The DynaFlex® Philosophy We are intensely committed to providing our customers with the service, quality and value that they expect and deserve. We will do whatever it takes to service our customers in every detail with consistency and courtesy. We want to be your first choice!
Best Fit Guarantee You demand it . . . DynaFlex® guarantees it! Our goal if for our appliances fit the first time every time. If you are unsatisfied with any appliance fit or function that we manufacture, DynaFlex will repair it at not cost to you, no matter when we manufactured it.
How to Send a Case DynaFlex® is a state of the art 3D Digital Laboratory. We can produce a physical model, from a digital record taken in your office, and fabricate any orthodontic appliance on it. You can send cases to us through our DynaFlex File Portal or through your scanners drop down menu (if that feature is available). If you are sending in working models or impressions, please wrap the model with the enclosed packaging. Also, it is very important to fill out the prescription fully and accurately - especially the date wanted box. Prescriptions can be downloaded at www.dynaflex.com.
Delivery Times Please utilize the date wanted box on all your prescription forms with a specific date, not ASAP or RUSH. We know how important it is to have your appliance back for your patient’s appointment. With a specific date, we can inform you ahead of time if there is a delay. TIP: Your date wanted should be the day prior to your patient’s appointment. General Lab Appliances - In lab time is 3-5 days. If circumstances require shorter or same day lab service, it is available on most appliances. EZ Align – In lab time is 5-7 days. Tooth Positioners and – In lab time is 7-10 days. If circumstances require shorter lab service (5 days or less), it Sleep Apnea Devices is available for Sleep Apnea devices for a fee of $100.00 per device. General shipping is 2-3 days each way but shipping times may vary.
Shipping & Handling For shipping your cases to DynaFlex®, we provide convenient postage pre-paid mailing labels. A postage paid label is available on our website. All your cases will be returned guaranteed FedEx for a small shipping and handling fee. OVERNIGHT DELIVERY is also available for an additional charge. To avoid damage, we recommend that each model is wrapped individually. All models should be marked with both the patient and doctor’s name for proper identification.
Technical Assistance DynaFlex® is as close as your telephone or computer. Feel free to call our toll free number 1-800-489-4020 or e-mail us at info@dynaflex.com for assistance on appliance designs and appliance adjustments.
Retainer Assurance When you purchase Retainer Assurance you are guaranteed a one time replacement of your retainer. The certificate is good for six months and is only valid on retainers.
Fax: 314.429.7575 > www.dynaflex.com
meet your helpful laboratory team John Pietroburgo Executive Vice President, CDT John has provided his expertise and knowledge in appliance design and manufacturing to DynaFlex® clients for more than 30 years. John is extremely committed to solving difficult problems in regards to orthodontic appliance selection and custom manufacturing. John has direct contact with all laboratory technicians to ensure that DynaFlex® consistently produces quality appliances that fit the first time. E-mail at johnp@dynaflex.com.
Max Hall Vice President of Sales Max comes to DynaFlex® with 30+ years of experience in the Orthodontic lab industry. The majority of that time was as co-founder, Director of Sales and Marketing and Key Accounts Manager at AOA labs. Throughout his career, Max has been dedicated to providing unparalleled appliance knowledge and expertise, innovative and high quality lab treatment solutions and outstanding customer care to the industry. E-mail at maxh@dynaflex.com.
Jennifer Novack Director of Digital Sales Prior to becoming a regional manager at DynaFlex, Jennifer worked for 7 years as an orthodontic assistant. She offers a wide variety of orthodontic knowledge as well as sales and marketing expertise. Jennifer is now the director of digital sales at DynaFlex and can assist in new account set-ups for all practices utilizing digital file transfer and for all new digital model storage customers. E-mail at jennifert@dynaflex.com.
3D. Ortho
Gary Kline Director of Digital Laboratory Gary is an expert in computerized digital technology and has led the way on the set-up of our 3D Ortho laboratory. Due to his extensive knowledge and expertise in digital orthodontics, Gary is now leading the implementation of our interactive digital indirect bonding system. If you or your staff have questions concerning our digital indirect bonding software, Gary is here to assist you. E-mail at garyk@dynaflex.com.
Tommy Manson Lead Digital Technician Tommy Manson is the lead technician for the 3D Ortho division and has been working with the DynaFlex® team for 2 years. He handles the on-site training for our desktop scanner systems and also assists with the setting up and training of doctors interested in our interoral orthodontics solution. With a background in information technologies and customer service, Tommy is always willing to help you find a solution to any technical issue you may have. E-mail at tommym@dynaflex.com.
Lab Services
Randy Williams Senior Technical Lab Advisor Randy has many years of experience in technical orthodontic appliance fabrication and design. Over the years Randy has attended many continuing education courses as well as lectured to multiple orthodontic groups. His extensive laboratory training and knowledge provides our clients with a level of service far beyond our competitors. Randy is always available to help you with custom appliance design and fabrication. E-mail at randyw@dynaflex.com.
Keith George Technical Laboratory Advisor Keith has several years of technical and custom laboratory design experience. As a Technical Laboratory Advisor, Keith is available to assist DynaFlex® clients with appliance selection, design and provide quality fabricated appliances. E-mail at keithg@dynaflex.com.
Sleep
Gary Quaka Director of Dental Sleep Medicine Gary has more than 30 years of laboratory sales and marketing expertise. He attends most of the continuing education courses as well as lectures to university programs and study clubs. Due to his extensive laboratory experience, he is an excellent source of information on the newest developments in sleep appliance design and function. E-mail at garyq@dynaflex.com.
Alex Buddemeyer Dental Sleep Medicine Technical Advisor Alex is our latest CDT to join the DynaFlex® team . With his knowledge and lab skills there is not a question he can’t handle. With this combined skill set he can help you over the phone and in the lab with your sleep devices. He helps make sure the OSA devices we fabricate in our brand new sleep laboratory are of the highest quality. He also makes sure each doctor is personally taken care of with his great customer service. E-mail at alexb@dynaflex.com.
800.489.4020 > 314.426.4020
table of contents
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3D.Ortho Utilizing the latest technology to create efficiency in your orthodontic and sleep appliance manufacturing! 3D.Ortho . . . . . . . . . . . . . . . . . . . . . . 1 - 8
3D.Ortho
Lab Services Manufacturing the highest quality orthodontic appliances in the industry for the past 45 years. Lab Appliances. . . . . . . . . . . . . . . . 9 - 40
Lab Services
Sleep Devices The ONLY laboratory in the country cleared by the FDA to manufacture 8 different anti-snoring & sleep apnea appliances.
Sleep Appliances
Sleep Appliances . . . . . . . . . . . . . 41 - 45
Fax: 314.429.7575 314.426.1967 > www.dynaflex.com
iii
LEADING THE WAY
1
™
a fully integrated digital orthodontic solution
revolutionizing
appliance fabrication ...one model at a time
With the technology behind our Objet Rapid Prototyping Printers, DynaFlex速 can print models and start appliance fabrication with the click of a mouse.
3
800.489.4020 > 314.426.4020
3D.Ortho
Changing the Way You Practice...Forever! In 2011, orthodontics reached a milestone: the ability to become alginate free. 3D.Ortho™, a division of DynaFlex®, began offering alginate-free appliance fabrication in January of 2011. This means that a practice can use an intra-oral scanner to scan your patient and send that electronic file to DynaFlex for appliance manufacture. We will then send that file to our rapid prototyping printer. Then the printer will create or “grow” a model from your file that will be sent to our technicians in the laboratory. DynaFlex® can also accept any open .stl file that most orthodontic scanners can produce. If you do not own your own scanner, we can also provide your practice with digital model storage. Please contact us at 800-489-4020 to schedule a free demonstration.
Fax: 314.429.7575 > www.dynaflex.com
4
DFT
Digital File Transfer
Send Your Digital Scan Files for Fabrication DynaFlex® is able to print your scanned orthodontic case on our Rapid Prototyping Printers into a physical working model. Using DFT, these models can then be sent into our laboratory for appliance fabrication. The modelbuilding material is a non-toxic durable material that does not break easily. The accuracy of the model is outstanding and the appliance fit is extremely accurate!
Getting the Most from Your Orthodontic Scanner iTero®
5
Lythos™
Trios®
800.489.4020 > 314.426.4020
3M™ True Definition
3D.Ortho Digital Model Storage
DMS
DynaFlex速 uses the most technologically advanced scanning system available to convert your impressions or models into a 3D image. DMS saves you time and space! Traditional time consuming, dusty and less accurate model making steps are eliminated when you send DynaFlex速 your upper and lower impressions and a bite registration. We scan the impressions and, within very short order, you will receive back digital scans of your models via our DynaFlex速 File Portal.
Each DMS case will receive; a digital model that you can easily manipulate on your computer, and a .pdf (containing six views of the case in a 1:1 ratio). All cases are stored forever in five different locations all meeting HIPA standards. If your patient breaks or loses their appliance, you can order a replacement with a simple phone call.
ABO Based Study Models can be printed on our Objet printers. Any case you store with DynaFlex速 can be printed into a physical form with the ABO base attached. These models have accurate and correct dimensions according to the ABO standards.
Fax: 314.429.7575 > www.dynaflex.com
6
D I G I TA L I N D I R E C T B O N D I N G S Y S T E M
Bracket placement where you want it.
DynaFlex® now offers state-of-the-art interactive software to put the control of bracket placement in your hands.
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•
igital interface allows the practice to D manipulate bracket placement.
•
S how patients a digital rendering of treatment simulation.
•
nce the case is approved, DynaFlex® O uses an advanced bracket-locking system to assure that brackets stay in place during tray fabrication.
