Recession Coverage * indicates required fields Clinician's First Name*Clinician's Last Name*Practice Name*Email Address* The Situation*Risk Profile Guidance https://www.iti.org/tools/sac-assessment-toolThe Risk ProfileLow Risk Medium Risk High RiskPatient HealthPatient healthLow riskPatient healthMedium riskPatient healthHigh risk Patient aesthetic requirements Patient aesthetic requirementsLow riskPatient aesthetic requirementsMedium riskPatient aesthetic requirementsHigh risk Height of smile lineHeight of smile lineLow riskHeight of smile lineMedium riskHeight of smile lineHigh risk Gingival biotype Gingival biotypeLow riskGingival biotypeMedium riskGingival biotypeHigh risk Shape of dental crowns Shape of dental crownsLow riskShape of dental crownsMedium riskShape of dental crownsHigh risk Infection at implant sight Infection at implant sightLow riskInfection at implant sightMedium riskInfection at implant sightHigh risk Bone height at adjacent tooth site(s) Bone height at adjacent tooth site(s)Low riskBone height at adjacent tooth site(s)Medium riskBone height at adjacent tooth site(s)High risk Restorative status of adjacent tooth/teeth Restorative status of adjacent tooth/teethLow riskRestorative status of adjacent tooth/teethMedium riskRestorative status of adjacent tooth/teethHigh risk Width of tooth gap Width of tooth gapLow riskWidth of tooth gapMedium riskWidth of tooth gapHigh risk Soft tissue anatomy Soft tissue anatomyLow riskSoft tissue anatomyMedium riskSoft tissue anatomyHigh risk Bone anatomy of the alveolar ridge Bone anatomy of the alveolar ridgeLow riskBone anatomy of the alveolar ridgeMedium riskBone anatomy of the alveolar ridgeHigh riskThe ApproachList of Geistlich Products User*The OutcomeUpload Image 1Max. file size: 128 MB.Image 1 DescriptionUpload Image 2Max. file size: 128 MB.Upload Image 2Upload Image 3Max. file size: 128 MB.Upload Image 3Upload Image 4Max. file size: 128 MB.Upload Image 4Upload Image 5Max. file size: 128 MB.Upload Image 5Upload Image 6Max. file size: 128 MB.Upload Image 6Upload Image 7Max. file size: 128 MB.Upload Image 7Upload Image 8Max. file size: 128 MB.Upload Image 8Upload Image 9Max. file size: 128 MB.Upload Image 9Add More ImagesConsent* *Geistlich Pharma Australia Pty Ltd Privacy Policy *Geistlich Pharma New Zealand Pty Ltd Privacy Policy *NameThis field is for validation purposes and should be left unchanged.
