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DentalGoneDigital.com
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Service Requested (Required) *

Surgical Guide Printed only (NOT Treatment Planning) Express Planning in BSP (Hybrid Plan) Design Surgical Guide (Full Service Treatment Planning) Plan Ortho Corrections (MAC) SLA 3D Printed Model(s) *Returning Guide file / File(s) Send* ! JUST Transferring a file (NO ORDER)
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Patient Name or ID: (Required) *
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Having issues with large size file uploads. Working on resolving it.

work around is to google drive or something the files to my email address brvoltz@digi3dworks.com
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Supported File Types: STL, ZIP, RAR, BSB, DCM Cancel of

Surgical Guide
Note: If you are using BlueCam (NOT OmniCam) to scan the model, there are known scan accuracy issues for the full arch scans.

** You MUST check the box to include Guide Tube(s), if you want a guide tube(s). **

** If the box is check and you do not provide the guide tube part number, the guide tube will not be included. **
Material Choice *

Taupe color - $43.00 Clear - $63.00
Guide Tube(s)? I only carry the Blue Sky tubes. *

Yes - for $12 per guide tube, Listed above? No
Guide Tube to be used:
We use to this information to verify the printed Guide
Qty of Guide Tube(s) Needed
If you send us a BSP file, and we have to draw the guide and/or update the settings, with out prior agreement, this order will be charge at "Express" rate. *

I understand above.

Surgcial Guide Design
- CT Scan MUST be open bite - Closed bite will cause issues with guide fit and design.

Included:
- Priority Shipping
- All planning in Blue Sky Bio
Add the following:
- Printed Surgical Guide
- Guide Tube(s)
- Blue Sky export fee
WorkFlow:
- Take CBCT Scan of the patient with an open bite, ideally the full arch.
- Either take an impression or intraoral scan of arch(s) or CT scan of the Stone Model.
- Send both to us for the plan
- Fill out the online order
- We will plan the case and schedule a time to review with you
Design Service *

Plan implant 1st implant Included (137.00) Bone Reduction / Implant Planning (550.00)
Additional Implants/Pins (40.00 each):
We do our best to turn order around but if you need to have the order rushed, below are the fees:
Rush Fee (optional)

Need guide done and sent out in 24 hours (Not Sundays) 135.00 Additional Need guide done and sent out in 48 hours (Not Sundays) 70.00 Additional
Add Printed Surgical Guide *

Yes - Taupe color guide ($43 Additional) Yes - Clear color guide ($63 Additional) No - I will print the guide on my local printer
Add Guide Tube(s) - Size defined in Plan *
Have us do the export from Blue Sky Plan? (if no, you plant use your BSP export) *

Yes ($20.00 Additional) No
Implant Details Table *
Sinus Lift: *
Ridge Expansion: *

Key Info
Guide System (NOT Implant Brand)? *
Below is for Hand Piece and bur not in Blue Sky Software. Not needed if you have selected a system above or using Blue Sky Burs with listed Hand Piece.
What Brand of Hand Piece?
What Drill bur will be used:
SHORT bur length?
(Measuring from tip to point of hubing)
LONG bur length?
(Measuring from tip to point of hubing)
Hand Piece
What Drill bur will be used:
SHORT bur
(Measuring from tip to point of hubing)
LONG bur
(Measuring from tip to point of hubing)
Case Notes
Express Plan Case Notes

CheckOut
Doctor Notes:
Notes to be used by the DOCTOR for this case.
Comments to Lab:
Any special instructions for the Lab.
Invoice will be sent to you when the order has shipped.

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