Order form scan service for NobelProcera® Implant BarsOne form per bar order required.

IDENTIFICATION

Customer lab number:* Dentist:

Equipment number:* Denturist:

Contact person:* Laboratory:

E-mail:* Your internal case identification:*

Phone:*

SECTION A:* Implant systems and retention elements

SECTION B: Additional services

The option below is available for fixed implant bars on Nobel Biocare platforms only

Opaque my bar with Sebond Pink Light* manufactured by Schütz Dental GmbH (fees may apply)

It is recommended to use a bonding agent before finalizing. * For more details on the material and instructions for use refer to Schütz Dental GmbH.

Send the complete order to:

NobelProcera Services Center Mahwah

800 Corporate Drive, Suite B

Mahwah, NJ 07430-2011

Customer support: +1 888-725-7100 option 4

SECTION C:* List of materials included

Master model is clean, undamaged and labelled

Removable soft tissue

Implant replicas are undamaged, stable and not buried. Remove soft tissue to double-check.

Diagnostic tooth set-up

Intaglio (optional)

Other: ___________________________

Take the implant platform and/or abutment from the next page and mark it at the relevant position on the model.

Optionally, mark the position of the attachment on the model with an ”x”.

See example on the last page.

With this form you request a scan service only.!

It is important that your implant replicas are undamaged, stable and not buried in the model. This will help avoid delays with your case.!

* required information Find your equipment number in your NobelProcera Software.

GMT 44255 GB 1511 Printed in Sweden © Nobel Biocare Services AG, 2015.

Manufacturer Platform Screw included Platform numberClinical Lab

Nobel Biocare

NobelActive®, NobelParallel™ CC and NobelReplace® Conical Connection

Internal conical connection NP 4Internal conical connection RP 5Internal conical connection WP 169

NobelReplace®, Replace Select™, NobelSpeedy® Replace, NobelReplace® Platform Shift

Internal tri-channel connection NP 7

Internal tri-channel connection RP 8

Internal tri-channel connection WP 9

Internal tri-channel connection 6.0 10Brånemark System® and NobelSpeedy® Groovy

External hex connection NP 1External hex connection RP 2External hex connection WP 3Multi-Unit RP 11Multi-Unit WP 12

Steri-oss HL 3.25 14Steri-oss HL 3.8/4.5 170

Replace Hex 3.5 15

Replace Hex 4.3 16

Steri-oss HL/Replace Hex 5.0 17

Steri-oss HL/Replace Hex 6.0 18

Internal Hexagon 6

Nobel Novum 13

AB Dental Devices

Narrow Platform – – 19

Alpha Bio

Internal Hex 4.5 – – 20

TCT System – – 21

Anthogyr

Anthofit™ HE System Conical Abutment 4.1

– –22

Anthofit™ OI System 3.5 – – 23

Anthofit™ OI System Conical Abutment 3.5

– –24

Axiom™ REG/PX Platform 4.0 – – 25

Axiom™ REG/PX Straight Conical Abutment

– –26

BEGO Semados®

S/RI-Line 3.25/3.75/4.1/4.5 – – 27S/RI-Line 5.5 – – 172

BioHorizons™

Abutment for Screw 3.5/4.0 – 28Abutment for Screw 5.0 – – 29Conical internal connection 3.5 – 30Conical internal connection 4.5 – 31

Conical internal connection 5.7 – 32

External implant system 3.5 – 33

External implant system 4.0 – 34

External implant system 5.0 – 35

External implant system 6.0 – 36

Single Stage Restoration 3.5 – – 37

Single Stage Restoration 4.5 – – 38

Single Stage Restoration 5.7 – – 39

Compatibility chart

NobelProcera® Implant Bar scan service

Manufacturer Platform Screw included Platform numberClinical Lab

Biomet 3i®

Certain® Internal 3.4 – 40

Certain® Internal 4.1 – 41

Certain® Internal 5.0 – 42

Certain® Internal 6.0 – 43

Conical Abutment 3.4 – – 44

Conical Abutment 4.1/5.0 – 45

Conical Abutment 6.0 – – 46

External Hex 3.4 – 47

External Hex 4.1 – 48

External Hex 5.0 – 49

External Hex 6.0 – 50

IOL® Abutment – – 51

Low Profile abutments – 52

Standard abutment – 53

Biotech Dental Implants

B.I.S. Conic 3.5/3.9 – – 54

B.I.S. Conic 4.0/4.4 – – 55

B.I.S. Conic 5/5.4 – – 56

B.I.S. Conic Base Analog 4.4 – – 57

BTI™

Externa Platform 4.1 – – 58

Externa Platform 4.1 (abutment level)

– – 59

Interna Platform 4.1 – – 60

Tiny™ Platform 3.5 – – 173

Camlog®

Camlog® Bar Abutment 3.3 – 61

Camlog® Bar Abutment 3.8 – 62

Camlog® Bar Abutment 6.0 – 63

Camlog® Implant System 3.8 – 64

Camlog® Implant System 4.3 – 65

Camlog® Implant System 5.0 – 66

Camlog® Implant System 6.0 – 67

CONELOG® Implant System 3.8 – – 68

Dentsply® (Ankylos®)

Balance Base Abutment – 69

Balance Base Abutment Narrow – 70

Balance Base C – 71

Regular C/X Abutment – – 72

Dentsply® (Astra Tech Implant System™)

