CT Anatomical Model Only RX Order Form

Please complete the entire form below. All fields indicated by * are required. 


Before you begin, please review the CT Guided Scan Protocol and Scan Quality tips.  You will also need to have the following in order to process your case:

  • Scan of patient (Required)
  • Scan of denture with markers (Dual Scan Protocol - if applicable; Optional if more detail is needed)
  • Upper and lower impressions or models (Optical Scan Conversion - if applicable; Optional if more detail is needed)

CT Guided Scan Protocol:

Scan Quality:

Before submitting your case, check that all your scans adhere to the following guidelines:
  • Scan field of view: Make sure no part of the desired arch to be treatment planned is cut off, there is no patient movement, and a scan appliance was used.
  • Scan resolution: Minimum of 0.3voxel is recommended. The smaller the number, the better (ex: 0.2, 0.1, etc.).
  • Scan format: Please send all files in DICOM format.

Please be specific if multiple locations exist.
If you are an existing customer, you can skip this.

Order Information


 

Approximate height of typical mandibular orders. (Depends on scan quality and volume.)

Approximate height of typical mandibular orders. (Depends on scan quality and volume.)