Scan&Smile Full Arch Design

Disclaimer:

This form should be completed and submitted in one session. You will not be able to continue filling this form on another device.
Scan&Smile Full Arch Design
Dr. First and Last Name

First NameLast Name
Dental Clinic Name

Clinic Name

Delivery Address

CityState

Zip Code
Country
Phone for any issues / question arises

Country CodeArea CodePhone Number
Dental Clinic Case ID
e.g. patient last name - this allows to identify the work precisely back to you
E-Mail to receive STL files and for us to contact

Confirmation Emailexample@example.com
Planned Date and Time of surgery (in your time zone)

MonthDayYear
Date
Hour MinutesAM/PM Option
US Timezone
Write your timezone
Have you purchased any TRI Dental Implants products in the past?
Please enter your TRI Dental Implants customer number:
Full Arch consultancy design preferences
Full Arch Design for
Number of Units in the Case
Preferred Fixed Prosthesis Type
Use of ScanBridge or Photogrammetry
Brand of Photogrammetry
Tell us technical information about the case and your design preferences
Midline
How many mm to move
Incisal edge position
How many mm to move
VDO
How many mm to move
Occlusion
list any changes needed to current bit relationship e.g. class1, edge to edge, open bite by how many mm
For surgical planning, specify desired implant positions, quantities, and sizes
By default we design with 2.8-L screws. If screw channel is going through the esthetic zone of the restoration (e.g. labial) would you like us to use 2.6 screw instead? If so you must have 2.6 screw in your clinic.
Tell us more about the case and your design preferences
Load required files up on booking

Cancelof
Pre-op I/O Scans

Cancelof
Promocode
calculation

Total

USDDescription

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty:

Disclaimer:

Scan&Smile Full Arch Design

Full Arch consultancy design preferences

Tell us technical information about the case and your design preferences

Total*

Total