Specialising in Crown & Bridge Work
0431 051 770
Dentist Name (required)
Dentist Email (required)
Patient (required)
Appointment Date
Appointment Type
—Please choose an option—Special try / BiteFrame try inBiscuit try inWax try inFit
Patient Age
10 - 19 yrs20 - 29 yrs30 - 39 yrs40 - 49 yrs50 - 59 yrs60 - 69 yrs70+
Patient Gender
MaleFemale
Colour
—Please choose an option—Next TimeA1A2A3A3.5A4B1B2B3B4C1C2C3C4D1D2D3Other
Neck Colour
Body Colour
Incisal Colour
Transparency
—Please choose an option—no0.5 mm1 mm1.5 mm2 mm2.5 mm3 mm3.5 mm4 mm
NoneLightMediumHight
Occlusal Staining
Antagonist will changeAntagonist will NOT change
Porcelain shoulderMetal collarall roundpalat. / lingv.
IrregularityDiasthema
Implant type:
Implant size:
Cement-retainedScrew-retained
Crown3/4 CrownBridgeInlay/OnlayBonded/MarylandPost & CoreVeneerTemporaryOther EmaxZirconiaP.F.M.GoldAcrylic/PMMAOther
ProsthesisMetal plateSpecial trayBite registration plate [checkbox uppera use_label_element ""Bleach tray" "Retention tray" "Bite lifting tray" "1mm 2mm 3mm"]
ProsthesisMetal plateSpecial trayBite registration plate [checkbox lowera use_label_element ""Bleach tray" "Retention tray" "Bite lifting tray" "1mm 2mm 3mm"]
Impression:
Bite:
Model type:
Laborimplant:
Alloy type:
Weight type:
Message / Comments:
Phone Number: Call Me Back!
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Richmond Ceramics dental laboratory has been in operation for over 20 years. We have a team of dedicated experienced dental technicians.