800.489.4020 > 314.426.4020
®
®
10403 International Plaza Drive indirecT Bonding PrescriPTion P.O. Box 99 • St. Ann, Missouri 63074
10403 International Plaza Drive
57251 57251
(800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 IF NEW ACCOUNT: info@dynaflex.com • www.dynaflex.com IF NEW ACCOUNT: 10403 International International Plaza Plaza Drive Drive DOCTOR 10403 DOCTOR P.O. Box Box 99 99 •• St. St. Ann, Ann, Missouri Missouri 63074 63074 P.O. ADDRESS (800) 489-4020 •• (314) (314) 426-4020 426-4020 •• FAX FAX (314) (314) 429-7575 429-7575 DOCTOR ADDRESS (800) 489-4020 DOCTOR info@dynaflex.com •• www.dynaflex.com www.dynaflex.com info@dynaflex.com CITY STATE ZIP CITY STATE ZIP ADDRESS ADDRESS IF NEW NEW ACCOUNT: IF ACCOUNT: EMAIL EMAIL CITY STATE ZIP CITY STATE ZIP DOCTOR DOCTOR ACCT. # OFC # # ACCT. # OFC EMAIL EMAIL ADDRESS ADDRESS
ACCT. # # OFC # # STATE ACCT. OFC CITY STATE RXCITY FORMS ARE ARE AVAILABLE AVAILABLE AT RX FORMS AT
BUSINESS REPLY LABEL
(800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 UNITED STATES info@dynaflex.com • www.dynaflex.com
NO POSTAGE NECESSARY IF DOCTOR IF MAILED MAILED IN IN THE THE ADDRESS UNITED UNITED STATES STATES IF NEW ACCOUNT: NECESSARY
BUSINESS REPLY LABEL CITY
FIRST CLASS CLASS PERMIT PERMIT NO. NO. 8722, 8722, ST. ST. LOUIS, FIRST LOUIS, MO MO POSTAGE WILL WILL BE BE PAID PAID BY BY ADDRESSEE ADDRESSEE POSTAGE
FIRST CLASS CLASS PERMIT PERMIT NO. NO. 8722, LOUIS, FIRST 8722, ST. ST. EMAIL LOUIS, MO MO POSTAGE WILL WILL BE BE PAID PAID BY ACCT. # OFC # POSTAGE BY ADDRESSEE ADDRESSEE
STATE
ZIP
BUSINESS P.O. Box Box 99 99 REPLY LABEL P.O.
ZIP ZIP www.dynaflex.com www.dynaflex.com
EMAIL PATIENT’S NAME EMAIL PATIENT’S NAME ACCT. # OFC ACCT. # OFC RX FORMS FORMS ARE## AVAILABLE AVAILABLE RX ARE
57251
AGE AGE
www.dynaf P.O. Box 99 P.O. Box 99 St. Ann, Ann,PROVIDE MissouriDATE 63074-9910 PLEASE PROVIDE WANTED St. Missouri 63074-9910 PLEASE DATE WANTED TO TO AVOID AVOID DELAYS DELAYS
FIRST CLASS CLASS PERMIT PERMIT NO. NO. 8722, 8722, ST. ST. LOUIS, FIRST LOUIS, MO MO RX FORMS ARE AVAILABLE AT St. Ann, Ann, Missouri 63074-9910 St. Missouri 63074-9910 PATIENT’S NAME POSTAGE WILL WILL BE BE PAID PAID BY BY ADDRESSEE ADDRESSEE POSTAGE
DATE SENT SENT DATE
REMOVE DAYS DATE WANTED WANTED IN LAB 3-5 DATE BRACKETS
RETURN FIRST FIRST CASE CASE
MODELS
SEND RXS P.O. Box Box 99 99 SEND MORE MORE AT www.dynaflex.com www.dynaflex.com PLEASE PROVIDE WANTED TO P.O. AT PLEASE PROVIDE DATE DATE WANTED TORXSAVOID AVOID DEL DEL SEND BOXES St. Ann, Missouri 63074-9910 UPPER COLOR SEND BOXES St. Ann, Missouri 63074-9910 DATE PATIENT’S NAME NAME AGE DATE SENT SENT FIRST PATIENT’S AGE DATE DATE WANTED WANTED FIRST CASE CASE OPEN BITE BITE CLOSE BITE BITE NEUTRAL BIONATOR REMOVE RETURN SEND OPEN CLOSE NEUTRAL BIONATOR REMOVE RETURN SEND MORE MORE 321 123 321AVOID 123 DELAYS RXCase FORMS ARE AVAILABLE AVAILABLEMODELS AT www.dynaflex.com www.dynaflex.com PLEASE PROVIDE DATE WANTED TO BRACKETS MODELS InformatIon Use Dynaflex® Brackets Upper EZ-ALIGN® Lower UPPER LOWER RESET RX FORMS ARE AT PLEASE PROVIDE DATE WANTED TO AVOID DELAYS SEND EZ-ALIGN® BRACKETS UPPER LOWER RESET SEND BOXE BOXE 321 123 PATIENT’S NAME NAME AGE DATE SENT SENT DATE WANTED WANTED FIRST CASE 321 123 PATIENT’S AGE DATE DATE FIRST CASE UPPER LOWER Digital Indirect Bonding RETURN EZ-2000® OPEN BITE CLOSE BITE NEUTRAL UPPER LOWER BIONATOR EZ-2000® REMOVE SEND MORE RXS stability® OPEN BITE CLOSE BITE NEUTRAL UPPER COLOR BIONATOR REMOVE RETURN SEND MORE RXS UPPER COLOR 321 Custom Base BANDED RPE DISTAL JET™ PENDULUM PENDEX FIXED sendingFIXED Impressions 321 123 123 SEND BOXES BRACKETS MODELS (mini-twin with mesh pad) DISTAL JET™ PENDULUM PENDEX UPPER LOWER RESET SEND BOXES EZ-ALIGN® BANDED RPE BRACKETS MODELS UPPER LOWER RESET EZ-ALIGN® 321 123 Digital model storage BONDED RPE WILLIAMS WILSON™ TYPE 321 123 or working models OPEN BITE BITE CLOSE BITE BITE LOWERNEUTRAL RPE WILSON™ BIONATOR REMOVE RETURN mtX® UPPERWILLIAMS EZ-2000® BONDED OPEN CLOSE NEUTRAL TYPE BIONATOR REMOVE RETURN UPPER LOWERLHA EZ-2000® 321 123 model Print fee NANCE TRANS PALATAL TYPE UPPER COLOR (MIM mini-twin) BRACKETS MODELS 321 123 UPPER LOWER RESET NANCE TRANS LHA TYPE UPPER COLOR EZ-ALIGN® BRACKETS MODELS BANDED RPEPALATAL DISTAL JET™ PENDULUM PENDEX UPPER LOWER RESET FIXED EZ-ALIGN® 321 123 BANDED RPE DISTAL(3x3) JET™ PENDEX FIXED 321PENDULUM 123 E ARCH revolution® BONDED FLEA UPPER LOWER RETAINER traditional Indirect Bonding E ARCH BONDED RETAINER (3x3) FLEA EZ-2000® Digital file transfer UPPER LOWER EZ-2000® BONDED RPE WILLIAMS WILSON™ TYPE UPPER COLOR BONDED RPE WILLIAMS TYPE (manualCOLOR bracket placement) (self-ligating bracket) TONGUE THUMB BLUE GRASS WILSON™ HABIT APPLIANCE UPPER BANDED RPE DISTAL JET™ PENDULUM PENDEX TONGUE THUMB GRASS FIXEDAPPLIANCE HABIT BANDED RPE DISTAL JET™TRANSBLUE PENDULUM PENDEX FIXED NANCELOWER PALATAL LHA TYPE UPPER ESSIX™ RETAINER NANCE TRANS PALATAL LHA TYPE HAWLEY ClearViz+ ™ Custom Base BONDED RPE WILLIAMS WILSON™ TYPE UPPER LOWER ESSIX™ RETAINER BracketsHAWLEY enclosed BONDED RPE WILLIAMS WILSON™ TYPE 314-429-4848
57251 57251
10403 International Plaza Drive (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 P.O. Box 99 • St. Ann, Missouri 63074 info@dynaflex.com • www.dynaflex.com ®®
NO POSTAGE NECESSARY NO POSTAGE® IF MAILED NECESSARY IN THE IF MAILED 10403 International UNITED STATES PlazaINDrive THE P.O. Box 99 • St. Ann, Missouri 63074
ALLEGRA MARKETING, PRINT, MAIL
57251 57251
ALLEGRA ALLEGRAMARKETING, MARKETING,PRINT, PRINT,MAIL MAIL 314-429-4848 314-429-4848
3D.Ortho
R
E ARCH BONDED RETAINER (3x3) FLEA (monocrystalline) CLASP CIRCUMFERENTIAL BALL ADAMS E ARCH BONDED RETAINER (3x3) FLEA NANCE TRANS PALATAL LHA TYPE CLASP CIRCUMFERENTIAL BALL ADAMS NANCE TRANS PALATAL LHA TYPE TONGUE THUMBFINGER BLUE GRASS HABIT APPLIANCE ARROW TONGUE THUMB(3x3) BLUE E ARCH BONDED RETAINER FLEAGRASS HABIT APPLIANCE ARROW FINGER E ARCH BONDED RETAINER (3x3) FLEA UPPER3THUMB LOWERCIRCUMFERENTIAL RETAINER X3 LABIAL WIRE QCM HAWLEY TONGUE BLUE GRASS ESSIX™ HABIT APPLIANCE UPPER LOWER ESSIX™ RETAINER 3 X 3 LABIAL WIRE QCM CIRCUMFERENTIAL HAWLEY tray sections TONGUE THUMB BLUE GRASS roth With Hooks HABIT APPLIANCE .018 FINGER SPRINGS MUSHROOM CLASP BALL CIRCUMFERE ADAMS UPPER LOWER ESSIX™ RETAINER HAWLEY FINGER SPRINGS MUSHROOM CLASP BALL CIRCUMFERE ADAMS UPPER LOWER ESSIX™ RETAINER 3 Pieces full arch midline split HAWLEY 21 12 mBt Without Hooks .022 UPPER RESET LOWER HAWLEY SPRING RETAINER 21 12 ARROW FINGER CLASP BALL CIRCUMFERENTIAL ADAMS UPPER RESET LOWER HAWLEY SPRING RETAINER ARROW FINGER 21 CLASP BALL CIRCUMFERENTIAL ADAMS 21 12 12 TYPE HERBST® 3 X 3 FINGER LABIALARROW WIRE Q CIRCUMFERENTIAL TYPE HERBST® 3 X 3 FINGER LABIALARROW WIRE Q CIRCUMFERENTIAL LOWER CUSTOM BASE PROVIDE BRACKETS UPPER INDIRECT BONDING 3X3 LABIAL WIRE QCM CIRCUMFERENTIAL FINGER SPRINGS MUSHROOM LOWER CUSTOM BASE PROVIDE BRACKETS UPPER On the diagram tO the right: INDIRECT BONDING 3X3 LABIAL WIRE QCM CIRCUMFERENTIAL FINGER SPRINGS MUSHROOM BUCCAL EXPANSION for missing, not to be bonded, or to be extracted teeth, markMARA with an “X”. for over-corrections, indicate with arrows. FINGER SHIELD SPRINGS BUCCAL EXPANSION UPPERMUSHROOM LOWER RESET 21 MARA HAWLEY SPRING SPRING RETAINER 21 FINGER SHIELD SPRINGS UPPERMUSHROOM LOWER 21 12RESET 21 HAWLEY LOWER UPPER RETAINER SAGITTAL UPPER LOWER RESET 21 12 HAWLEY SPRING RETAINER LOWER UPPER SAGITTAL 21 TYPE HERBST® UPPER LOWER RESET 21 12 HAWLEY SPRING RETAINER TYPE LOWER HERBST® UPPER SCHWARZ TYPE 21 12 HERBST® LOWER UPPER LOWER COLOR SCHWARZ Only cOmplete with traditiOnal bOnding LOWER CUSTOM BASE PROVIDE BRAC UPPER TYPE INDIRECT BONDING HERBST® SAL® BASE MAX® LOWERDMJ® CUSTOM PROVIDE BRAC UPPERDMAX® SERIES 2000® LOWER CUSTOM BASE PROVIDE UPPER INDIRECTINDIRECT BONDINGBONDING COMMENTS DMJ® DMAX® SAL® BRACKETS MAX® SERIES 2000® LOWER CUSTOM BASE PROVIDE BRACKETS UPPER Custom BUCCAL SHIELD EXPANSION Custom INDIRECTMARA BONDING SAG® MJX® SAN® MSX® BUCCAL SHIELD EXPANSION MARA HeigHt BUCCAL SHIELD EXPANSION HeigHt MARA SAG® SAN® BUCCAL SHIELD EXPANSIONUPPERMJX® MARA SAGITTAL MSX® LOWERMSC® TB-SAG® CS-2000®standard EAS® standard 2.0 mm LOWER UPPER LOWER UPPER SAGITTAL SAGITTAL 3.0 mm 4.0 mm 4.5 mm 5.0 mm 