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Information for Dentists
Digital Case
YOUR DETAILS
Doctor's Name *
Mobile Number *
Patient's Name *
Clinic Address *
City *
Pincode *
Email *
Type of case *
Submit data for Cad/cam Surgical Guide
Retain details for my next visit
Submit data for Cad/cam Surgical Guide
SURGICAL PLAN
Select implant site (s)*
UR
8
7
6
5
4
3
2
1
UL
1
2
3
4
5
6
7
8
LR
8
7
6
5
4
3
2
1
LL
1
2
3
4
5
6
7
8
Total No. of teeth selected
UR
UL
LR
LL
PROSTHETIC PLAN
Choose one *
Type of abutment *
Implant level prosthesis
Abutment level prosthesis
Choose one *
Type of Final prosthesis*
Screw retained prosthesis
Cement retained prosthesis
Screw+Cement retained prosthesis
Hybrid Denture with Acrylic
Combination (Malo) Bridge
PFM
Overdenture
Additional comments
Link to DICOM Raw Data - Using Google Drive/WeTransfer/YouSendIt/Dropbox
Intra Oral Impressions: Upper
Intra Oral Impressions: Lower
Submit Form
×
Add details
Type of Implant (Company and brand)*
Desired Implant diameter and length*
Type of Implant Placement*: (Choose one)
With Flap
Flapless
Mouth Opening*: (Choose one)
Normal
Reduced
Mobility of Teeth: (Choose one)
Grade 0
Grade 1
Grade 2
Grade 3
Additional surgical procedures*: (Choose one or more)
None
Extraction and Immediate Placement
Socket Shield
Osteoplasty
Sinus Graft
GBR
Tilt Distal Implants
×
View details
Type of Implant (Company and brand)*
Desired Implant diameter and length*
Type of Implant Placement*: (Choose one)
With Flap
Flapless
Mouth Opening*: (Choose one)
Normal
Reduced
Mobility of Teeth: (Choose one)
Grade 0
Grade 1
Grade 2
Grade 3
Additional surgical procedures*: (Choose one or more)
None
Extraction and Immediate Placement
Socket Shield
Osteoplasty
Sinus Graft
GBR
Tilt Distal Implants
