Digital Prescription Form




   





REMOVABLE RX

COMPLETE DENTURES

     Standard Denture

                    Success Injecction Denture

 

PARTIALS                      

Cast (Complete):

         Classic Cast Partial

              Premium Cast Partial

      Framework Only

    Acrylic (Complete):

  Classic Partial

      Premium Partial

      Flexible (Complete):

Classic Flexi 

    Premium Flexi

 

TEETH TYPE                 

                    Classic        Premium

              Shade    Ant.     Post.

                Mold    Ant.     Post.

 

        ADDITIONAL PRODUCTS

                    Baseplate with Bite Rim

                      Light Cured Custom Tray

Nightguards:  

                   Hard          Soft

Repairs:          

                  Acrylic Fracture

                    Additional Tooth

Reline

   Rebase

         Laser Weld

        Add Clasp

           Metal Mesh

          Lingual Bar

FIXED RX

PORCELAIN FUSED TO METAL

     High Noble Yellow Gold

    High Noble White Gold

   Noble (Semi Precious)

          Base Metal (Non-Precious)

 

METAL-FREE                               

e-Max                           

e-Max Veneer             

   Elite Zirconia (Layered)

Full Z (Contoured)      

 

          FULL-CAST CROWN-INLAY-ONLAY

                     Type II Yellow High Noble (Inlay)

                      Type III Yellow High Noble (Inlay)

      Type IV Yellow or White:
     High Noble or Noble

           Base Metal (Non Precious)

 

MARGINS                                 

Lingual                                 

Show No Metal         

Metal Collar (Thick)  

Metal Collar (Thin)    

        Porc.Butt (Shoulder) 180

        Porc.Butt (Shoulder) 360

Facial                                    

Show No Metal         

Metal Collar (Thick)  

Metal Collar (Thin)    

        Porc.Butt (Shoulder) 180

       Porc.Butt (Shoulder) 360

 

PONTIC DESIGN

A     B     C     D     E

 

OCCLUSAL STAIN

    None

  Light

        Medium

  Dark
IF NO OCCLUSAL CLEARANCE

Call Doctor

                   Adjust opposing tooth

         Metal occlusion

 

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