CT Anatomical Model Only Order

CT Anatomical Model Only RX Order Form

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

 

Important Information to Review:

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:

• Single/Double Arch Fully Edentulous
• Single/Double Arch Terminally Dentate
• No Teeth Behind Cuspids

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.