4.5 mm 5.0 mm 2.0 mm HeigHt 5.0 mm 4.5 mm 5.0 mm 4.5 mm 4.0 mm 3.0 mm MSC® TB-SAG® CS-2000® EAS® HeigHt SAGITTAL LOWER UPPERLOWER SCHWARZ UPPER TYPE SLEEP APPLIANCE UPPER SCHWARZ LOWER UPPERLOWER SCHWARZ TYPE SLEEP APPLIANCE UPPER SCHWARZ DMAX®DMJ® SAL® MAX® LOWER TYPE SERIES 2000® SPLINT PHONE NUMBERDMJ® SIGNATURE DMAX® SAL® MAX® SERIESSERIES 2000® 2000® DMJ® DMAX®DMJ® SAL® MAX® DMAX® TYPE SPLINT SAL® MAX® SERIES 2000® UPPER TANDEM SAG® MJX® LOWER SAN® MSX® MJX® SAG® SAN® MSX® UPPER LOWER TANDEM SAG® MJX® SAN® MSX® SAG® MJX® SAN® MSX® TYPE TOOTH POSITIONER MSC® TB-SAG® CS-2000® EAS® TB-SAG® MSC® CS-2000® EAS® TYPE TOOTH POSITIONER MSC® TB-SAG® CS-2000® EAS® TB-SAG® MSC® CS-2000® EAS® TO OPEN TYPE TO CLOSE TYPE TWIN BLOCK™ TYPE SLEEP BLOCK™ APPLIANCE SLEEP APPLIANCE TO CLOSE TO OPEN TYPE TYPE TWIN TYPE PT1= ORIGINAL (RETURN TO DYN SLEEP APPLIANCE SLEEP APPLIANCE STUDY MODELS (SOAPED PRESENTATION) DUPLICATE MODELS TYPE FORTYPE SPLINTSPLINT STUDY MODELS (SOAPED PRESENTATION) DUPLICATE MODELS TYPE FORTYPE SPLINTSPLINT LOWER COLOR DIGITAL MODEL STORAGE UPPER LOWER TANDEM LOWER COLOR UPPER LOWER TANDEM DIGITAL MODEL STORAGE UPPER LOWER TANDEM UPPER LOWER TANDEM COMMENTS TYPE TOOTH POSITIONER TYPE COMMENTS TOOTH POSITIONER standard TYPE TOOTH POSITIONER 2.5 mm 2.5 mm standard 3.0 mm 3.5 mm 4.0 mm 4.5 mm 4.0BLOCK™ mm 4.0 mmPOSITIONER 4.0 mm 4.0 3.0 mm TYPE 4.0 TOOTH HeigHt HeigHt TO mm CLOSE3.5 mm TO mm OPEN4.5 mm TYPE TWIN TO CLOSE TO OPEN TYPE TWIN BLOCK™ TO CLOSE TO OPEN TYPE TWIN BLOCK™ Custom Custom
(price of custom base included with digital IDB, $39 add’l on traditional IDB)
with case
Bracket Prescription
R RR
TradiTional BrackeT HeigHT PrescriPTion -
r
l
TO CLOSE OPEN BLOCK™ STUDYTWIN MODELS (SOAPED FORTO PRESENTATION) DUPLICATETYPE MODELS HeigHt MODELS FOR PRESENTATION) MODELS STUDYSTUDY MODELS (SOAPED (SOAPED FOR PRESENTATION) DUPLICATEDUPLICATE MODELS DIGITAL MODEL STORAGE (SOAPED FOR PRESENTATION) STUDY MODELS DUPLICATE MODELS DIGITAL DIGITAL MODEL STORAGE MODEL STORAGE
HeigHt
LOWER COLOR LOWER COLOR LOWER COLOR
LOWER COLOR COMMENTS COMMENTS COMMENTS PHONE NUMBER COMMENTS PHONE NUMBER
DIGITAL MODEL STORAGE
SIGNATURE SIGNATURE
PRINT NAME PRINT NAME
MARGINALS HERE MARGINALS HERE PHONE NUMBER PT1= PHONE NUMBER
SIGNATURE
PRINT NAME
ORIGINALSIGNATURE (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES) PRINT NAME PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN YOUR FILES) PHONE NUMBER SIGNATURE PRINTFOR NAME
PHONE NUMBER
SIGNATURE
PRINT NAME
MARGINALS HERE
MARGINALS HERE Fax: 314.429.7575 > MARGINALS www.dynaflex.com HERE
PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’SHERE COPY (RETAIN FOR YOUR FILES) MARGINALS PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
8
LEADING THE WAY
9
800.489.4020 > 314.426.4020 314.426.4428
Quality Orthodontic Laboratory Appliances
Fax: 314.429.7575 > www.dynaflex.com
10
Fixed Expanders Fixed maxillary and mandibular expanders include a broad range of appliance designs. The designs are used to correct cross-bites, narrow arches and crowding. The fixed expanders utilize some mechanism of force (expansion screws, self-activating spring or wire activation) for development of the arch. These fixed designs require minimal patient compliance and provide the doctor with total control during active orthodontic treatment. Auxiliary attachments such as brackets and habit breakers can be requested for most of the expander appliances.
Stealth
Haas
Stealth The new stealth palatal screw is used in cases requiring a physically smaller expansion screw. The screw allows for approximately 11mm of activation and more patient tongue space providing optimal patient comfort. It is ideal for cases needing upper & lower arch development.
Bondable RPE
Haas This fixed design is both tissue and tooth borne to provide orthopedic and orthodontic changes.
Bondable RPE Acrylic onlays or pads are placed over the posterior teeth and then bonded in place.
Memory Screw RPE
Memory Screw RPE The new line of memory screw expanders puts the control back in the clinician’s hands. Once the Memory screw is activated 4-to-5 turns the Niti coil springs that are built into the screw become active. The Niti coil springs then provide light continuous forces for biocompatible arch development. This new screw can be used in both fixed and removable appliance designs.
“Snap-Fit” RPE “Snap-Fit” RPE The .036 contoured buccal-lingual wire eliminates path of insertion problems. Composite is used to lock in the appliance
Super Screw The Super Screw expander is used in situations that require a larger degree of arch development but a physically smaller screw is desired. A 12mm or 16mm screw can be requested. A special adjustment wrench is sent along with each appliance.
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Super Screw
800.489.4020 > 314.426.4020
lab appliances Fixed Expanders Fixed Fan Gear The fixed fan gear appliance is the appliance of choice when presented with a tapered maxillary arch and a fixed appliance is required. The screw provides 9mm of activation.
Fixed Fan Gear
Spring Jet I & II
Achieve slow arch expansion with controlled continuous NiTi spring force. No patient compliance required. Substitute for screw or pre-set wire expanders. Provides reliable results with minimal tipping & no patient compliance.
Spring Jet I & Spring Jet II
Quad-Helix This appliance allows for the development of the maxillary arch by utilizing active helical springs. The springs can be activated to provide overall arch form improvement or to address either anterior or posterior expansion needs. The design of the appliance also allows for improvement of molar rotation.
Quad-Helix
NiTi-Expander This is a pre programmed thermally activated appliance. The appliance comes in several different sizes to allow for a wide range of expansion. The individual appliances are anchored in place via horizontal sheaths attached to molar bands. This is an exceptional appliance when mild to moderate expansion is required. It is possibly the finest appliances at acquiring distal rotation of 1st permanent molars.
NiTi-Expander
E-Arch Typically a lower appliance designed to upright lingually inclined posterior teeth. This NiTi spring loaded appliance is a very effective & popular choice do to its streamlined design. When the desired lateral development is achieved the spring can be deactivated by adding composite.
E-Arch
Slimline This fixed expander improves the lower archform with an expansion screw along with extensions to engage the lingual surface of posterior teeth as well as primary or permanent canines.
Slimline
Williams The most popular of our lower uprighting appliances. This appliance uses a mini screw capable of 10mm of activation. The design incorporates an .018 NiTi archwire that freely slides labially to apply pressure to the lingual of the lower incisors to improve alignment as arch form improvement occurs.
Williams
Fax: 314.429.7575 > www.dynaflex.com
For more fixed expanders, see our Series 2000速 on page 17 & 18.
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Schwarz A variety of active appliances can be fabricated for arch width and arch length development. Active designs are beneficial for development of the arches prior to fixed treatment. A minimum of four clasps is suggested to maximize retention. In addition to our standard designs; springs, small expansion screws and wires provide forces to move individual teeth. Maxillary occlusal coverage can be added as desired.
Schwarz Upper & Lower
Designed to gain lateral arch development in the upper and /or lower arches.
Schwarz Upper & Lower
Three Way Schwarz
Three Way Schwarz
Used in the upper arch for both lateral and anterior development.
Nord
Nord A Maxillary appliance, designed for the correction of unilateral cross bites.
Fan Gear
Fan Gear
Designed to develop the bicuspid area, it is ideal for correcting tapered arch forms.
Arch Length Development - Sagittal The Sagittal appliances are designed to regain lost arch length in an anterior and/or posterior direction.
Anterior Sagittal Upper & Lower
Anterior Sagittal Upper & Lowe To ensure anterior development, the design maximizes posterior anchorage with screw placement and occlusal indentations.
