Professional Denture Help



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	Obtain 100 FREE logo cards (and a display stand) to pass along to patients. Enter your contact information below, complete a short survey, and then click on the "Send Form" button at the bottom of this survey. Your cards will be mailed to you within a week. It's that easy.

First Name:

Last Name:

Address:

City / State:

Email Address:

Zip / Postal Code:

Country:

USA

Canada

Other

Affiliation:

Dental Laboratory

Dentist/Denture Professional (please answer short questions below)

Select One:

Dental Hygienist

Dental Assistant or Administrator

Dental Student

Dental Distributor/Dealer

Short Denture Survey (For clinical professionals only):

1. How many denture arches do you complete in an average month?

Full Partial

2. Who selects brand of artificial teeth used?

I select brand My Lab selects brand

3. What are the primary and secondary brands of teeth that you specify?

Primary	Secondary	Tooth Brand (s) Used
		Trubyte^® Premium (Portrait^® IPN^®, Bioblend^®, Bioform^®, Trublend^®)
		Trubyte Other
		Ivoclar (Antaris, Vivadent)
		Vita (Vitapan teeth)
		Other (please specify)

4. Would you like to learn more about increasing denture patient satisfaction and obtaining CE credits on denture topics?

Yes No

I agree with the usage and terms of this site, and I am a dental professional as indicated above.

Ivoclar, Antaris and Vivadent are registered trademarks of Ivoclar AG
Vita and Vitapan are registered trademarks of Vita Zahnfabrik GmBh