Scan Review Order

nSequence® Scan Review RX Order Form

In order to meet the needs of our clients, we are now offering three levels of Scan Review: CBCT Scan Check, Quick Case Review and Full Case Review.
While we will provide our best evaluation for case efficacy, this laboratory review is not a definitive qualifier or disqualifier for a case. The initial evaluation must be supplemented with a thorough clinical assessment, using complete and accurate records.

For more detailed instructions for scanning of various configurations of dentition, please see:

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Assessment of CBCT scan only, to determine if the case is suitable for a full arch, Implant supported restoration. Assessment will be done via email.

Please fill out the form below:

Note: A tech will reach out via email to begin scan review for option 2 and 3.

Patient Identification

Treatment Plan Information

 
If you are an existing customer, you can skip this.
Please provide as much treatment information as possible so our technicians know what to look for in the CBCT

Complete workup and implant planning for a full arch Guided Prosthetics case including live consultation with a case planner. This will be credited towards the full arch surgical case if moves to completion.

  • Click Here to complete a nSequence Guided Prosthetics RX form. Complete the form as if you are submitting a case. If you do not wish to proceed with the case, you will be charged $300.