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Full Arch Restorative Rx
Full Arch Screw-Retained Restoration (Digital Workflow ONLY)
Dr. Info
First Name
*
Last Name
*
Practice Address
*
Phone
*
Email Address
*
Patient Info
First Name
*
Last Name
*
Age
*
Sex
*
Select
Male
Female
PROSTHETIC STAGE
*
Try-in
Please select type:
*
Finished
Unfinished (no pink)
Definitive Prosthesis
Please select the material desired:
*
Select an option
Universal Titanium Bar with Acrylic Denture
OEM Titanium Bar with Acrylic Denture
Zirconia (Monolithic)
Zirconia with Layered Ceramic
Zirconia Wrapped Universal Titanium Bar
Zirconia Wrapped OEM Titanium Bar
NobelProcera Zirconia
Nano Ceramic
Would you like to request changes from the Try-in?
*
Yes
No
Please select all that apply:
Midline
Lip Support
Central Length
Buccal Corridors
Occlusal Table
Is Conversion Occlusion dialed in?
*
Select
Yes
No
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