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Implant System Preferences Survey

Implant System Preferences Survey


About you:

Dentist Name _________________________________

Clinic Name   _________________________________

Phone Number ________________________________

Email ________________________________________


1- Does your clinic per form implant surgeries?
( ) Yes ( ) No

1.1- Brands of dental implants used at your clinic, (m.c)
( ) BioHorizons
( ) Zimmer Biomet 3iTm                                                                          ( ) MegagenTm 
( ) Astra Tech Tm 
( ) XlveTm                                                                                               
( ) Nobel Blocare Tm 
( ) Straumann Tm 
( ) Other _______

1.2- Approx. Number of dental implants used by your clinic per month?

____________________________________________

1.3- Which type of implantation procedures do you carry out? (m.c)
( ) one stage implantation 
( ) Two stage implantation 
( ) Immediate loading 
( ) Basal/Compressive 
( ) Guided surgery 
_____________________________________________

2- Does your clinic also carry out the restoration process?

( ) Yes ( ) No

2.1- Implant abutment connection - choose your preference, (m.c) 

( ) Conical connection

( ) Internal hex connection

( ) Other ______________ _

2.2- What is your clinic's main restoration method? (m.c)

( ) Cemented restoration

( ) Screwed restoration

( ) CAD/CAM restoration

( ) Removable restoration

2.3- Do you restore, (m.cl

( ) Single units

( ) Multiple units

( ) Full arches

3-What can be added to your currently used brand? (Im.cl) 

( ) More restoration options

( ) CAD/CAM restoration

( ) Guided surgery

( ) Primary stability and Immediate loading

Q Other ______________

4-Does your current brand provide, (m.c)

( ) Single restoration platform

( ) 3.0mm diameter implant

( ) Full CAD/CAM prosthetic solution

( ) Guided surgical service

( ) Bioactive surface

6- What do you like about your current Implant system?

_____________________________________________

_____________________________________________

7- Additional comments,

______________________________________________

______________________________________________

 

Name                                                 Date