20° UniAbutment 3.5/4.0 – 7345° UniAbutment 3.5/4.0 – 74Astra Aqua – 75Astra Lilac – 76

Manufacturer Platform Screw included Platform numberClinical Lab

Dentsply® (XiVE®)FRIADENT 3.0 – – 77FRIADENT 3.4 – – 78FRIADENT 3.8 – – 79FRIADENT 4.5 – – 80

FRIADENT 5.5 – – 81

Friadent MP 3.8 – – 82

Friadent MP 4.5 – – 83

Friadent MP 5.5 – – 84

Xive® TG Platform 3.4-4.5 – – 174

Hiossen

ET III SA mini – 85

ET III SA regular – 86

HI-TEC implants

Universal Unit System – – 87

Implant Direct

Legacy™ 3.5 – 88

Legacy™ 4.5 – 89

Legacy™ 5.7 – 90

RePlant®/RePlus® 3.5 – – 91

RePlant®/RePlus® 4.3 – – 92

RePlant®/RePlus® 5.0 – – 93

ScrewPlant®/ScrewPlus® 3.7 – – 94

ScrewPlant®/ScrewPlus® 4.7 – – 95

ScrewPlant®/ScrewPlus® 5.7 – – 96

Implant Direct ScrewIndirect – – 175

Implant Direct ScrewIndirect 5.0 – – 176

Implant Direct (Attachment International)

3.25 – – 97

3.3 – – 98

Implant Direct (Sybron)

Endopore® Internal Hex 4.1 – – 99

Entegra™ External Hex 3.5 – – 100

Entegra™ External Hex 4.1 – – 101

Entegra™ External Hex 5.0 – – 102

PITT-EASY® Paracentric Line 3.75 – – 103

PITT-EASY® Paracentric Line 4.0 – – 104

PITT-EASY® Paracentric Line 4.9 – – 105

SybronPRO™ Series 3.5 Hex – – 106

SybronPRO™ Series 4.1 Hex – – 107

Compatibility chart

NobelProcera® Implant Bar scan service

Manufacturer Platform Screw included Platform numberClinical Lab

Straumann®

BoneLevel NC (3.3) 137

BoneLevel RC (4.1/4.8) 138

Multi-base NC 3.5 – 139

Multi-base RC 4.5 – 140

Multi-base RC 6.5 – 141

Octagon (Standard / Standard Plus) 4.8 142

Octagon (Standard / Standard Plus) 6.5 143

Ortho System 4.2 – – 144

SynOcta® RN – 145

SynOcta® WN – 146

Thommen Medical

SPI®RETAIN DIRECT System – – 147

SPI®VARIOmulti System 4.0/4.5/5.0 – – 148

VARIOeco system 3.5 – – 149

VARIOeco system 4.0 – – 150

VARIOeco system 4.5 – – 151

VARIOeco system 5.0 – – 152

VARIOeco system 6.0 – – 153

Titan implant

Internal Hex 4.5 platform – – 154

Internal Hex 5.7 platform – – 155

Zimmer® Dental

AdVent® 4.5 – 156

Calcitek 3.25 – – 157

Calcitek 4.0 – – 158

Screw-Vent® 3.5 – 159

Screw-Vent® 4.5 – 160

Screw-Vent® 5.7 – 161

Specta-Cone – – 162

Spline® Implant System 3.25 – – 163

Spline® Implant System 3.75/4.0 – – 164

Spline® Implant System 5.0 – – 165

SwissPlus® Implant System 3.8 – – 166

SwissPlus® Implant System 4.8 – – 167

Tapered abutment 4.5 – 168

Manufacturer Platform Screw included Platform numberClinical Lab

LifeCore Dental (Keystone)

Genesis System 3.8 – – 108

Genesis System 4.5 – – 109

Genesis System 5.5 – – 110

PrimaConnex® System 3.5 – – 111

PrimaConnex® System 4.1 – – 112

PrimaConnex® System 5.0/7.0/8.0 – – 113

PrimaConnex® System Multi-unit 3.5/4.1

– –114

PrimaConnex® System Multi-unit WD – – 115

Renova™ Implant System RDI 4.5 mm – – 116

Renova™ Implant System SDI 3.75 mm

– –117

Restore™ Implant System WD – – 118

Restore™ System RD 3.75/4.0 – – 119

Restore™ System SD 3.3 – – 120

Stage-1 system RDS – – 121

MIS®

Internal Hex – 122Multi-Unit system – 123Standard Platform – – 124Wide Internal Hex – 125

Neoss®

Access Abutment – 126Neoss Implant System 3.25 – – 177

Osstem™

TS & GS System mini 4.0 – – 127TS & GS System standard 4.5 – – 128US System Esthetic Low – – 129

US System Regular platform – – 130

SIC Implants

Sic Platform 3.3 – – 131

Sic Platform 4.2 – – 132

Simpler Implants

Implant Analog 3.25 – – 133

Implant Analog 4.0 – – 134

Southern Implants

External Hex 4.0 – 135

External Hex 5.0 – 136

Specify the implant position and platform number on the model on the first page as shown here.

10 10

9 9

GMT 44255 GB 1511 Printed in Sweden © Nobel Biocare Services AG, 2015. Nobel Biocare, the Nobel Biocare logotype and all other trademarks are, if nothing else is stated or is evident from the context in a certain case, trademarks of Nobel Biocare. Refer to nobelbiocare.com/trademarks for trademark information of other manufacturers. Disclaimer: Some products are not regulatory cleared for sale in all markets.

Example