Reva digital denture order form

Reva digital denture instruction form
Thank you for having an interest in Reva digital denture. Please fill in the necessary information to complete your order.

◆ Note:
This order form is specifically for the final denture fabrication. If you're only interested in ordering design services, please click on the link provided below.
Reva design order form

Please send the fully filled instruction file along with the essential STL data file to the email address provided below.

・info_int@bitecglobal.com

◆ Contact:
Bitec Global Japan Inc
International Sale Team
Email: info_int@bitecglobal.com
HP: https://www.reva-digital.net/
Phone: +81-3-5546-0877 (Services and Technician inquiries)
Dental Clinic information
Orderer Name

First NameLast Name
Occupation
Dentist Name *

First NameLast Name
Dental Clinic Name *
Phone Number *
Please enter a valid phone number.
Email*
Delivery Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Patient Name*

First NameLast Name
Patient ID*
Instruction detail
◆Note:
・Please be aware that the delivery date may be delayed if there are any unchecked items on the instruction sheet or if essential STL data is missing.
The payment method will be PayPal or a settlement link (credit). We will send the settlement link via e-mail after confirming the order content. After confirming the payment and receiving all necessary, production will be started. Production takes 5 working days.
・We will inform the tracking number after shipping. The delivery date may be delayed due to the influence of corona.
◆Data Recipient Email Address:
・info_int@bitecglobal.com
1. Product*
prevnext( X )
Reva - Initial Print(758)Silicone relining denture
$490.00 Quantity



Reva - Reprint(761)Silicone relining denture. Reprint from the previous data.
$350.00 Quantity



Reva hard - Initial Print（759)Without silicone relining
$270.00 Quantity



Reva hard - Reprint(762)Without silicone relining. Reprint from the previous data
$190.00 Quantity



Reva white - Initial Print(760)For try-in denture
$250.00 Quantity



Reva white - Reprint(763)For try-in denture. Reprint from the previous data.
$180.00 Quantity



Total

$0.00
Note:

1: The price does not include shipping from Japan.
2: Manufacturing duration: 5 working days after fixed design and payment completed.
2. Denture type*
3. Type of production*
4. Shade selection of artificial teeth*
5. Name of your scanner Device *
※）If your answer of 6 is other, please write down the detail.
6. STL data information (Total number of data files pieces)
7. Type of STL data*

UpperLowerOcclusionReference dataOther
8. Gum festooning *
(Available for Option 1 - Make a new denture in Question 3)
9. Other direction*
Enter what notes you think will help us understand the case and your desire better.
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.
Upload your illustration after filling out the instruction detail here.
Please ensure that the files are in JPEG/PNG format, as other formats are not supported.
10. Please check the following content if you want to make a new denture.

Note: Please do not check this section if you wish to duplicate an existing denture, instead, proceed to section 3, "Type of Production," and select the option for duplicating the existing denture.　
10.1. Occlusal plane median line*

1. Reference of current denture2. Completed(Impression body, bite, stone model, denture etc)3. Others, details explained in the ”9.Other direction” column
10.2 Anterior teeth arrangement*

1. Average2. Similar to current dentures3. Bite plate・match the labial surface to bite4. Others, details explained in the ”9.Other direction” colunm
10.3. Anterior teeth position・overbite・over jet*

1. Average(1.5mm)2. Similar to current dentures3. Others, details explained in the "9.Other direction” colunm
10.4. Posterior Teeth Arrangement*

1. Arranged from the alveolar ridge and opposing teeth2. Similar to current dentures3. Others, details explained in the ”9.Other direction” colunm
Terms and Conditions Check
Before submitting, please ensure that the following all essential data is ready and checked.
Scanned data checklist*

Maxillary and mandibular full impression dataOcclusal bite impression dataOpposing dentition dataData of the existing denture ( If there is an existing denture )
STL Data 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 in addition to 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"
Should be Empty:

Reva digital denture instruction form

Dental Clinic information

Instruction detail

Terms and Conditions Check

STL Data Data transfer method