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Published byAngel Old Modified over 9 years ago
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NAME: ADDRESS: MOBILE NO:
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CASE NO 1 Name of the Patient: Type of case:- ( Single / Multiple / Full Maxilla / Full mandible) Procedure: ( Surgical / Flapless / CT guided.. Etc) Implant: ( Name & company, diameter & length of implant) Eg- Implant, XYZ company, manufacturer, Place, Diameter, length, type of implant surface)
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PHOTOGRAHS TO BE SUBMITTED FRONTAL PROTRUSIVE OCCLUSAL, MAXILLARY OCCLUSAL, MANDIBULAR LEFT LATERAL RIGHT LATERAL LEFT WORKING RIGHT WORKING
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CASE 1, PHOTOS 1-4, CLOCKWISE, DATE OF PHOTOS
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CASE 1, PHOTOS 5-8, CLOCKWISE, DATE OF PHOTOS
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RADIOGRAPHS PRE-OP OPG POST - OP OPG OR POST –OP IOPA (for single tooth implant within 3 days of surgery) POST-PROSTHETICS ( with prosthesis in place) OPG after 1 year of prosthetic placement
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CASE 1 - RADIOGRAPH VIEWS View 1 – Date of photo View 2 – Date of photo View 4 – Date of photoView 3 – Date of photo
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REPEAT THE SLIDES FOR CASES 2-10 Do not add extra slides Please be specific for all the cases with respect to number of slides and the content
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