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Noble Dental Ceramics
ABN 480 884 37423
Toorak Offices, 1st floor Suite 14762 Toorak Road, Glen Iris 3146
T 03 9882 8822 F 03 9813 0011 E [email protected] www.nobledental.com.au
Please email digital images to [email protected]
[OFFICE USE ONLY]
Dentist:
Patient:
Return Date:
Insert Date:
Reduction of prep
Reduction of Opposing
Time:
We require 10 working days from arrival in lab & 15 days for implants
Please complete to avoid discrepancies
If insufficient clearance
LAB SHEET
Surgery:
DATE:
CALLER:
NOTES:
TIME:
Metal Island
*Call DentistAt Lab
Surgery
SHADE
ABUTMENT TYPE
Milled Abutment - CO/CR
Atlantis CAD/CAM Abutment
Implant System
Platform Diameter
Cast Gold
Titanium
Zirconia
Cement retained
Screw retained (occlusally)
Cross pin (lingually)
IMPLANT CROWN
Heavy Light Open
OCCLUSAL CONTACT
RESTORATION TYPE
Crown
Bridge
Inlay/Onlay
Maryland Bridge
Post and Core
Veneer
Temporary Crown
e.Max Monolythic
Zirconia Monolythic
ALL CERAMIC
Zirconia Layered
e.Max Layered
MARGIN TYPE
Fine Metal Margin 360˚
Buccal Porcelain Margin
360˚ Porcelain Margin
FULL CAST
Yellow Gold
Non Precious (Ni Free)
Non Precious Yellow Gold
OCCLUSAL STAINING
None
Medium
Light
Dark
Vital
Non Vital (dentine or composite)
Non Vital (metallic/discoloured core)
Stump Shade
ABUTMENT DETAILS (STUMP)
*CALL DENTIST
Instructions:
Titanium Base
Biaxial Angle Correction
High Precious
Semi Precious
Non Precious(Ni Free)
PORCELAIN FUSED TO METAL
DIAGNOSTICWAX-UP
Silicone Impression
Opposing Impression
Opposing Model
Study Model.
Pre-Op Model.
Bite Registration
Diagnostic Wax-Up Model
FTP
Photos/disc
USB Key
Silicone Keys
Face bow
Articulator
Denture
Implant Replica.
Implant Guide pins
Implant abutments.
For Lab Use Only
Memo
