1 Surgery CAMLOG Compendium
1 Surgery CAMLOG Compendium
1 Surgery CAMLOG Compendium
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Dental Office/Laboratory Information Worksheet<br />
Patient<br />
Last Name: _________________________________________ First Name(s): _______________________________ Date of Birth: _______________________<br />
Dental Office<br />
✼ 1 2 3 4 5 6 7 8<br />
▲ 18 17 16 15 14 13 12 11<br />
▲ 48 47 46 45 44 43 42 41<br />
✼ 32 31 30 29 28 27 26 25<br />
Name<br />
Date<br />
Alloy / Solder: ______________________________________________________ Technician: __________________________________________________________<br />
Ceramic: ____________________________________________________________ Final check / date: _________________________________________________<br />
Acrylic: ______________________________________________________________ Patient ID / Date: __________________________________________________<br />
Tooth shade: _______________________________________________________<br />
Date:<br />
Dental Laboratory<br />
9 10 11 12 13 14 15 16<br />
21 22 23 24 25 26 27 28<br />
31 32 33 34 35 36 37 38<br />
24 23 22 21 20 19 18 17<br />
Type of treatment<br />
Buccal marks<br />
Abutment<br />
Implant diameter<br />
Implant length<br />
Type of implant<br />
Type of implant<br />
Implant length<br />
Implant diameter<br />
Abutment<br />
Buccal marks<br />
Type of treatment<br />
Implant diameter: 3.3 / 3.8 / 4.3 / 5.0 / 6.0 mm<br />
Implant length: 9 / 11 / 13 / 16 mm, Type of treatment: SC / bridge / telescopic / bar / ball abutment / Locator ®<br />
Implant type: SL= SCREW-LINE / RL = ROOT-LINE / CL = CYLINDER-LINE / SCL = SCREW-CYLINDER-LINE<br />
✼ USA numbering<br />
▲ European numbering<br />
157
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