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*-Disclaimer: Users are solely responsible for complying with HIPAA and applicable privacy laws and should avoid sharing patient-identifiable information; any information submitted is provided at the user’s own discretion and legal responsibility and agree to waive and hold Teethbook harmless from any liability.
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*-What do you want to do?
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Modification
Same Day Surgery
Design Only
Mill only
Design and Mill
*-Case ID
*
*-Patient Appointment
Next
*-Click an image to choose the restoration type:
*
Crown & Bridge
Implants
Full Arch/AOX
Aligners and Retainers
Mouthguard and Splints
Partial Denture
Digital Denture
Models/Wax-Up
Implant Planning / Surgical Guide RX
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Implant RX
*
Screw Retained Crown - $25.00
Abutment & Crown - $30.00
Screw Retained Bridge - $0.00
Abutment & Bridge - $0.00
Abutment - $15.00
Choose Product:
*
Posterior Crown/Bridge
Anterior Crown/Veneer/Bridge
Onlay/Inlay
Full Arch Wax-Up
Full Arch-on natural prep
*-Full Arch Fixed RX
All On X
Implant Bars
*-Choose Arch - AOX
*
Upper - Maxillary
Lower - Mandibular
Both
Abutment Material
Abutment Material
Titanium
Hybrid
*-Implant System
Implant System
Ankylos
Astra EV
Astra OsseoSpeed
BioHorizons Internal Hex
Biomet 3i Certain
Biomet 3i Osseotite
Camlog
Dentium
Dentsply Sirona Xive
Hahn
Hiossen - Osstem
Megagen
MIS C1
MIS V3
MIS Seven
Neodent
Nobel Active
Nobel Replace
Nobel Branemark
Neoss
Prima Connex
Straumann, BLX
Straumann, Bone Level
Straumann, Tissue Level
Sweden & Martina
Zimmer
Others
Pontic Type
Ridge Lap Pontic
Modified Ridge Lap Pontic
Stein Pontic
Sanitary Pontic
Ovate Pontic
Nobel Active Implant Size
3.0
NP
WP
Astra EV Implant Size
3.6
4.2
4.8
Primma Connex Implant Size
SD
RD
WD
MIS Seven Implant Size
3.0
Standard
Wide
MIS V3 Implant Size
Standard
MIS C1 Implant Size
NP
SP
WP
Neodent Implant Size
GM
Straumann Tissue Level Implant Size
RN
WN
Straumann Bone Leve Implant Size
NC
RC
Zimmer Implant Size
3.5
4.5
5.7
Biomet 3i Implant Size
3.4
4.1
5.0
6.0
Biohorizons Implant Size
3.0 - 0.099
3.5 - 0.087
4.5 - 0.088
5.7 - 0.089
Biomet Osseotite Implant Size
3.4 - 0.011
4.1 - 0.012
5.0 - 0.013
Nobel Replace Implant Size
NP
RP
WP
6.0
Dentsply Sirona Xive Implant Size
3.4
3.8
4.5
5.5
Straumann BLX Implant Size
RB - 0.062
WB - 0.063
Dentium Implant Size
4.5
Megagen Implant Size
3.5 - 5.5
Hiossen Implant Size
Mini
Mini 3.0
Standard
Neoss Implant Size
4.0
Sweden & Martina Implant Size
3.3
3.8
4.25
5.0
Ankylos Implant Size
4.0
Hahn Implant Size
3.0
3.5
4.3
5.0
7.0
Camlog Implant Size
3.3
3.8
4.3
5.0
6.0
Astra Implant Size
3.0
3.5/4.0
4.5/5.0
Branemark Implant Size
RP
Choose Arch- Partial
Upper
Lower
Both
Upper Left
1
2
3
4
5
6
7
8
Lower Left
32
31
30
29
28
27
26
25
Upper Left
9
10
11
12
13
14
15
16
Lower Right
24
23
22
21
20
19
18
17
Upper Left - Implant
1
2
3
4
5
6
7
8
Lower Left - Impalnt
32
31
30
29
28
27
26
25
Upper right-Implant
9
10
11
12
13
14
15
16
Lower Right -Implant
24
23
22
21
20
19
18
17
Upper Left - Implant planning
1
2
3
4
5
6
7
8
Lower Left - Implant planning
32
31
30
29
28
27
26
25
Upper right-Implant planning
9
10
11
12
13
14
15
16
Lower Right -Implant planning
24
23
22
21
20
19
18
17
Add different system/size or product?
