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Argen Clear Aligner Order Form

UPLOAD YOUR ZIP FILE

Make sure you have a ZIP file ready with intraoral scanning files (STL) for both upper and lower arches, as well as patient photos. You’ll need the file before you start filling out this form.
* Files are shared via a secure, encrypted download link to protect patient data.

1. GENERAL INFORMATION

Add your contact details so we can reach you if needed during case planning.

2. PATIENT INFORMATION

Enter a patient reference only. Avoid full names or ID numbers to comply with GDPR. Include age, medications, and relevant dental history that may affect tooth movement or treatment planning.

3. PERIODONTAL STATUS

Provide information on the patient’s periodontal condition to ensure safe tooth movement and avoid stressing sensitive tissues.

4. TREATMENT SPECIFICATION

Select the treatment type and specify which teeth are to be aligned for this case.
IPR gently reduces enamel between teeth to create space, improving movement predictability and shortening treatment time.
Attachments improve grip and movement control, often reducing the number of aligners needed.

5. MIDLINE

Specify desired midline adjustment for better symmetry.

6. ANTEROPOSTERIOR RELATION

Specify if adjustments are needed and in which direction.

7. ANTERIOR LEVELING

Select the preferred reference for anterior leveling to achieve optimal esthetics.

8. OVERJET & OVERBITE

Select if overjet and overbite should be maintained or improved.

9. TOOTH SIZE DISCREPANCY

Specify if minor enamel reduction in the opposite arch is allowed, and whether small spaces distal to laterals or canines should remain to balance tooth size or create space if needed.

10. POSTERIOR CROSSBITE

Specify if posterior teeth should be corrected to improve occlusion, if applicable.

ADDITIONAL COMMENTS

CONFIRMATION

Before submitting, please review and confirm the following:

I confirm that the attached scanned impressions, patient photos, and all information provided in this form are accurate and complete, and that I’m responsible for the clinical decisions and selections made in this order.

I also acknowledge that a treatment proposal fee of 1.200 SEK will be charged for case analysis, regardless of whether the patient proceeds with treatment.

12.1 I agree