Part 2 Oral Examination

Part 2 Oral Examination

Registration Form
Name

First Name Middle Name Last Name
Clinic Name
Clinic Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail
Mobile Number

Area Code Phone Number
Phone Number

Area Code Phone Number
Work Number

Area Code Phone Number
Educations of Dental School
Type a question
Experience with Implantology

Yes No
Notes:
- Applicable fees must accompany your application(s).
- Payments must be in U.S. Dollars can be paid Online, Money Transfer or Checks.
- Examination Dates will be posted on the IBOI website and our Social Media as soon as they are available
Requirements:
- 50 Documented Cases is required for the General Practicioner and 25 Documented Cases for the Specialist
- You will be required to submit only TEN (10) cases that should be Fully Documented in (IBOI Case Submission Form linked with this form) in all.
- The 10 Cases should cover the following:
1. Anterior Single-tooth replacement
2. Posterior Single-tooth replacement
3. Immediate Dental placement after extraction
4. Free-end "saddle" edentulous (Maxilla or Mandible) requiring with more than one implant
5. Bounded Mandible or Maxilla with more than one implant to support a bridge
6. Fully edentulous Maxilla with fixed prosthesis
7. Fully edentulous Mandible with fixed prosthesis
8. Fully edentulous Mandible or maxilla with implant overdenture
9. Pneumatized Maxillary Sinus requiring augmentation
10. Horizontal and/or Vertical Ridge Augmention
- The remaining Cases Documentation can be filled in the following Table attached with:
  - High Resolution:
  - Preopertive and Postopertative OPG
  - Photographs for the Prosthetic part
- Your cases must be restored and functional for a minimum of one year at the time of case submission
- Any Applicant shoud successfuly completed IBOI part 1 examination.
- I am submitting my binding application concerning the participation in the above-mentioned examination.
- I am aware that there are Additional Fees to be paid in case i fail the examinaion, and i know that i must score a minimum of 70% Iin the written examination.
- The legal and Contractual Regulations detailed in the examination Brochure become the basis of this Application and as such are an integral part of the contract. However, it must be noted again that changes and amendments beyond the scope shown there in can be made at the sole discretion of the Organizers.
- I am a ware that the examination fees are nonrefundable and must accompany this application.
- A written confirmation must be received for the examination elegibility of the applicant, date, time and location from the organizer, otherwise entry to the exam is denied.
- I will submit my examination qualification in English translation to the Board of Directors.
- Fees is 750$
Date

Month Day Year
Date
Signature

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