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Before & after
Contact us
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Home
Who we are
Products
Our technology
Before & after
Contact us
Warranty
Online Lab
Instagram
Facebook
Linkedin
Home
Who we are
Products
Our technology
Before & after
Contact us
Warranty
Online Lab
Instagram
Facebook
Linkedin
Online Lab
If you have any questions, feel free to
contact us
trough other channels.
Doctor's Name
*
Contact Email
*
Licence Number
*
Contact Name and Number
Patient's Name
*
D.O.B./Age*
*
Gender
*
Male
Female
Prefer not to answer
All Ceramic
E. Max Classic
E. Max Premium
E. Max Deluxe
Zirconia Premium
Zirconia Deluxe
Splinted
Implant
Implant Abutments
Cad Zirconia
Cad Tatanium
Stock Abutment
Other/Implant System
Occlusal Staining
Light
Medium
Dark
None
If No Occlusal Clearance
Lab Should Contact Dentist
Reduction Coping
Mark/Reduce on Opposing
Place Metal Island
If other/Implant system.. please list here.
Shade and Stump Shade
Fixed Removables
Zirconia Implant Bridge
Pekkton Implant Bridge
Titanium/Zirconia Implant Bridge
Titanium/Acrylic Hybrid
CAD Titanium Bar Overdenture
Contacts
Normal
Heavy + Broad
Point
Implant Abutments
Acrylic/Composite Try In (ATI)
Metal Try In
Bisque Try In
Attachment Type
Parts Sent With Case
Tissue Displacement
None
Slight
Agressive
Preliminary Restorations
Study Models
Diagnostic Wax Ups
Temporary
Evaluation/Tx Plan
Surgical Sting
Confirmation Jig
Bleaching Trays
Night Guard
Hard/Soft
ThermoGuard
Hard
Upper Removables
U Custom Tray
U Survey + Design
U Wironium Frame w/Bite
U Bite Block
U Tooth Set Up
U Reset Teeth
U Process Case
U Flipper Partial
U Wire Claps
U Repair
U Immediate Case
Lower Removables
L Custom Tray
L Survey + Design
L Wironium Frame w/Bite
L Bite Block
L Tooth Set Up
L Reset Teeth
L Process Case
L Flipper Partial
L Wire Claps
L Repair
L Immediate Case
Teeth to remove
Extra Instructions
File Upload
Upload your case file(s)
Upload supported file (Max 15MB)
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