üplease tick docklands vic 3008 all ... - dentart ceramicdec28).pdf · 1800 dentart / 1800 336 827...
Post on 11-Oct-2020
4 Views
Preview:
TRANSCRIPT
1800 DENTART / 1800 336 827enquiries@dentartceramic.com
106/838 Collins StreetDocklands Vic 3008
Dentist:
Client:
Age: 20’s 30’s 40’s 50’s 60’s Male / Female
Date: Date required by 5pm:
ü Please tick
ALL PORCELAIN Emax Veneer Emax Inlay / Onlay Emax Crown Monolithic Emax Crown Layered
Zirconia Crown Monolithic Zirconia Crown Layered
PFM PFM Maryland Bridge Implant Crown
Sytem
FULL GOLD VENEERS Crown Post & Core Inlay / Onlay
MISCELLANEOUS Temporary Crown / Bridge Diagnostic Wax Up Special Trays Study Models
ITEMS ENCLOSED Impression Opposing model Model of wax up Pattern Resin post & core Bite reg Implant Components Articulator Photos Old crown
SHADE:
SPECIAL INSTRUCTIONS / DESCRIPTION:
ü Please tick
Surface: Smooth Medium Rough Glaze: Gloss Satin MattFissures: Stain No stain
.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
top related