IOS Socket Denture Order Form (Dental Clinic)

【STL Data】Socket and Socket Plus Technical Instruction Form
This is a technical instruction form for ordering Socket and Socket Plus using scan data from digital impressions or plaster model data）

Order Method　
Please upload and send your instructions via cloud. The instructions should include the STL data for the complete upper and lower arch data, bite data (required), and your specific instructions.

●Acceptable data
- 3D data (stl/obj/ply)
※(Dicom is not supported, so please convert it into STL data at your clinic)
【Reference image data】: jpg/png/gif/pdf
If you would like to include intraoral illustrations in addition to this form, please print out this illustration and upload the completed images to the reference information form below.

●Available scanners：
Available scanner data include Primescan, iTero, TRIOS3, SHINING 3D, laboratory scanners, etc. When placing your order, please consider that older scanners may have accuracy issues that could impact the quality of the results.

●Contact information
Bitec Global Japan Inc
International Sale Department
Email: info_int@bitecglobal.com
Product website:
Corporate website: https://bitecglobal.jp/en/
Order Information
Occupation
Orderer Name

First NameLast Name
Dentist Name*

First NameLast Name
Dental Clinic Name*
Phone Number*
Agency Name*
E-mail*
Delivery Address*

Street Address 1

Street Address 2

CityState / Province

Postal / Zip Code
Patient name*

First NameLast Name
Patient ID*
Instruction detail
Products*
prevnext( X )
Socket (754) For 1 ~ 2 consecutive missing teeth (Resin rest design. If you prefer a metal rest design please add the Metal rest option when placing an order).
$490.00 Quantity



Metal Rest optionOnly for Socket product
$30.00 Quantity



Socket Plus (757) For 1 ~ 3 consecutive missing teeth (Metal rest design)
$750.00 Quantity



Total

$0.00
Note:
1. Please note that the price of the product includes shipping costs, from Japan.
2. Product is delivered by DHL or FedEx.
Defective site

Maxillary

	1	2	3	4	5	6	7
Maxillary/Right
Maxillary/Left

Mandibular

	1	2	3	4	5	6	7
Mandibular/Right
Mandibular/Left

Rest details
Rest option*
Rest type*
Rest position*
Please indicate where the denture rests are 'placed' in the dental formula.
Mesial/distal*
Additional rest*
Write the Type of teeth, Mesial/ distal and rest type for additional rest here.
Design
Occlusion Bite Adjustment*
Design*
Teeth arrangement
Number of teeth*
Change in number of teeth*
Occlusal pattern*

Artificial tooth shade*

	A1	A2	A3	A3.5	A4
Shade

Design (Other)
Bite*
Occlusion*
Arm retention force*
Extraction socket*
Bone protuberance*
Other technical instructions*
Please fill out the other instruction into this box.
If you would like to include intraoral illustrations in addition to this form, please print out this illustration and upload the completed images to the reference information form below.
Data transfer method
1. Data prepare
Please perfare full upper and lower arch and bite data
(Right and left lateral molars or right and left lateral molars + premolars)

2. Data Confirmation
Always double-check the data before sending.
*Check that the scan is particularly thorough on the abutment tooth and the mucosal surface below the abutment tooth (resin arm).
Also, if there are any data holes, deficiencies, or bite shifts in the data, please take another impression.

3. Data transfer method
Please upload data to https://www.sendgb.com/ and send the link via the following email.

Email: info_int@bitecglobal.com

If you wish to provide technical instructions based on an oral illustration and the manufacturing data, please print this out and upload the image as a reference.

※Acceptable data：【3D data】 stl／obj／ply (Dicom is not supported so please convert into STL data at your clinic)
【Reference image data】: jpg/png/gif/pdf"
Terms and Conditions Check
Should be Empty:

【STL Data】Socket and Socket Plus Technical Instruction Form

Order Information

Instruction detail

Defective site

Rest details

Design

Teeth arrangement

Design (Other)

Data transfer method

Terms and Conditions Check