Distal-Drive Upper & Lower
Distal-Drive Upper & Lower
This design facilitates distal driving of posterior teeth to regain lost arch length. To maximize distalization, splits are cut mesial to first molars.
3 Screw Sagittal Upper & Lower This features the Sagittal design with a midline expansion screw for lateral development.
3 Screw Sagittal Upper & Lower
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800.489.4020 > 314.426.4020
lab appliances Pendulum Appliances The Pendulum expanders provide both distalization and rotation of the maxillary first molars with .032 TMA速 wire. A midline expansion screw can be added for arch development. The design includes upper first molar bands with bands or rests placed on the first bicuspids.
Pendulum
Pendulum
An .032 TMA速 wire provides light forces to distalize and rotate upper first molars. A Nance button provides anchorage.
Pendex
Pendex
Upper arch development along with molar distalization is gained by adding an expansion screw in the acrylic.
T-Rex
T-Rex
This appliance is used for maxillary arch expansion and molar distalization. An expansion screw is used to first develop the maxillary arch. Once transverse movement is gained, the pre-activated .032 TMA速 wires are trimmed loose for molar rotation and distalization. * TMA is a registered trademark of ORMCO.
Distal Jet
Distal Jet Appliances The Distal Jet offers the unique feature of unilateral or bilateral molar distalization and molar rotation correction with one appliance. The appliance is anchored off the first bicuspids or in cases requiring maximum anterior stabilization second bicuspids can be used. For lateral arch development an expansion screw can be requested.
Distal Jet with Expansion
Frog Appliance Frog
The Frog is designed for maxillary molar distalization without adjustment of palatal wires. The small expansion screw provides the force to move the molars. Each counterclockwise activation delivers 0.4mm of distalization. The Frog design can be used for the first phase or in combination with fixed appliances.
Bowman Distal Jet
Nitanium Molar Rotator Nitanium Molar Rotator
Specially designed heat-activated nickel titanium palatal wire is used to correct mesially and distally rotated molars. The rotator fits easily into lingual sheaths for immediate activation. Once molar rotations are corrected the appliance can be used as a transpalatal retainer.
Fax: 314.429.7575 > www.dynaflex.com
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SmartJet™ - DynaFlex® Exclusive This brilliant new design is super-efficient, supercomfortable and very simple to manage. All of the mechanisms are built for comfort and convenience. The larger anterior mechanism (SmartStop) has a small set screw that locks into place after you have made your necessary adjustments to the appliance (Figure 1). The smaller mechanism (SmartGuide) is threaded on the coil spring for secure positioning and will accept our exclusive Z clip for connection to the lingual sheath. The super elastic nickel titanium spring maintains a consistent 200 grams of force and slides friction free along the wire. Another incredible feature of the SmartJet™ is the ability to mesialize a molar by sliding the SmartStop anteriorly and pulling the molar into position as shown in the picture (Figure 2). The SmartJet™ is truly the smartest appliance….
Fig. 1
Fig. 2
Fixed Retention Appliances Fixed appliances are used for anchorage and retention between phases of treatment and after final orthodontic treatment. Various appliance designs are utilized to preserve space and hold teeth in a desired position. Stainless steel wire is used in appliance fabrication and is available in a number of round and rectangular sizes.
6 x 6 or L.H.A.
Composite Pads Transfer Tray
3x3
Nance
Transpalatal
Fixed Habit Appliances The fixed habit appliances are used for correcting both tongue thrust and thumb sucking habits. A variety of appliance designs can be used for habit correction. In some cases, persistent finger habits may require a more aggressive appliance design such as small prongs or spikes to act as a deterrent to correct the habit.
Myo-Functional Bead
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Tongue Habit
Spiked Thumb Habit
800.489.4020 > 314.426.4020
lab appliances Retainers The Hawley Retainers are used for finished orthodontic cases to securely maintain the teeth in their new position. DynaFlex® finishing retainers meet all the major criteria for effective retention of your finished orthodontic cases.
Mandibular Retainer
San Antonio Retainer (wrap around)
Maxillary Retainer
Spring Retainer
Essix® Retainer Modified Spring Retainer
QCM Clear Bow Retainer The new highly esthetic clear labial bow retainers are excellent for your teenage and adult patients. The labial bow will remain crystal clear and guaranteed not to stain or discolor with extended wear. The “QCM” retainer can be used in both the upper and lower arch.
Bracket Carving/ Removal: To assure stability for your finished cases, DynaFlex® can accurately remove brackets from working models. Your retainer can be inserted at the debracketing visit. This eliminates the possibility of “drifting” of the teeth between patient visits. It is important to take the impression with the arch wire removed to prevent the impression material from tearing.
Fax: 314.429.7575 > www.dynaflex.com
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Series 2OOO®
Maxillary Designs MAX-2000™ MAX-2000™ is a maxillary spring loaded palatal expander. The MAX-2000™ utilizes the nickel titanium open coil spring rod-tube mechanism for a continuous low force system to gain arch width.
DMAX-2000™
MAX-2000™ DMAX-2000™
DMAX-2000™ or “Distalizing Maxillary Expander” utilizes either a midpalatal nickel titanium open coil spring rod-tube mechanism or a standard jackscrew for transverse movement and the same rod-tube mechanism on the lingual to distalize the molars.
DMAX/RPE-2000™ DMAX/RPE-2000™ or “Fixed Distalizing Maxillary Expander”. The hygienic fixed design is superior for total maxillary arch development. The rapid palatal expansion screw provides positive force for transverse movement. No adjustments are needed for molar distalization. Bodily movement without crown tipping is gained by the low continuous forces of the nickel titanium open coil springs.
DMJ-2000™
DMAX/RPE-2000™
DMJ-2000™
DMJ-2000™ or “Distalizing Molar Jig” is designed to distalize maxillary molars with the telescopic rod-tube using a low continuous nickel titanium force. The DMJ-2000™ also utilizes an acrylic Nance button for additional anchorage.
SAG-2000™
SAG-2000™ is a fixed sagittal appliance which incorporates a midpalatal jackscrew as well as the telescopic rod-tube nickel titanium open coil spring design. The SAG-2000™ is designed to be used in Class III skeletal cases with midface deficiencies anterior-posterior as well as transversely.
TB SAG-2000™
SAG-2000™
TB SAG-2000™
TB SAG-2000™ Tooth borne sagittal design for Class II Division II correction. This appliance will distalize maxillary molars and simultaneously put pressure on central and lateral incisors for forward movement. It is excellent for Class III skeletal cases.
SAN-2000™
SAN-2000™ or “Spring Advancing Nance” is a superior appliance following SAG-2000™ treatment to maintain skeletal arch advancement. The nickel titanium spring loaded SAN-2000™ supplies a predetermined amount of continuous force to the maxilla. The totally spring activated design requires no adjustments by the patient or doctor.
SAN-2000™
*Stainless steel crowns or Rollo Bands may be substituted for bands.
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800.489.4020 > 314.426.4020
lab appliances
Series 2OOO®
Mandibular Designs MSX-2000™
MSX-2000™
MSX-2000™ or “Mandibular Spring Expander” is a totally spring activated appliance requiring only recall observation visits. The MSX-2000™ employs the nickel titanium open coil spring rod-tube mechanism bilaterally and replaces the midline jackscrew with nickel titanium open coil spring rodtube mechanism.
MJX-2000®
MJX-2000™ MJX-2000® or “Mandibular Jackscrew Expander” is a lower arch developing appliance that utilizes a midline jackscrew for arch width and a lingual nickel titanium open coil spring rod-tube mechanisms bilaterally for distalizing molars simultaneously gaining arch length.
MSC-2000™
MSC-2000™
MSC-2000™ or “Mandibular Space Closer” is excellent for bodily advancing molars mesially where second bicuspids have been removed. The unique rod-tube and titanium spring produces light force for space closure without crown tipping. The self adjusting springs require no adjustments once the appliance is cemented in place.
SAL-2000™
SAL-2000™
SAL-2000™ or “Spring Advancing Lingual” is excellent to advance mandibular incisors to a predictable result. The SAL-2000™ does not require activation or de-activation chair side adjustments. The telescopic rod-tube and open coil titanium springs provide low continuous forces for advancement of the incisors to a predetermined position. This is also an excellent choice for single tooth cross bites in the maxillary arch.
Mandibular Advancement Designs EAS-2000™
EAS-2000™ *EAS-2000™ or “Expanding Advancing Sheath” combines the MAX-2000™ design for maxillary transverse movement with mandibular advancing mechanics for skeletal Class II correction. The lower appliance designs incorporate Series 2000™ options for either development of arch width, arch length or extraction space closure.
EAS MSX-2000™
EAS MSX-2000™
EAS MSX-2000™ is a totally spring activated appliance requiring only recall observation visits. The MSX-2000™ employs the nickel titanium open coil spring rod-tube mechanism bilaterally and replaces the midline jackscrew with nickel titanium open coil spring rod-tube mechanism.
EAS MJX-2000®
EAS MJX-2000® EAS MJX-2000® is a lower arch developing appliance that utilizes a midline jackscrew for arch width and a lingual nickel titanium open coil spring rod-tube mechanisms bilaterally for distalizing molars simultaneously gaining arch length.
EAS MSC-2000™
EAS MSC-2000™
EAS MSC-2000™ or “Mandibular Spring Closure” is excellent for bodily advancing molars mesially where second bicuspids have been removed. The unique rod-tube and titanium spring produces light force for space closure without crown tipping. The self adjusting springs require no adjustments once the appliance is cemented in place.
Fax: 314.429.7575 > www.dynaflex.com
© Copyright 2014 DynaFlex® is the exclusive licensed laboratory in the United States to fabricate Series 2000® appliances. Series 2000® appliances are trademarked and are covered by one or more of the following patent numbers 5645422, 5769631, 5919042, 6036488, 6241517, 6402510, 6520772, 6719557.
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CS-2OOO Your Class II and Class III Solution ®
This revolutionary system will guarantee results with your Class II and Class III orthodontic cases. The CS-2000® Niti springs are a DynaFlex® exclusive, utilizing a patented, low-continuous force (350 grams), closed coil spring and a specially built “key-hole” end which fits over a patented slotted base pivot similar to a Herbst® housing nut. BEFORE
AFTER
Simply break off the tip of the screw allowing the pivot to move freely on the archwire
New design:
The newly designed collared pivot allows for an arch wire to slide easily through the base and reduces the possibility of abrasion. The new hybrid screw can be active or passive allowing you the ability to lock the pivot to the archwire, if desired. The pivot is designed to be used on the archwire or can also be welded to a band or crown for amazing versatility.
X-rays compliments of Dr. Andy Hayes of St. Louis, MO
There are multiple options to use CS-2000® in Class II & III along with upper and lower fixed appliances.
