Send New Cosmetic Design Case

Doctor Name
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Format: (000)-000-0000.
Patient Name
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Email to send files / designs
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Restoration Design
No. of teeth to be included in the Trial Smile?
Who is printing the design?
Shade
Use my previously approved design diagnostic wax-up design by ROE?
- Trial Smile design STLs will be provided in 24 hrs.
- Trial Smile's fabricated by ROE will be shipped in 3 days.
Restoration Type

Other
Pontic Design
* For Bridge
Final Restoration Material
Final Restoration Material
* For Veneers
Who is milling the final restoration?
Turnaround Time: It will take 8 days in lab for eMax or Bespoke zirconia, or 10 days in lab for PFZ upon either digital receipt or physical receipt of all appropriate records.
Stump Shade
Shade
Turnaround Time
Have you pre-booked design services?
In order to guarantee a 1-hour turnaround time you need to have pre-scheduled planning resources 48 hours in advance. If you have not done so call us 800-228-6663 to confirm available resources.
Do you want to approve your diagnostic wax-up before we fabricate?
What files are you requesting?
Teeth to be restored
How do you want to print your temporary restorations?
Explain how you want the temp restoration segmented
Planned Restoration Type
Planned Restoration Type

Other
- Implant Brand and Size
- Scan Body Brand
- Gingival Height
- Abutment Type
- Implant Bridge?
- Pontic Design
- Occlusal Anatomy
- Occlusal Guidance
- Occlusal Contact
- Lingual Anatomy
- Contour Instructions
- Hollywood
- Natural
- Detailed Natural
- Functional
- Detailed Functional
- Youthful
- Detailed Youthful
- Enhanced
- Detailed Enhanced
- Oval
- Detailed Oval
- Additional incisal length to the central incisor?
- Create ideal gingival architecture?*
  * This may require a gingivectomy or crown lengthening to achieve the final results.
- Create uniform gum heights?
- Please include -
- Explain what you wish to achieve with the gum height
- Lack of Restorative Space
- Patient Records
- Scan type being submitted
- Confirm Individual Scans
- How are you submitting your files?
- Confirm the required photos are being uploaded with this case
- Confirm the required photos are being uploaded with this case
- IOS Portal
  Digital preparations: Only need pre-op scan. Post-operative for temps/veneers: Need post-op scans and HIGHLY RECCOMEND pre-op as well
- Other IOS Portal
- Additional Notes
- Patient Files
  
  *
  Cancelof
- Please verify that you are human
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Patient Records