IMPRESSIVE DENTAL STUDIO
28720 ROADSIDE DRIVE, SUITE 177, AGOURA HILLS, CA 91301
1-818-706-0546          1-800-944-1244
FAX 1-818-706-2976

NOTE: PLEASE SEND A STUDY MODEL ON ALL WORK INVOLVING ANTERIOR RESTORATIONS SHADE INSTRUCTIONS
Desired Shade_________ Stump Shade_________ OCCLUSAL STAINING None Light Medium Dark

ALL-CERAMIC & POLY-CERAMIC IPS EMPRESS SCULPTURE FIBREKOR SCULPTURE IN-CERAM SPINELL IN-CERAM PORCELAIN VENEERS PORCELAIN FUSED TO METAL PORCELAIN TO WHITE GOLD PORCELAIN TO SEMI-PRECIOUS PORCELAIN TO NON-PRECIOUS GES-PORCELAIN TO 24 KARAT GOLD CROWN & BRIDGE GOLD CROWN GOLD INLAY/ONLAY YELLOW NON-PRECIOS CROWN POST AND CORE FULL CAST NON-PRECIOUS IMPLANT BRANEMARK 31 STERI-OSS CALCITEK OTHER ATTACHMENTS CEKA CEKA REWAX GL DALBO DOLDER BAR STRESSBREAKER PD NEY MINI REST ATTACHMENT OTHER

INSTRUCTIONS: MARGIN DESIGN Disappearing Margin        #_________ Porcelain Buccal Margin  #_________ Metal Margin _____mm.  #_________ CONTACT Occlusal Normal_____ Tight_____ Light______ Proximal Normal_____ Tight_____ Light______ METAL DESIGN Occlusal Lingual PONTIC DESIGN METAL Precious Semi-Precious Yellow Precious Type III Gold Non-Precious IF NO OCCLUSAL CLEARANCE Metal Occlusion Reduction Coping Spot Opposing

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