(upper view)
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Actual Class III patient treated with the CS-2000® system placed directly on the archwires and the case required no compliance.
(lower view)
800.489.4020 > 314.426.4020
lab appliances
Say Good Bye to Face Masks... Say Hello to the Modified Tandem™ Face mask in use.
MTA in use.
Modified Tandem™
Fixed MTA
The Modified Tandem™ Appliance (MTA) is designed for orthopedic correction of the growing Class III patient. The appliance design is more comfortable than conventional devices because it is worn intraorally. The simple MTA utilizes three separate units; an upper appliance (active or inactive), a lower appliance (fixed or removable), and a traction bow. Design modification is simple for both the upper and lower arch, any combination of fixed or removable appliance designs may be requested.
Removable MTA
For more information, refer to these JCO Articles: April 2003, “Early Orthopedic Class III Treatment with a Modified Tandem™ Appliance”. June 2011, “Early Treatment of Skeletal Class III Open Bite with the Tandem™ Appliance”. (available at www.dynaflex.com)
Fax: 314.429.7575 > www.dynaflex.com
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Twin Block Appliances Dr. William Clark, an Orthodontist, developed an uncomplicated technique that incorporates the use of upper and lower bite blocks to reposition the mandible forward for skeletal Class II correction. The Twin Block technique is easy to use and very patient friendly. The design utilizes two separate appliances that fit the maxilla and mandible. The unique design allows for more patient comfort and increased patient cooperation. The Twin Block design also allows for independent development of the upper and lower arches with the addition of transverse and/or sagittal screws.
Standard Twin Block
Twin Block to Close
Sagittal Twin Block
Dr. James McNamara designed Twin Block includes two upper expansion screws for maxillary arch development. To enhance retention of the lower portion of the appliance a labial bow with acrylic is added to the design. In addition, the lower flanges of acrylic are extended to the molars.
McNamara Twin Block
Twin Block Stage II Once “three-point” contact has been achieved a fixed or removable incline bite plane is used to support Class II correction. The Stage II appliance is used until the bicuspids have erupted into occlusion and the posterior open bite has been closed.
“Stage ll”
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Rick-A-Nator
Rick-A-Nator ll
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lab appliances Mara® Appliance MARA (Mandibular Anterior Repositioning Appliance) is used to achieve Class II correction treatment goals in the “noncompliant” patient. For the MARA patient to close his / her mouth and occlude the teeth, they must posture the jaw forward into the desired Class I occlusion. With the MARA, the mandible is held forward in Class I occlusion by the labs positioning of the buccal attachments on the molars. The MARA is anchored to the molars in the same manner that a Herbst appliance is i.e. crowns, modified crowns or bands. The lower buccal attachments are fixed to the molars while the upper buccal attachments (called Elbows) are removable. The upper Elbows being removable enable the Orthodontist and/or staff to make adjustments and advancements in the appliance. Each MARA comes with both upper and lower archwire tubes to facilitate the option of fixed mechanics being used in conjunction with MARA treatment. Additionally, advancement shins in various sizes are available by request.
Mara® “U” Appliance To enhance the effectiveness of the Mara Appliance in very deep overbite cases the U-Mara is an excellent alternative. In deep overbite cases when the mandible is advanced there is a large posterior open bite making it difficult for the patient to keep the upper elbow and lower loop properly engaged. The “U” modification addresses this problem by reversing the lower loop to provide additional millimeters of vertical engagement between the lower arm and upper elbow.
Fax: 314.429.7575 > www.dynaflex.com
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Herbst
®
Appliances The Herbst® appliance is a superior fixed functional appliance which effectively corrects skeletal Class II malocclusions. DynaFlex® has created quality Herbst® appliances for doctors all over the world for forty years and counting. DynaFlex laboratory offers value pricing, expertise, and a vast knowledge of current Herbst® designs. Herbst® Designs: The Herbst® designs include stainless steel crowns, Rollo Bands, bands and/or acrylic. The amount of mandibular advancement and bite opening depends on the case and appliance design. All Herbst® designs can be reactivated by using precut “shims” or “spacers” to gain further advancement of the mandible. The EAS® design allows for 5 additional mm of advancement with a built-in screw mechanism.
MiniScope™ & MiniScope w/ Apple Core™ The MiniScope Herbst is a three section telescoping mechanism that will not become disengaged during patient opening. The Apple Core housing nut has a curved radius to allow for increased lateral excursion, reduction of breakage and optimum patient comfort.
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800.489.4020 > 314.426.4020
lab appliances Traditional Herbst®
This design highlights the traditional rod and tube mechanism, however any Herbst mechanism can be used with this Dr. Jim Hilgers designed Herbst. The upper first molar crowns and the lower first bicuspid crowns provide sufficient anchorage; however the LHA rest can be bonded for greater anchorage.
Hanks™ Telescoping Herbst®
The HTH was developed by Dr. Stephen Hanks as a major improvement to the traditional rod and tube design and is the only true “one piece” design available for Herbst® treatment. The telescoping design eliminates problems of disengagement and incorporates a ball and socket pivotal screw that is built into the telescoping mechanism. The ball and socket allows for tremendous lateral excursion and increased patient comfort. Also, the built in screw makes chair side placement extremely easy.
Flip-Lock® Herbst® The Flip Lock mechanism is comprised of a simple ball joint hinge that allows for maximum lateral excursion and extremely easy chair side assembly. It can be fabricated with the traditional design or the cantilever design for increased patient comfort. Any Herbst design can be fabricate with the Flip-Lock mechanism. All Herbst accessories can be included in a Flip-Lock Herbst.
EAS-2000™ EAS-2000™ or “Expanding Advancing Sheath” combines the MAX-2000™ design for maxillary transverse movement with mandibular advancing mechanics for skeletal Class II correction. The lower appliance designs incorporate Series 2000™ options for either development of arch width, arch length or extraction space closure.
Fax: 314.429.7575 > www.dynaflex.com
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Wilson 3D® Appliances The 3D® appliances are a group of prefabricated “fixed-removable” modules that are interchangeable at chairside. The 3D® lingual tubes provide a quick and secure plug in system to achieve various orthodontic movements such as arch development, single tooth movement and maintenance of arch space. The 3D® system is easily incorporated into any fixed technique.
3D® Palatal Appliance 3D® Palatal Appliance
This very popular maxillary appliance can be used as a traditional transpalatal bar or can be used to provide lateral development throughout the arch or can be selectively adjusted to provide bicuspid/cuspid expansion.
3D® Bi-Metric Arch
This product allows for predictable molar distalization without the use of external headgear. The appliance can be used either unilaterally or bilaterally & require minimal adjustment and patient compliance.
3D® Bi-Metric Arch
3D® Lingual Arch
3D® Lingual Arch
The 3D® Lingual Arch allows for multiple functions ranging from anchorage control to maintaining or improving arch length. It can easily be adjusted to provide buccal expansion and molar uprighting.
3D® Quad-Helix
3D® Quad-Helix
Traditionally used as a maxillary expansion appliance, it is also a very effective appliance at providing molar rotation.
3D® Quad-Action 3D® Quad Action
* Wilson 3D is a registered trademark of Rocky Mountain Orthodontics
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This appliance is an excellent alternative to multiple arch lengthening and expansion appliances. This versatile appliance allows for a variety of movement with minimal adjustment and great patient acceptance.
800.489.4020 > 314.426.4020
lab appliances Bionator/Orthopedic Corrector The functional appliances include Activators,
Frankels,
Bionators,
Orthopedic Correctors, Twin Block™
Bionator l to Open
and Herbst® designs. The doctor can choose from various removable and fixed appliance designs. All functional appliance designs address Skeletal Class II problems by advancing the mandible forward to a corrected Class I position.
How To Send A Case: All Functional Appliance designs
Orthopedic Corrector
require accurate working models. A construction bite should be provided to indicate the amount of mandibular advancement and vertical change.
Frankel Appliances The Frankel appliances are removable designs invented by Professor Rolf Frankel. The Frankel philosophy uses the vestibules to enhance favorable growth in developing dentition and restrict undesirable muscle forces. Thus, the Frankel appliance is reported to provide an “ideal” environment for maximum arch development and proper skeletal jaw relationship. The three most commonly used designs are the Frankel II, Frankel III and Frankel IV.
Frankel ll
Fax: 314.429.7575 > www.dynaflex.com
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Orthopedic Splints DynaFlex® has over 45 years of experience fabricating orthopedic splints. DynaFlex® is experienced at constructing a variety of splints custom made to the specific needs of your patient. The splints pictured below are some of the more commonly requested designs used to treat TMJ dysfunction. Additional splint designs are available upon request.
Maxillary Anterior Deprogrammer
How to Send a Case: Send accurate maxillary and mandibular working models from high quality alginate impressions. To guarantee “best fit” the impressions should be poured immediately. For proper appliance fabrication include a wax bite to the desired vertical opening and mandibular advanced position.
Maxillary Anterior Deprogrammer
Maxillary Flat Plane
Full coverage splint most often used for clenching and bruxing problems. A flat platform lingual to the upper incisors is designed to provide contact with the lower incisors. The lower posterior teeth are held out of occlusion which differentiates this splint from a maxillary flat plane splint.
Maxillary Flat Plane Upper splint designed to have all lower teeth to strike evenly. This splint is commonly designed to include cuspid disclusion or anterior guidance. It is most commonly used as a traditional night guard for occlusion related problems.
Dorsal Splint
Dorsal Splint
A nighttime splint designed to provide aggressive mandibular repositioning. The Dorsal fin on the mandibular appliance interfaces with the maxillary appliance preventing the lower jaw from retruding during sleep. This appliance is most often fabricated out of a dual laminate material, but can also be fabricated with traditional acrylic.
Farrar Splint Farrar Splint, often referred to as a maxillary repositioning splint, utilizes an aggressive incline plane lingual to the incisors to force the mandible into a protrusive position. This splint can be fabricated with or without posterior support depending upon personal preferences. This is a very common nighttime appliance.
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Farrar Splint
800.489.4020 > 314.426.4020
lab appliances Orthopedic Splints Gelb A traditional lower diagnostic splint. Most commonly used to establish proper vertical dimension with slight to moderate anterior repositioning. The amount of repositioning dictates how heavily indexed the posterior bite pads become.
Gelb
Modified Gelb
Modified Gelb Most popular splint similar to Gelb splint with the addition of anterior acrylic for additional support.
Pull Forward Splint
Pull Forward Splint
Tanner
Mandibular splint designed to aggressively reposition the lower jaw to a down and forward position. The lingual flange or acrylic helps guide the mandible to a specific position. These flanges also help prevent lateral movements, and are generally reduced over time as the patient becomes comfortable in the new position.