Implants RX
*
Abutment Only
Custom Abutment & Crown
Custom Abutment & Bridge
Screw Retained Crown
Screw Retained Bridges *units
Abutment Material
Abutment Material
Titanium
Hybrid
Implant System B
*
Implant System
Ankylos
Astra EV
Astra OsseoSpeed
Biohorizons Internal Hex
Biomet 3i Certain
Biomet Osseotite
Camlog
Dentium
Dentsply Sirona Xive
Hahn
Hiossen - Osstem
Megagen
MIS C1
MIS V3
MIS Seven
Neodent
Nobel Active
Nobel Replace
Nobel Branemark
Neoss
Prima Connex
Straumann, BLX
Straumann, Bone Level
Straumann, Tissue Level
Sweden & Martina
Zimmer
Others
Branemark Implant Size
RP
Hiossen Implant Size
Mini
Standard
Hahn Implant Size
3.0
3.5
4.3
5.0
7.0
Prima Connex Implant Size
SD
RD
WD
Camlog Implant Size
3.3
3.8
4.3
5.0
6.0
Megagen Implant Size
3.5 - 5.5
Astra EV Implant Size
3.6
4.2
4.8
MIS Seven Implant Size
3.0
Standard
Wide
MIS V3 Implant Size
Standard
MIS C1 Implant Size
NP
SP
WP
Nobel Replace Implant Size
NP
RP
WP
6.0
Astra Implant Size
3.0
3.5/4.0
4.5/5.0
Straumann Bone Level Implant Size
NC
RC
Zimmer Implant Size
3.5
4.5
5.7
Straumann Tissue Level Implant Size
RN
WN
Sweden & Martina Implant Size
3.3
3.8
4.25
5.0
Biohorizons Implant Size
3.0 - 0.099
3.5 - 0.087
4.5 - 0.088
5.7 - 0.089
Dentsply Sirona Xive Implant Size
3.4
3.8
4.5
5.5
Straumann BLX Implant Size
RB - 0.062
WB - 0.063
Dentium Implant Size
4.5
Biomet 3i Implant Size
3.4
4.1
5.0
6.0
Neoss Implant Size
4.0
Ankylos Implant Size
4.0
Nobel Active Implant Size
NP
WP
0.7
Biomet Osseotite Implant Size
3.4 - 0.011
4.1 - 0.012
5.0 - 0.013
Add Implant Model
With Analog
Without Analog (with the restoration in place)
Choose Arch- Denture
Upper - Maxillary
Lower - Mandibular
Both
Choose Arch-waxup
Upper - Maxillary
Lower - Mandibular
Both
Choose Arch - Implant Bar
Upper - Maxillary
Lower - Mandibular
Both
Choose Arch - Aligners
Upper - Maxillary (6trays)
Lower - Mandibular (6trays)
Both
Choose Arch - Mouthguard
Upper - Maxillary
Lower - Mandibular
Both
MUA Details
MUA Details
Astra EV 15.058
Astra OsseoSpeed 20 Degrees 15.036
Astra OsseoSpeed 45 Degrees 15.037
Dess Angled 36.007
Dess Nobel Straight 15.007
MIS Basic 15.085
SRA Basic 15.098
Straumann Tissue Level RN 15.010
Straumann Tissue Level WN 15.048
Add
Verification Jig
Wax Rim
PMMA Try-in
Model
Aligners and Retainers RX
Aligner Treatment Plan
Essix Retainer
Ortho Indirect Bonding Tray
Space Maintainer
Complexity Level
Mild Case (6 Trays)
Medium Case (12 Trays)
Sever Sever (20+ Trays)
Occlusal setup
Flat Plane
Anterior Guidance
Fabrication:
Printed (chairside)
Milled
Cuspid Lock:
Yes
No
Mouthguard and Splints RX
Mouthguard
Dawson B-splint
NTI
Gelb Appliance
Band Thickness
Selected Value:
0.8
Move the slider for the desired thickness
Bar Thickness (
Selected Value:
1
Move the slider for the desired thickness
Partial Denture RX
Class I - Class III
Complete Denture (Removable) RX
Mono Block
Split Files
Custom Tray
Bite Block
Implant Length
*
Implant Planning / Surgical Guide RX
*
Tooth supported
Tissue supported
Bone reduction guide/ stackable
*-Contacts
Light
Optimal
Tight
*-Occlusion
In Occlusion
Optimal
Out Of Occlusion
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Pre-op/post-op (Upper)
Click or drag files to this area to upload.
You can upload up to 10 files.
Upper Scan Body Scan (photogrammetry)
Click or drag files to this area to upload.
You can upload up to 10 files.
Pre-op/post op(Lower)
Click or drag files to this area to upload.
You can upload up to 10 files.
Lower Scan Body Scan (photogrammetry)
Click or drag files to this area to upload.
You can upload up to 10 files.
Upload Upper Jaw (STL/PLY)
Click or drag files to this area to upload.
You can upload up to 15 files.
Upload Lower Jaw (STL/PLY)
Click or drag files to this area to upload.
You can upload up to 10 files.
Upload Bite/Occlusion
Click or drag files to this area to upload.
You can upload up to 10 files.
Upload DICOM/ CBCT Scan (please zip the file for faster upload)
Click or drag files to this area to upload.
You can upload up to 10 files.
Add Patient Photos (zipped files)
Click or drag files to this area to upload.
You can upload up to 10 files.
Extra Instructions
Modifications Required
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Next
Supporting Photos
Click or drag files to this area to upload.
You can upload up to 10 files.
*-Material
*
Material
Good/ EZ Gum/ Polished
Better/ MiYO Pink/ Polished
Best/ MiYO Full Arch
China Lab/material
PMMA
*-Teeth Shade
*
*-Gum Shade
*
*-Finish/Stain & Gaze
Yes
No-Green state
*-Add direct to implant screw
*-Address (First Time Users only)
Address Line 1
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Design, Milling and Shipping Cost
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