Case description
Tooth to be extracted
Unmovable tooth
Attachment restriction
Restorative plan for Crown
Restorative plan for Veneer
Tooth integrity
Tooth alignment on upper
18
17
16
15
14
13
12
11
21
22
23
24
25
26
27
28
FDI
Universal
Tooth alignment on lower
48
47
46
45
44
43
42
41
31
32
33
34
35
36
37
38
Tooth integrity
Restorative plan for Veneer
Restorative plan for Crown
Attachment restriction
Unmovable tooth
Tooth to be extract
Residual tooth
Previously
reconstructed tooth
Missing tooth -
Replacement planned
Missing tooth -
Omit replacement
Restorative planned
Arch Treatment:
Both
Upper
Lower
Client name:
Patient name:
Date of birth:
Please enter a valid date in the format YYYY-MM-DD.
Tooth Shade:
Planned restorative material:
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Notes:
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