Tanner
Popular lower splint that includes both posterior support as well as an anterior cap of acrylic. This cap is a common addition on patients who will wear this splint for an extended period of time.
Luco Lower splint fabricated on the buccal as opposed to the lingual. This is a patient friendly splint as it preserves tongue space. Similar to other lower splints, the amount of repositioning is controlled by the design of indexing of the upper posterior teeth into the occlusal pads.
Stack Bionator A monoblock style appliance that aggressively holds the lower jaw in a down and forward position. This is most commonly used in adult post mandibular repositioning patients to prevent dual bites from occurring. It is considered a night-time appliance.
Luco
Stack Bionator
Fax: 314.429.7575 > www.dynaflex.com
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Pro-Form Mouthguards Custom made Pro-Form mouthguards from DynaFlex速 give your patients the absolute best in comfort, fit, retention and protection. Pro-Form mouthguards offer the best protection available for athletes without interfering with breathing or speech during play and they can also protect your patients from many types of oralfacial injuries during athletic events including tooth fracture and concussions. All Pro-Form mouthguards are custom made by skilled technicians with many years of experience and the fit is always guaranteed. They are available in a variety of colors and can be made with or without a helmet strap.
Glitter
Multiple color choices for each style!
Green Orange Pink
Tie-Dye Midnight Patriot Wilderness
Color Black Blue Clear Green Orange Red Purple Yellow
Basic Mouthguard
The Glitter Guard
Tie-Dye Guard
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Mouthguard straps
800.489.4020 > 314.426.4020
Tooth Positioner
lab appliances
For many years now, the Orthodontic community has considered the Positioner to be the ultimate case finishing appliance. The Positioner combines the use of state-of-the-art materials, an intelligently constructed tooth set-up, used at the ideal time to move the teeth into the best occlusion possible. This combination allows the Orthodontist to finish off those difficult movements of correcting rotations, tipping, torquing, leveling, width discrepancies, space closure and occlusal plane corrections all in a relative short wearing time. Achieving these tasks in such a relative short time allows the case to be finished several months / weeks earlier than without using a Positioner. All DynaFlex® Positioners are custom fabricated to your specifications; material type, flange thickness and height, retention auxiliary are designed to blend appliance efficiency and patient comfort. Sending DynaFlex a Positioner case: There are a variety of ways and times in treatment to send DynaFlex® your case. The ways to send DynaFlex® a case is either digitally (DynaFlex® accepts scans for nearly all scanners i.e. iTero, Lythos, Trios, True Definition), or plaster models sent in shipping boxes that we provide via UPS, FedEx or U.S. Mail. The times in treatment to send DynaFlex® Positioner cases varies from the end of treatment after brackets are removed, to several months prior to finish with bracket still on the models. The majority of Positioner cases at DynaFlex® are received a few months/weeks prior to bracket removal from your patient. We remove the brackets from the models; fabricate the set-up and positioner and return both to you prior to you removing the brackets from the patient. This technique allows you to take advantage of the teeth being most mobile when brackets/archwires are just removed and the teeth can most easily settle into the ideal set-up of the Positioner.
Demonstration Appliances DynaFlex® offers a complete line of orthodontic display appliances for patient‘s education and case presentation. All demonstration appliances are constructed from superior materials and finished to a high quality gloss. Demonstration appliances are excellent for enhancing your patient understanding of the orthodontic treatment you are prescribing for them. They are great for increasing patient acceptance of both fixed and removable appliances. Demonstration appliances can be ordered in complete sets or individually. Any of the appliances in the DynaFlex® catalog can be ordered as demonstration appliances. The cost of these appliances are comparable to our standard laboratory fees. White or two-tone models are available. Enhance the way your demonstration models are showcased. DynaFlex® now offers an exquisite brown leather case with a light soft fabric interior. Also makes travel safer and easier. Available for purchase, ask for details.
Fax: 314.429.7575 > www.dynaflex.com
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EZ-Align
®
Affordable Aligner System EZ-Align® is a clear tray system that will progressively align your patients teeth until the final results have been achieved. EZ-Align® is an affordable alternative to other aligner systems!
EZ-Align® is a time proven system that has provided tremendous results for thousands of patients over the past several years.
EZ-Align® trays are custom fitted clear trays with progressive tooth alignment built into each tray. Your will start with tray “A” then move to tray “B” and so on, until treatment has been completed. Each tray should be worn for approximately 2-3 weeks prior to moving to the next tray. Each aligner tray comes individually packaged and labeled for easy identification.
Fast Removable Easy to clean Proven Results Comfortable Affordable FDA Clearance Custom Fit
Smooth Edges
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800.489.4020 > 314.426.4020
Medical Grade Material
lab appliances Patient Marketing Kit Increase office revenue by marketing directly to patients in your practice with the FREE EZ-Align patient marketing kit. The brochure will inform your patient how the clear tray aligner system is the easy and affordable way to align minor crowding.
EZ-Align® Marketing Kit Ask about our FREE patient marketing kit
EZ-2000® Appliances
EZ-2OOO®
Excellent for pre-aligner treatment
• Completely invisible
• Easily opens space
• Reduces or eliminates interproximal reduction
• Qualify more candidates for aligner therapy
• Nickel Titanium spring loaded screw for patient comfort
Call a laboratory technical representative today for more information on the EZ-2000® expanders.
Scalloped edges for patient comfort.
Fax: 314.429.7575 > www.dynaflex.com
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1 Penguin
2 Tennis Racket
3 Racing Stripes
4 Black/White Dots
5 Floral Design
6 Bear Claw
10 Tic-Tac-Toe
11 Snoopy
12 New York New York
13 Kite
14 Piano Keys
15 Ying–Yang
16 Pin Wheel
17 Camouflage
18 Lightning Strikes
19 Black/Sunflower
20 Apple Seed
21 Tiger Claw
22 Pair of Dice
23 Zebra Stripes
24 Watermelon
25 Frog
26 Black/Daisy
27 Racing Car
28 Life Saver
30 Pink Pig
31 A B C
32 No To Drugs
33 Golf Green
34 Flower
35 American Flag
36 Black Eye Susans
76 Alien
29 Baseball
67 Soccer Ball
68 Football
69 Basketball
70 Volleyball
71 Cow Print
73 Paw Prints
74 Mouse Trap
75 Eight Ball
77 Comedy Tragedy
78 Orange Slice
79 Smiley
80 Cherries
88 Lips
89 Lady Bug
85 Stars
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86 Heart With Arrow 87 Cause Ribbon (change color for your cause)
94 Cross
95 Balloons
96 Butterfly
97 Sunset
103 Fish
105 Pacman 95 Yellow/Green
106 Lizard
107 Sun
72 Tiger Print
81 Stl
90 Paradise Island
98 Tropical Dots 99 Stained Glass
108 Class of
7 White/Red Stripe 8 White/Black Dots
109 Small Hearts (change to your school colors)
82 Peace Sign
83 Cash Money
91 Spider Web
92 Shamrock
100 Blue Marble
110 Cup Cake
101 Green Marble
111 Superman
800.489.4020 > 314.426.4020
9 Strawberry
84 Angel
93 Clouds
102 Hello Kitty
artistic retainers lab appliances Assorted Colors
49 3 Color Combo
65 Green
119 Tropical Green
50 Rainbow
51 2 Color Combo
55 Red
66 Orange
112 Tropical Red
113 Tropical Orange
120 Dark Pink
121 Black
