Platinum Case Upload with 3d Verify

Important Instruction – please follow exactly

Step 1: Complete Doctor and Patient Info and drag and drop you zipped folder (image to the right). Then, wait for an evaluation of your records for accuracy. Review the warnings and approve or replace with better files (new zipped folder if new files).
Step 2: Complete the Rx below and submit
Step 3: On the next page, book your meeting!

Data Folder Structure

"*" indicates required fields

Step 1: File Verification

Drag and drop a file here

Status

Warning

Images

Step 2: Doctor and Patient Info - Do Not Complete Until Step 1 is Approved and Submitted

File ID

Doctor Name*

First Last

Restorative Doctor Name*

First Last

Doctor Ship-To Address*

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

CHROME Experience*

Nobel Rep Name

Nobel Rep Email

Submitting Case To*

Doctor Email*

Doctor Phone*

Restorative Doctor Phone

Select Case Type*

Nobel Voucher Instructions

In order to progress, please do the following, please enter your voucher number(s) below (See video "How to Redeem a Voucher"). If you do not have any active vouchers, please contact Nobel Biocare to make purchase.

Article No.*

Platinum Package - GuidedSMILE*

NobelProcera Bridge

Upper Arch

Article No.*

Platinum Package - GuidedSMILE*

NobelProcera Bridge

Lower Arch

Article No.*

Platinum Package - GuidedSMILE*

NobelProcera Bridge

Are all submitted voucher numbers correct?*

Yes

Patient Info

Patient Name*

First Last

Patient Age*

Gender

CHROME GuidedSMILE Standard Treatment Info

Single Arch Type*

Single Arch, Describe the Opposing Condition*

Maxillary Occlusion*

Maxillary Arch Denture*

Mandibular Occlusion*

Mandibular Arch Denture*

Mobile Teeth*

Identify Mobile Teeth Number(s)

Provisional Tissue Shade*

Provisional Tooth Shade*

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 or 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

Bite Adjustment Options

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

Labial Injection Points for Prosthetic Pick-Up

GuidedSMILE will create holes from the labial and buccal that allow the pick-up material to be injected with the prosthetic seated on the Carrier Guide with the patient biting in occlusion.

Surgical Bite Included?

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.

Fixation Kit (Pins and Drills)*

Maxillary Conversion Denture

Mandibular Conversion Denture

Acknowledgment*

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

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

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.

Get your Patient Records ebook today!

Get your ‘Surgical Protocol of CHROME GuidedSMILE’ ebook today!

Platinum Case Upload with 3d Verify

Step 1: File Verification

Step 2: Doctor and Patient Info - Do Not Complete Until Step 1 is Approved and Submitted

Nobel Voucher Instructions

Upper Arch

Lower Arch

Patient Info

CHROME GuidedSMILE Standard Treatment Info

Patient Records & Case Design

Surgery Information