Praxisdaten
Patientendaten
[checkbox* Versicherung use_label_element „privat“ „gesetzlich“ „andersartig“ „gleichartig“ „Härtefall“ „Regelversorgung“]
Angaben zum Kostenvoranschlag
Gesichtsbogen
[radio Gesichtsbogen use_label_element default:2 „ja“ „nein“]
Material [select Material include_blank „hochgoldhaltig“ „Galvano“ „Zirkon“ „PEEK“ „Vollkeramik“ „NEM“ „sonstiges“]
Zahn
18
17
16
15
14
13
12
11
21
22
23
24
25
26
27
28
Therapieplan
[text TP-18 maxlength:3 size:3]
[text TP-17 maxlength:3 size:3]
[text TP-16 maxlength:3 size:3]
[text TP-15 maxlength:3 size:3]
[text TP-14 maxlength:3 size:3]
[text TP-13 maxlength:3 size:3]
[text TP-12 maxlength:3 size:3]
[text TP-11 maxlength:3 size:3]
[text TP-21 maxlength:3 size:3]
[text TP-22 maxlength:3 size:3]
[text TP-23 maxlength:3 size:3]
[text TP-24 maxlength:3 size:3]
[text TP-25 maxlength:3 size:3]
[text TP-26 maxlength:3 size:3]
[text TP-27 maxlength:3 size:3]
[text TP-28 maxlength:3 size:3]
Befund
[text B-18 maxlength:3 size:3]
[text B-17 maxlength:3 size:3]
[text B-16 maxlength:3 size:3]
[text B-15 maxlength:3 size:3]
[text B-14 maxlength:3 size:3]
[text B-13 maxlength:3 size:3]
[text B-12 maxlength:3 size:3]
[text B-11 maxlength:3 size:3]
[text B-21 maxlength:3 size:3]
[text B-22 maxlength:3 size:3]
[text B-23 maxlength:3 size:3]
[text B-24 maxlength:3 size:3]
[text B-25 maxlength:3 size:3]
[text B-26 maxlength:3 size:3]
[text B-27 maxlength:3 size:3]
[text B-28 maxlength:3 size:3]
Zahn
48
47
46
45
44
43
42
41
31
32
33
34
35
36
37
38
Therapieplan
[text TP-48 maxlength:3 size:3]
[text TP-47 maxlength:3 size:3]
[text TP-46 maxlength:3 size:3]
[text TP-45 maxlength:3 size:3]
[text TP-44 maxlength:3 size:3]
[text TP-43 maxlength:3 size:3]
[text TP-42 maxlength:3 size:3]
[text TP-41 maxlength:3 size:3]
[text TP-31 maxlength:3 size:3]
[text TP-32 maxlength:3 size:3]
[text TP-33 maxlength:3 size:3]
[text TP-34 maxlength:3 size:3]
[text TP-35 maxlength:3 size:3]
[text TP-36 maxlength:3 size:3]
[text TP-37 maxlength:3 size:3]
[text TP-38 maxlength:3 size:3]
Befund
[text B-48 maxlength:3 size:3]
[text B-47 maxlength:3 size:3]
[text B-46 maxlength:3 size:3]
[text B-45 maxlength:3 size:3]
[text B-44 maxlength:3 size:3]
[text B-43 maxlength:3 size:3]
[text B-42 maxlength:3 size:3]
[text B-41 maxlength:3 size:3]
[text B-31 maxlength:3 size:3]
[text B-32 maxlength:3 size:3]
[text B-33 maxlength:3 size:3]
[text B-34 maxlength:3 size:3]
[text B-35 maxlength:3 size:3]
[text B-36 maxlength:3 size:3]
[text B-37 maxlength:3 size:3]
[text B-38 maxlength:3 size:3]
E
= zu ersetzender Zahn
K
= Krone
T
= Teleskopkrone
B
= Brückenglied
O
= Verbindungsvorrichtung
–
= Verblockung, Steg, verblockte Brücke
V
= Vestibuläreverblendung
M
= Vollverblendung
H
= Halte- u. Stützvorrichtung, Klammer
P
= provisorische Krone/Brücke
I
= Inlay (+ Anzahl der Flächen)
MS
= Metall-Stiftaufbau
KS
= Keramik-Stiftaufbau
VE
= Veneer
Imp.
= Implantat
TK
= Teilkrone
MK
= Vollkeramikkrone
MB
= Vollkeramikbrückenglied
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