Provider Phone Number *

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Patient Name *

First Name

Last Name

Patient Contact Number *

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Date Patient First Reported Symptoms *

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DD

YYYY

Reason for Scan *

Implant Placement (bone density, bone width, nerve canal location, sinus chamber location)

Endodontics (detecting hard to find canals, root resorption, periodical osseous lesions)

Oral & Maxillofacial Surgery (displaced teeth, fracture diagnostics, sinus diagnostics, cysts, retained roots)

Orthodontics (displaced, impacted teeth, ceph analysis, root resorptions, cleft lips, jaws and palates

TMD treatment (functional diagnostics of TMD)

General dentistry (contradictory findings, difficult or impossible to view in 2D pan image, apical radiolucency, etc)

Airway analysis (3D visualization of airway while taking position of condyle into consideration)