56 Pink
122 Teal
114 Tropical Pink
123 Maroon
57 Clear
58 Purple
59 Yellow
115 Tropical Purple 116 Tropical Yellow 117 Tropical Blue
60 Blue
118 Tropical Teal
124 White
Glow In The Dark
61 Orange 62 Pink Glow-In-The Dark Glow-In-The Dark
63 Red Glow-In-The Dark
130 Blue Yellow 131 Pink Orange Swirl Swirl
37 Pink/Purple Sparkles
38 Yellow/Green Sparkles
46 Green Glitter
47 Clear/Gold Sparkles
64 Clear Glow-In-The Dark
125 Purple Glow-In-The Dark
126 Teal Glow-In-The Dark
127 Blue Glow-In-The Dark
128 Green Glow-In-The Dark
129 Yellow Glow-In-The Dark
44 Blue Glitter
45 Clear/Pink Glitter
Glitter & Sparkles
39 Blue Sparkles
48 Red/Green Sparkles/Hearts
40 Orange/Purple Sparkles
52 Rainbow Glitter
41 Green Sparkles
42 Purple Sparkles
43 Red Glitter
53 Multi Glitter
54 Gold Glitter
132 Stardust
133 Purple Glitter
134 Silver Glitter
135 Orange Glitter 136 Blue Silver Swirl 137 Glitter Vortex 138 Star Sparkles
CUSTOMIZE ANY DESIGN BY CHANGING THE COLOR OR ADDING GLOW-IN-THE-DARK AND GLITTER
Fax: 314.429.7575 > www.dynaflex.com
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®
ORTHO PRESCRIPTION
57251
57251
57251
10403 International Plaza Drive ® P.O. Box 99 • St. Ann, Missouri 63074 (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 info@dynaflex.com • www.dynaflex.com 10403 International Plaza Drive IF NEW ACCOUNT: P.O. Box 99 • St. Ann, Missouri 63074 (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 DOCTOR info@dynaflex.com • www.dynaflex.com ADDRESS IF NEW ACCOUNT:
BUSINESS REPLY LABEL
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO
CITY STATE ZIP ® DOCTOR EMAIL ADDRESS ACCT. # OFC # 10403 International Plaza Drive ZIP CITY STATE P.O. Box 99 • St. Ann, Missouri 63074 (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 EMAIL info@dynaflex.com • www.dynaflex.com RX FORMS ARE AVAILABLE AT www.dynaflex.com ACCT. # OFC # PATIENT’S NAME AGE IF NEW ACCOUNT:
POSTAGE WILL BE PAID BY ADDRESSEE
BUSINESS REPLY LABEL FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO
P.O.POSTAGE Box 99WILL BE PAID BY ADDRESSEE St. Ann, Missouri 63074-9910
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
PLEASE PROVIDE DATE WANTED TO AVOID DELAYS P.O. Box 99 DATE WANTED FIRST CASE St. Ann, Missouri 63074-9910
DATE SENT
BUSINESS REPLY LABEL PERMIT NO.PROVIDE 8722, ST. LOUIS, MO WANTED RX FORMS ARE AVAILABLE AT www.dynaflex.com FIRST CLASS PLEASE DATE ADDRESS OPEN BITE CLOSE BITE NEUTRAL BIONATOR DOCTOR
SEND BOXES
TO AVOID DELAYS OPEN BITE SENT CLOSEBY BITEADDRESSEE NEUTRAL POSTAGE WILL BE PAID DATE DATE WANTED 321 123 FIRST CASE LOWER RESET MORE RXS UPPERUPPER LOWER 321 321 123 123 SEND SEND BOXES LOWER UPPERUPPER LOWER RESET 321 123 PENDEX BANDED DISTAL JET™ PENDULUM OPEN BITE CLOSE BITE NEUTRAL P.O. Box 99 RPE UPPER LOWER 321 123 St. Ann, Missouri 63074-9910 BONDED WILLIAMS WILSON™ UPPERRPE LOWER RESET TYPE BANDED RPE DISTAL JET™ PENDULUM PENDEX 321 123 NANCE TRANS PALATAL LHA TYPE UPPER LOWER PROVIDE DATEWILSON™ WANTED TO DELAYS BONDEDPLEASE RPE WILLIAMS TYPEAVOID _________ E ARCH RETAINER (3x3) FLEA BANDED RPE BONDED DISTAL JET™ FIXED AGE DATE WANTED FIRST CASE HAAS SENT TRANS DATE PALATAL LHA PENDULUM E ARCH PENDEX TONGUE THUMB BLUE GRASS TYPESEND MORE RXS HABIT APPLIANCE STEALTH BONDED RPE FLEA WILLIAMS NANCE WILSON™ BONDED RETAINER (3X3) SEND BOXES UPPER LOWER HAWLEY NANCE TRANS PALATAL ESSIX™ LHA RETAINER TYPE SUPER SCREW FAN GEAR QUAD HELIX OTHER ________ OPEN BITE CLOSE BITE NEUTRAL BIONATOR
BIONATOR AGE EZ-ALIGN® ESSIX™ RETAINER EMAIL EZ-2000® EZ-ALIGN® UPPER COLOR ACCT.REMOVE # OFC # FIXED BIONATOR RETURN EZ-2000 UPPER COLOR _________________ BRACKETS MODELS FIXED EZ-ALIGN® LOWER COLOR _________________ EZ-2000® RX FORMS ARE AVAILABLE AT www.dynaflex.com UPPER COLOR REMOVENAME PATIENT’S BRACKETS CITY REMOVE BRACKETS
ALLEGRA MARKETING, PRINT, ALLEGRA MAIL 314-429-4848 MARKETING, PRINT, MAIL 314-429-4848 ALLEGRA MARKETING, PRINT, MAIL 314-429-4848
SEND MORE RXS
RETURN MODELS STATE ZIP RETURN MODELS
PATIENT’S NAME
REMOVE BRACKETS
RETURN MODELS
UPPER COLOR
R R R LOWER COLOR COMMENTS
LOWER COLOR
DIGITAL MODEL STORAGE DENTAQUEST PROCESSING
COMMENTS
PHONE NUMBER
SIGNATURE
LOWER COLOR COMMENTS
CLASP E ARCH
BALL ADAMS BONDED RETAINER (3x3)
FLEA 321 CIRCUMFERENTIAL 123
UPPER LOWER RESET EZ-ALIGN® TYPE ________________________________ FRANKEL ARROW FINGER 321 123 TONGUE THUMB BLUE GRASS HABIT APPLIANCE UPPER LOWER EZ-2000® 3 X 3 LABIAL WIRE QCM CIRCUMFERENTIAL HABIT APPLIANCE UPPER LOWER ESSIX™ RETAINER TONGUE THUMB BLUE GRASS HAWLEY BANDED RPE DISTAL JET™ PENDULUM PENDEX FIXED FINGER SPRINGS MUSHROOM UPPERBONDED HAWLEY CLASPRPE LOWER BALL CIRCUMFERENTIAL ADAMS WILLIAMS WILSON™ TYPE 21 12
UPPER LOWER RESET HAWLEY SPRING RETAINER CLASP BALL CIRCUMFERENTIAL ARROW FINGER NANCE TRANS PALATAL ADAMS LHA TYPE 21 12 TYPE HERBST® ARROW FINGER 3 X 3 RETAINER (3x3) LABIAL WIRE BONDED QCM CIRCUMFERENTIAL E ARCH FLEA LOWER CUSTOM BASE PROVIDEQCM BRACKETS INDIRECT BONDINGLABIALUPPER WIRE 3X3 WRAP AROUND FINGER SPRINGS MUSHROOM TONGUE THUMB BLUE GRASS HABIT APPLIANCE BUCCAL SHIELD EXPANSION MARA SPRINGS FINGER___ MUSHROOM UPPER LOWER ESSIX™ RETAINER RESET 21 12 UPPER LOWER HAWLEY HAWLEY SPRING RETAINER 21 12 21 12 LOWER UPPER SAGITTAL CLASP BALL ADAMS HAWLEY SPRING RETAINER TYPE UPPER LOWER RESET CIRCUMFERENTIAL HERBST® 21 12 LOWER UPPER SCHWARZ ARROW FINGER LOWER CUSTOM BASE PROVIDE BRACKETS UPPER INDIRECT BONDING HERBST® TYPE ________________________________ DMJ® DMAX® SAL® MAX® SERIES 2000® 3 XBUCCAL 3 LABIAL WIRE QCM CIRCUMFERENTIAL SHIELD EXPANSION MARA INDIRECT BONDING UPPERSPRINGS LOWER CUSTOM BASE PROVIDE SAG® MJX® SAN® BRACKETS MSX® FINGER MUSHROOM LOWER UPPER SAGITTAL 21 12 MARA® EXPANSION BUCCAL SHIELD MARA® U TYPE ______ MSC® TB-SAG® CS-2000® EAS® UPPER RESET LOWER HAWLEY SPRING RETAINER LOWER UPPER SCHWARZ TYPE COLOR __________________________ SLEEP APPLIANCE HELMET STRAP 21 12 PROFORM MOUTH GUARD TYPE HERBST® DMJ® DMAX® SAL® MAX® SERIES 2000® TYPE SPLINT LOWER DRIVE CUSTOM BASE BRACKETS INDIRECT BONDINGUPPERUPPER LOWER ANTERIOR DISTAL DRIVE PROVIDE 3-SCREW SAGITTAL SAG® MJX® SAN® MSX® UPPER LOWER BUCCAL SHIELD EXPANSION TANDEM MARA UPPER EAS® LOWER 3-WAY SCREW MSC® NORD FAN GEAR SCHWARZ TB-SAG® CS-2000® LOWER UPPER TYPE SAGITTAL TOOTH POSITIONER TYPE DMAX® MAX® DMAX® -RPE DMJ® SAL® SLEEP APPLIANCE SERIES 2000® LOWER UPPER SCHWARZ TO CLOSE TO OPEN TYPE TWIN BLOCK™ MSX® MJX® SAG® SAN® TYPE SPLINT DMJ® DMAX® SAL® MAX® SERIES MODELS 2000® (SOAPED FOR PRESENTATION) STUDY DUPLICATE MODELS EAS® MSX® CS-2000® SAN® UPPERTB-SAG® MJX® MSC® LOWER TANDEM DIGITAL MODEL STORAGE SAG® TYPE ________________________________ TYPE SLEEP APPLIANCE TOOTH POSITIONER MSC® TB-SAG® CS-2000® EAS® TO CLOSE TO OPEN TYPE TYPE TYPE ________________________________ TWIN BLOCK™ SLEEP APPLIANCE SPLINT TYPE SPLINT UPPER ________________ _________________ STUDY MODELS (SOAPED FOR PRESENTATION) LOWERDUPLICATE MODELS TANDEM UPPER TANDEM DIGITAL MODEL STORAGE LOWER TOOTH POSITIONER TYPE ________________________________ TYPE TOOTH POSITIONER TWINTWIN BLOCK™ TO OPEN TOTO CLOSE TYPE _______________ CLOSE TO OPEN TYPE BLOCK™ PRINT NAME ABOSTUDY FULL BASED STUDY (SOAPED MODELS FOR PRESENTATION) DUPLICATEDUPLICATE MODELS MODELS MODELS SLIM BASED STUDY MODELSDIGITAL MODEL STORAGE WORKING MODELS
MARGINALS HERE
PHONE NUMBER
SIGNATURE
PRINT NAME
PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
PHONE NUMBER
35
SIGNATURE
MARGINALS HERE
PRINT NAME
PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
800.489.4020 > 314.426.4020
MARGINALS HERE
®
®
NO POSTAGE NO POSTAGE NECESSARY IFNECESSARY MAILED IFTHE MAILED IN THE UNITEDIN STATES UNITED STATES
RetaineR PRescRiPtion
57251 57251
