Mahwah Gold Package
CombiGuide Case Upload

Welcome to Nobel Biocare’s Voucher-Based GuidedSMILE Work Authorization

With your Voucher numbers in hand, here are the steps:

Page 1: Complete all required fields and “Submit and go to Records Upload”.
Page 2: Upload patient records. Once files are 100%, the case is submitted in full.

If you have any questions, please email care@guidedsmile.com, or call us at 800-763-7821.

"*" indicates required fields

Doctor Info

Doctor Name*

First Last

Doctor Ship-To Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Submitting Case To*

Nobel Rep Name

Nobel Rep Email

Doctor Email*

Doctor Phone*

CombiGuide Arches*

Nobel Voucher Instructions

In order to progress, please do the following:

Enter your voucher number(s) below (See video "How to Redeem a Voucher")
Upload the voucher PDF as a part of your patient records submission later in the Rx process.

If you do not have any active vouchers, please contact Nobel Biocare to make purchase.

Article No.*

Gold Package - CombiGuide*

Same Day Design Service?*

Design Article No.*

Same Day Design Voucher #*

Upper Arch

Article No.*

Gold Package - CombiGuide*

Same Day Design Service?*

Design Article No.*

Same Day Design Service*

Lower Arch

Article No.*

Gold Package - CombiGuide*

Same Day Design Service?*

Design Article No.*

Same Day Design Service*

Are all submitted voucher numbers correct?*

Yes

Patient Info

Patient Name*

First Last

Patient Age

CombiGuide Treatment Info

Single Arch Type*

Grammetry or Photogrammetry

SurgiMat Implant Info and Organizer

Patient Records & Case Design

Please use our checklists to help with record collection. They are based on how patient presents - Patient Record Checklists

CBCT DICOM*

IOS Records*

Other IOS Scanner*

Analog Records*

Doctor/Office Submitting Files*

Doctor/Office Phone*

Photographs*

Smile Design Options for Full Package

Smile Design Notes

VDO Change*

Adjust VDO in mm's

Bite Adjustment Options

JC Try-In will add 6 to 8 business days to the production schedule, assuming immediate patient try-in appointment.

The JC Try-In is a digitally designed and printed flipper that is used to confirm the patient’s bite. A JC Try-In is used:

when a closed bite requires opening for the procedure, usually more than the 3 mm’s recommended limitation of the articulator
when patients present with few or no centric stops
when the vertical needs to be determined and confirmed

Include Pink Stellar ($98 each - quantity)

Include White Stellar ($110 each - quantity)

Surgery Information

Implant Line*

Guided Kit*

Name of Other Guided Kit

Chairside Support*

Fixation Kit (Pins and Drills)*

GuidedSMILE uses specific, custom designed, long and short fixation drills and pins. The standard kit includes one drill and four pins. This is determined after the planning meeting and the pins and drills will be sent with the case, if the doctor does not already have a set. It is recommended to purchase a full kit when starting the first case.

Maxillary Conversion Denture

Mandibular Conversion Denture

Acknowledgment*

I recognize that my impressions need to include full palate and all land areas.

Clinician Agreement and Warranty Statement Acknowledgment*

I agree to the Clinician Agreement and Warranty Statement per the text below

Schedule Surgery After The Online Meeting*

I AGREE

Additional Notes

Once you click Submit and go to Records Upload a .pdf copy will be emailed to the email provided. If you do not see this email appear immediately please check your spam/junk folder.

On the next page you will be prompted to upload patient files and complete the Rx process.

Mahwah Gold Package CombiGuide Case Upload

Doctor Info

Nobel Voucher Instructions

Upper Arch

Lower Arch

Patient Info

CombiGuide Treatment Info

Patient Records & Case Design

Surgery Information

Mahwah Gold Package
CombiGuide Case Upload