Guide Order Form

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Guide Order Form

NeoBiotech Digital Center, Guide order Form

1. Order Date *

YYYY

2. Clinic Name *

3. Patient Name *

4. Due date (10 business days from confirming all necessary data) *

YYYY

5. Delivery Address *

6. Implant planning (Tooth Number) *

* Tooth number for Immediate Placement

7. Implant Type *

IS II

IS III

Required

* Comment

8. Email address (For surgical report approval) *

9. Phone Number (For implant planning communication) *

10. Data Information *

CT DICOM file (Required)

Impression / IntraOral Scan (.stl)

Required

1st link: https://driveuploader.com/upload/eBZGGfIBhv/

In the case above link does not work, please use below link to upload:
2nd link: https://www.dropbox.com/request/jeRMSJnXY7oPn8zEM80B

* Remark

*** The impression should contain the information of 3-4 neighboring teeth from implant site & 2-3mm under cervical line of teeth
*** For free-end case, please take FULL arch impression of at least 6-8 neighboring teeth from implant site
*** When provided CBCT data have movement, low resolution, small FOV size not capturing enough working site,
we will contact your office for a retake within 24 hours of receiving CT scan
*** When impression is inadequate for guide fabrication, we will contact your office for a retake within 48 hours of receiving impression
*** When there are any metallic restorations on the working site (3-4 neighboring teeth on both mesial and distal side of implant site),
please place RESIN CONE markers before taking CT and impression
*** For edentulous case, please contact Neobiotech Digital Center to get special materials and instruction prior to CT taking

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