Documente Academic
Documente Profesional
Documente Cultură
INCLUDES: Scan Template, Plan, and Surgical Guide DOCTOR ADDRESS CITY PHONE EMAIL STATE FAX ZIP PATIENT NAME AGE MALE / FEMALE
GUIDED SURGERY Rx
5 Business Days In Lab
TODAYS DATE
/ /
DUE DATE
/ /
Scan Template:
Partially Edentulous Fully Edentulous 1-8 Teeth 9+ Teeth
STEP 1
STEP 2
Plan:
Doctor Plans Case Allure Dental Studio Creates Proposal* Email Address:
STEP 3
Surgical Guide:
Straumann Other Manufacturer* Size:
*Does not include Depth Control
Surgery Type
Flapped Flapless Immediate Extraction
Abutment Selection
Emergence Width
No Tissue Displacement
(Default)
Restorations
e.max
Tissue Displacement
Titanium
Zirconia
Surgical Placement
Instructions:
Shade
DOCTORS SIGNATURE
460 West Larch Road, Suite #1 Tracy, Ca 95304 Toll Free: (877) 325-5873 Fax: (209) 221-6792 asds@alluredentalstudio.com
LICENSE NUMBER