Implant Solutions

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Practice Name *

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Name of Dentist *

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First

Last

Return Date *

Email *

Patient Sex *

Rx *

the implant Collection *

Straumann Bio Horizon Hiossen Nobel Astra Zimmer

Abutment Type *

Titanium Abutment CAD/CAM All Zirconia Abutment CAD/CAM UCLA w Metal - white color Custom Abutment None Of The Above

Screw Retained Restorations *

Zirconia CAD/CAM UCLA

Temporary crown *

w/ Titanium Abutment w/ Temp Abutment w/ Zirconia Abutment

Abutment emergency profile *

Contour Tissue Tissue Displacement No Tissue Displacement

CAD/CAM Fixed Bar - Hybrid Bar *

All on 4 All on ____ 3i Straumann Other

Hybrid Screw Retained Bridge *

Titanium Frame w/ PFM Restoration Titanium Frame w/ Zirconia Restoration Zirconia Frame w/ Zirconia Restoration

Hybrid Bar w Attachments *

Locators Ball Attachments

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