Phase 02: Digital Clinical Intake

New Digital Prescription Slip

Select anatomical teeth on odontogram, specify restoration material and upload intraoral 3D scans.

1. Patient Profile

Patient Full Name

Clinic Patient ID

Age

Gender

Click individual tooth indices to mark restorations. Selected teeth turn blue.

FDI Odontogram ChartSelected: None

MAXILLARY ARCH (UPPER)

MANDIBULAR ARCH (LOWER)

Restoration Type

Substrate Material

Vita Classical Shade

Translucency

Clinical Instructions & Special Requests

Upload upper jaw, lower jaw, or buccal bite scans.

Select Mesh Files