Patient Name * First Name Last Name Metal Type Silver925 10KT Number Of Teeth (Top) * 1 2 3 4 5 6 7 8 9+ 0 Number Of Teeth (Bottom) * 1 2 3 4 5 6 7 8 9+ 0 Plating Or Metal Color * Plating - Gold Plating - Rose Gold 10KT Gold 10KT White gold 10KT Rose Gold Natural Silver Explain what patient wants * Thank you! We’ll reach out with any questions!
