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About All at Once
®
About Us
What’s Happening
Resources
Contact Us
About All at Once
®
About Us
What’s Happening
Resources
Contact Us
Information
for Patients
Submit Case
Screening
Screening service for the All at Once
®
Implant Bridge provides:
• Screening tool for suitability
Submission of patient data does not guarantee the provision of the AuDentes service. AuDentes reserves the right to withhold the service at its sole discretion.
The All at Once
®
Implant Bridge and associated protocols are protected intellectual property. Disclosure of protocols, tools, accessories, guide designs by the signatory to any other individuals is prohibited unless prior approval has been obtained.
I acknowledge that the responsibility for clinical data collection, decision making, and implementation lies solely with the clinician. Responsibility of clinical outcomes does not lie with the AuDentes service, nor its owners, associates, staff or affiliates at any time.
Patient Name
Patient Date of Birth
Dentist Name
Dentist Phone
Dentist Email
Surgeon's Name
Date of Surgery
Surgery Location
Clinic
Hospital
Clinic / Hospital Name
Patient is insured
Yes
No
Medical Conditions
Current smoker
Diabetic
Osteoporosis medications
None
Product
All at Once® with zirconia bridge
All at Once® with PMMA bridge
All at Once® with 3D printed bridge
Smie Design
Use my design
Make new design
Arch
Maxilla
Mandible
Both
Colour (A1, A2, etc)
A1
A2
A3
B1
Bleach (BL2)
Bleach (BL3)
Shape
Length
Prominence
Midline
Number of Teeth
Amount of gingiva showing
Occlusal scheme
Conform to opposing occlusion
Ideal occlusion
Vertical dimension
As recorded
Open (1mm)
Open (2mm)
Open (3mm)
Implant brand
Straumann
Southern Implants
Ideal number of implants
Pre-existing implant information (site, brand, size)
Additional Notes
New users
- upload all data files to Dropbox and share with
plans@audentes.com.au
Existing users
- upload all data files to our shared Dropbox folder.
Select if relevant:
I have sent CBCT and IOS data via coDiagnostiX caseXchange.
Submit
