NIGHT GUARD / SPLINT
CUSTOM IMPRESSION TRAY
DUAL ARCH – IMMEDIATE
Please complete the order form below.
Desired Anterior Overjet:
REGULAR (Class I,>2mm)
RETROGNATHIC (Class II,>3mm)
PROGNATHIC (Class III,<-1mm)
If you want a specific tooth mold please specify in the Notes below.
Teeth Mold Shape:
Set Up Type:
Do teeth need to be digitally removed?
*If YES, specify amount of bone reduction in notes.
Final Output of File (Choose all that apply):
FULLY PRINTED OPTION (All in one Try-in, and split files for Printed Base and Teeth)
PRINTED BASE ONLY (Printed Base and Carded Teeth, includes tooth jig if necessary)
CONVENTIONAL OPTION (All in one Try-in and Tooth Jig if necessary)
Please upload scans of the Upper Intaglio/Incisal scan of the denture to be duplicated. Upload a Bite Scan if the scans are not articulated.
Scan files should be in *.STL format. If uploading more than three files, the files will need to be compressed into a *.zip file.
This field is for validation purposes and should be left unchanged.