Unmatched Restorations -
Esthetic and Functional Harmony
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CT Guided
Surgical Order
Before you start…

Read about some important notes below. This will assist in making your case processing smooth and manageable for all parties.

Scan Quality

Please be sure to check all scans prior to submitting your case. We will also check, but it will avoid frustrations from your office if your scan can be checked.

Scan field of view: make sure no part of the desired arch to be treatment planned is cut off, no patient movement, and scan appliance was used (RRD or existing dentures with markers, etc.)

Scan resolution: Minimum of 0.3voxel is recommended. The smaller the number the better (ex: 0.2, 0.1, etc.)

Scan format: Please send all files in DICOM format.

Clear Duplicate Protocol (for All on X Cases)

For large All on X cases, clinicians will have the option to follow the Clear Duplicate Protocol. The Clear Duplicate allows final impression, try in, verification jig, and bite block records to be taken at surgery and provisionalization stage. The Clear Duplicates are picked up just like the Long Term Provisional (LTP). They are inserted into the bridge carriers, and picked up through the buccal access holes.

Guided Prosthetics RX

Please complete the form entirely. All fields in red are required. In order to initiate your cases, you will be charged a startup fee for each arch, which goes toward the total cost of the case.


Yes    No
Please be sure to have the following in order to process your case:
  1. Mail in upper and lower impressions or models
  2. Mail in bite registration
  3. Mail in used RRD (if partially edentulous)
  4. Upload or mail CT scan of patient in DICOM format (upload after clicking submit)
  5. Upload or mail CT scan of denture scan appliance (if fully edentuolous)
  6. Upload or mail digital photographs and shade information for restorative fabrication

Doctor 1 Details: (confirmation email will be sent to this doctor)

Bill to
Ship to
Charge credit card on file



Doctor 2 Details:

Bill to
Ship to
Charge credit card on file


Treatment Plan Information

Maxilla    Mandible





Yes      No

Yes      No
Please do not order
additional temporary
Yes, I would like to order
additional temporary
cylinders for clear dupe
Not applicable

Please input teeth numbers
(note international numbering if used)

Measurement at smallest vertical
at an implant position

Please complete the form entirely.
All fields in red are required.
The next prompt will instruct you on how to submit your scan data.

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