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DENTCA Immediate - Complete (Upper & Lower)
Price:
$600.00
Order Information
Patient Number
(your patient #, account#, or case #, if applicable)
Patient Initials
*
(patient initials should be entered so that you or your staff can identify the patient)
Patient Photo Reference Number (
What is this?
)
Input patient photo reference number or upload it manually
Add a new file
x
Drop files here to upload
or
Browse
Files must be less than
1000 MB
.
Allowed file types:
jpg jpeg png
.
Gender
*
Male
Female
Case Type
*
Include Try-in
Request to skip Try-in
Please choose whether you want to receive a Try-in or go directly to Final. * If this is your first case, you will receive a try-in denture first before going to final regardless of your case type selection.
Enter ID Here
(8 character limit, the following special characters are acceptable - / )
Teeth shade color
*
A1
A2
A3
A3.5
B1
B2
C1 (RDP only)
C2 (RDP only)
C3 (RDP only)
D2 (RDP only)
(C1, C2, C3 and D2 are only for removable partial dentures – Valplast)
Gum shade color
*
Light Pink
Reddish Pink
Original Pink
Dark Pink
Upper Lip Length
*
5mm
5.5mm
6mm
6.5mm
7mm
7.5mm
8mm
8.5mm
9mm
9.5mm
10mm
10.5mm
11mm
11.5mm
12mm
12.5mm
13mm
13.5mm
14mm
14.5mm
15mm
15.5mm
16mm
16.5mm
17mm
17.5mm
18mm
18.5mm
19mm
19.5mm
20mm
20.5mm
21mm
22mm
23mm
24mm
25mm
n/a
Wax Rim
Desired Anterior Overjet
*
Regular (Class I, >2mm)
Retrognathic (Class II, >3mm)
Prognathic (Class III, <-1mm)
(note: extreme cases may not be able to be designed to desired anterior overjet)
Tray Size
*
Small
Medium
Large
X-Large
n/a
Wax Rim
(If different sizes were used for the maxillary and mandibular arches, enter the smaller of the two.)
Teeth Mold Shape
*
Universal
Oval
Square
Impression and/or CBCT DICOM File Upload
*
Upload Scans and/or CBCT
Physical Impression will be mailed
Scan Upload
1. CBCT DICOM (CBCT files must be zipped before uploading) or Bite STL Scan file
2. Implant-level 3D digital impression STL impression file (Single Arch - Maxillary or Mandibular / Complete - Both)
3. SA - Opposing stone scan STL
Add a new file
*
x
Drop files here to upload
or
Browse
Files must be less than
1000 MB
.
Allowed file types:
stl obj zip dcm jpg 3oxz
.
Special Instructions