www.aurumgroup.com Comprehensive Smile Design Checklist (FULL ARCH RECONSTRUCTION) Dentist:____________________________________ Patient____________________________________ Date: ____________________________________ Master Upper Full arch impression with Clear hammular notches Analog / Digital Lower impression or Original Lower Model (if no adjustments Made) Diagnostic Wax Up or temp Model with Mounting Plates Relined Bite Stent Stick Bite Numbers of teeth and Products Vertical index numbers Please indicate if Opening Bite, and indicate Product for Lower Length of Centrals Prepared Tooth Shade Shade of Final Restorations Smile Design Digital Patient Photos
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Diagnostic Wax-up & treatment planning
Dentist: ______________________________________
Patient: ____________________________________
Date: ________________________________________
Full arch impression Upper & Lower with Clear
Hammular notches
– Clear, accurate with Labial Vestibules– Analog / Digital (non alginate)
Bite Registration
Stick Bite
Digital Patient Photos (DSD/AACD)
Desired Length of Centrals
Number of Teeth Involved, Bridges, Implants, etc
Removable Orthotic
Bonded Orthotic
NaturalFit Orthotic
Smile Design
Description of Patients Goals and Desires
www.aurumgroup.com
ComprehensiveSmile Design Checklist(FULL ARCH RECONSTRUCTION)
Dentist:____________________________________
Patient____________________________________
Date: ____________________________________
Master Upper Full arch impression with Clear hammular notches Analog / Digital
Lower impression or Original Lower Model (if no adjustments Made)
Diagnostic Wax Up or temp Model with Mounting Plates
Relined Bite Stent
Stick Bite
Numbers of teeth and Products
Vertical index numbers
Please indicate if Opening Bite, and indicate Product for Lower
Length of Centrals
Prepared Tooth Shade
Shade of Final Restorations
Smile Design
Digital Patient Photos
www.aurumgroup.com
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