10403 International Plaza Drive 10403 Plaza 63074 Drive P.O. Box 99 •International St. Ann, Missouri P.O. •Box 99 426-4020 • St. Ann,•Missouri 63074 (800) 489-4020 (314) FAX (314) 429-7575 (800) info@dynaflex.com 489-4020 • (314) 426-4020 • FAX (314) 429-7575 • www.dynaflex.com info@dynaflex.com • www.dynaflex.com IF NEW ACCOUNT: IF NEW ACCOUNT: DOCTOR DOCTOR FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO ADDRESS FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO POSTAGE WILL BE PAID BY ADDRESSEE ADDRESS POSTAGE WILL BE PAID BY ADDRESSEE CITY STATE ZIP CITY STATE ZIP ® NO POSTAGE EMAIL NECESSARY EMAIL ACCT. # OFC # P.O. Box 99 IF MAILED International Plaza Drive ACCT. # 10403OFC # 99 St.P.O. Ann,Box Missouri 63074-9910 IN THE P.O. Box 99 • St. Ann, Missouri 63074 UNITED STATES St. Ann, Missouri 63074-9910 (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 info@dynaflex.com • www.dynaflex.com RX FORMS ARE AVAILABLE AT www.dynaflex.com PLEASE PROVIDE DATE WANTED TO AVOID DELAYS RX FORMS ARE AVAILABLE AT PLEASE PROVIDE DATE INWANTED TO AVOID DELAYS PATIENT’S NAME AGE DATE SENT DATE WANTED LAB 3-5 DAYS FIRST CASE IF NEW ACCOUNT: PATIENT’S NAME AGE DATE SENT DATE WANTED FIRST CASE SEND MORE RXS DOCTOR SEND BOXES SEND MORE RXS
BUSINESS BUSINESSREPLY REPLYLABEL LABEL
ALLEGRA MARKETING, PRINT, ALLEGRA MAIL 314-429-4848 MARKETING, PRINT, MAIL 314-429-4848 ALLEGRA MARKETING, PRINT, MAIL 314-429-4848
57251
www.dynaflex.com BUSINESS REPLY LABEL
ADDRESS REMOVE
reMoVe BrACKetS
BRACKETS REMOVE CITY
RETURN MODELS RETURN STATE ZIP MODELS
BRACKETS UPPERCoLor COLOR Upper _________________ ACCT. # OFC # UPPER COLOR EMAIL
BIONATOR retAinerS BIONATOR
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO OPEN BITE CLOSE BITE NEUTRAL POSTAGE WILL BE PAID BY ADDRESSEE OPEN BITE CLOSE BITE NEUTRAL321 UPPER LOWER RESET
SEND BOXES
ACCeSSorieS
EZ-ALIGN® Upper Lower UPPER LOWER EZ-ALIGN® UPPER LOWER EZ-2000® essix™ retainer UPPER LOWER EZ-2000® BANDED RPE DISTAL JET™ FIXED P.O. Box 99 Hawley St. Ann, Missouri BANDED RPE63074-9910 DISTAL JET™ FIXED BONDED RPE WILLIAMS
123 321 123 321 123 Finger Springs RESET Holding Spurs321 123
PENDULUM
PENDEX
Soldered Springs Flat Bow Hawley Habit Crib TYPE BONDED RPE TRANS WILLIAMS WILSON™ NANCE PALATAL LHA TYPE RX FORMS ARE AVAILABLE AT www.dynaflex.com Standard wrap PLEASE PROVIDE DATE WANTED TO AVOID DELAYS Around Design Support Wires NANCE TRANS PALATAL (3x3) LHA TYPE ARCH BONDED RETAINER FLEA PATIENT’S NAME AGE DATEESENT DATE WANTED FIRST CASE Soldered to “C” ClaspTHUMB Pontics Shade SEND E ARCH BONDED RETAINER (3x3) FLEAMORE RXS TONGUE BLUE GRASS HABIT APPLIANCE Soldered to Adams Clasp SEND BOXES LOWER ESSIX™ TONGUE THUMB BLUE RETAINER GRASS HAWLEY HABIT APPLIANCE UPPER Solid WireBITE OPEN CLOSE BITE CLASpS NEUTRAL BIONATOR REMOVE RETURN CLASP BALL CIRCUMFERENTIAL ADAMS UPPER LOWER ESSIX™ 321 RETAINER HAWLEY 123 BRACKETS MODELS Soldered “C” Clasps UPPER LOWER RESET Flat Bow wrap Around Design EZ-ALIGN® ARROW FINGER CLASP BALL CIRCUMFERENTIAL ADAMS 321 123 UPPER to “C” Clasp LOWER EZ-2000® “C” Clasps Soldered 3 X 3 LABIAL WIRE QCM CIRCUMFERENTIAL ARROW FINGER UPPER COLOR BANDED DISTAL JET™ PENDULUM FIXED Soldered toRPE Adams Clasp Adams Clasps PENDEX SPRINGS MUSHROOM 3X3 LABIAL WIRE FINGER QCM CIRCUMFERENTIAL BONDED WILSON™ TYPE Solid Wire RPE WILLIAMS BallMUSHROOM Clasps UPPER LOWER RESET 21 12 HAWLEY SPRING RETAINER FINGER SPRINGS NANCE PALATAL LHA TYPE 21 12 wrapRETAINER Around DesignTRANS Arrow Clasps TYPE HERBST® UPPER LOWER RESET 21 12 HAWLEYQCM SPRING E ARCH BONDED RETAINER (3x3) FLEA 21 12 Soldered to “C” Clasp LOWER CUSTOM BASE PROVIDE BRACKETS UPPER Delta Clasps INDIRECT BONDING TYPE HERBST® TONGUE THUMB BLUE GRASS HABIT APPLIANCE Soldered to Adams Clasp BUCCAL SHIELD EXPANSION MARA Other LOWER CUSTOMRETAINER BASE PROVIDE BRACKETS UPPER INDIRECT BONDING UPPER LOWER ESSIX™ HAWLEY
RR
UPPER SAGITTAL EXPANSION BonDeD MARA LingUAL retAinerS CLASP UPPER SCHWARZ UPPER *indicate teeth to be bonded SAGITTAL MAX® SERIES 2000® LABIAL WIRE UPPER SCHWARZ
Upper Lower MSX® MAX® SERIES 2000® Composite padsSPRINGS EAS®
R LOWER COLOR COMMENTS
LOWER COLOR Lower CoLor ________________
COMMENTS
StUDy MoDeLS (SoApeD For preSentAtion) DUpLiCAte MoDeLS PHONE NUMBER SIGNATURE retUrn LOWERMoDeLS COLOR PHONE NUMBER
SIGNATURE
COMMENTS
LOWER BUCCAL SHIELD BALL LOWER LOWER ARROW DMAX® 3 XLOWER 3 MJX® FINGER DMAX® TB-SAG® UPPER MJX®
PENDULUM WILSON™ TYPE PENDEX
ADAMS ACryLiC optionS CIRCUMFERENTIAL FINGER
Horseshoe Palate Scallop Anteriors Add Acrylic to Bow 21 12 Anterior MSC® Bite PlaneCS-2000® CUSTOM BASE PROVIDE BRACKETS Flat Inclined LOWER Posterior Bite Plane DMJ® SAL® QCM CIRCUMFERENTIAL SAG® SAN® MUSHROOM DMJ® SAL® 21 12 MSC® CS-2000® RESET LOWER SAG® SAN®
HAWLEY SPRING RETAINER MSX® 3 2 1 1 2 3 TYPE r L SLEEP APPLIANCE HERBST® TB-SAG® EAS® 3 2 1 TYPE 1 2 3 TYPE SPLINT LOWER INDIRECT BONDING TYPE pads UPPER SLEEPMesh APPLIANCE UPPER BUCCAL SHIELD TANDEM MARA 3 2 1 EXPANSION 1 2 3 TYPE SPLINT r L LOWER UPPER TYPE SAGITTAL TOOTH POSITIONER 1 1 2 3 UPPER LOWER TANDEM3 2 LOWER UPPER SCHWARZ TO CLOSE TO OPEN TYPE TWIN BLOCK™ TYPE TOOTH POSITIONER MAX® DMJ® DMAX® SAL® SERIES MODELS 2000® (SOAPED FOR PRESENTATION) Spring retAinerS Upper Lower STUDY DUPLICATE MODELS TO CLOSE TO OPEN TYPE TWIN BLOCK™ SAG® MJX® SAN® MSX® DIGITAL MODEL STORAGE Hawley Spring retainer STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATECS-2000® MODELS MSC® TB-SAG® EAS® Do not reset teeth DIGITAL MODEL STORAGE SLEEP APPLIANCE 3x3 4x4 Spring retainerTYPE SPLINT Spring retainerTYPE with 3x3 4x4 UPPER TANDEM wire extensions TYPE TOOTH POSITIONER (Allow 5-7 Days TO in Lab) TO 3 CLOSE2 OPEN TWIN BLOCK™ PRINT NAME r STUDY MODELS (SOAPED FOR PRESENTATION) Upper Lower 3 2 DIGITAL MODEL PRINTSTORAGE NAME
eZ-ALign®
reset teeth ideally reset teeth circled on diagram below
LOWER
1 TYPE 1 2 3 DUPLICATE MODELS L 1 1 2 3
MARGINALS HERE
MARGINALS HERE COPY (RETAIN FOR YOUR FILES) PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
PHONE NUMBER
SIGNATURE
PRINT NAME
MARGINALS HERE
314-429-4848
ALLEGRA MARKETING, PRINT, MAIL ALLEGRA MARKETING, PRINT, MAIL 314-429-4848
®
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
10403 International Plaza Drive EZ-Align® PrEscriPtion P.O. Box 99 • St. Ann, Missouri 63074
57251
(800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 info@dynaflex.com • www.dynaflex.com IF NEW ACCOUNT:
BUSINESS REPLY LABEL
®
DOCTOR
57251
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO
ADDRESS
POSTAGE WILL BE PAID BY ADDRESSEE
10403 International Plaza Drive CITY STATE ZIP P.O. Box 99 • St. Ann, Missouri 63074 (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 EMAIL info@dynaflex.com • www.dynaflex.com ACCT. # OFC # IF NEW ACCOUNT: DOCTOR
RX FORMS ARE AVAILABLE AT ADDRESS PATIENT’S NAME CITY
P.O. Box 99 St. Ann, Missouri 63074-9910
www.dynaflex.com
AGE
STATE
ZIP
BUSINESS REPLY LABEL
PLEASE PROVIDE DATEMO WANTED TO FIRST CLASS PERMIT NO. 8722, ST. LOUIS, DATE SENT DATE WANTED IN LAB 5-7 DAYS POSTAGE WILL BE PAID BY ADDRESSEE
AVOID DELAYS FIRST CASE SEND MORE RXS SEND BOXES
OPEN BITE CLOSE BITE NEUTRAL BIONATOR P.O. Box 99 321 123 UPPER LOWER RESET EZ-ALIGN® St. Ann, Missouri 63074-9910 321 123 EZ-ALIGN® SYSTEM UPPER DIGITAL FILE TRANSFER LOWER EZ-2000® EZ-aLigN® is designed to facilitate minor tooth alignment of the upper & lower anterior teeth, using up to 5 trays. UPPER COLOR BANDED RPE PROVIDE DISTAL JET™ PENDULUMTO AVOID PENDEX DELAYS RX FORMSSTONE ARE MODELS AVAILABLE AT www.dynaflex.com PLEASE DATE WANTED FIXED OR IMPRESSIONS
REMOVE OFC # ACCT. # BRACKETS
RETURN MODELS
DATE SENT RPE UPPER DATE WANTED Number of Trays BONDED WILLIAMS
PATIENT’S NAME
AGE
RETURN MODELS
NANCE
DUPLICATE MODELSRETURN REMOVE BRACKETS
MODELS
UPPER COLOR
Lab DiscretionE ARCH
R SEND DYNAFLEX® EZ-ALIGN® PATIENT MARKETING KIT Free of Charge
LOWER COLOR
SIGNATURE
SEND BOXES
FLEA
NEUTRAL BLUE GRASS 321 123 RESET 321 123 ESSIX™ RETAINER
TB-SAG®
1 2 3 L ESSIX™ 1 RETAINER 2 PROVIDE 3 BRACKETS CUSTOM BASE ADAMS
CIRCUMFERENTIAL
FINGER QCM
CIRCUMFERENTIAL MUSHROOM DMJ® LOWER SAG®
SAL® RESET SAN®
MSC® CUSTOM BASE
CS-2000® PROVIDE BRACKETS
21 12 21 12
LOWER
DMJ® TYPE SAG®
SAL®
SAN® DUPLICATE MODELS
MSC®
COMMENTS
MARGINALS HERE PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES) PHONE NUMBER
FIRST CASE
SEND MORE RXS
TYPE
CS-2000® DIGITAL MODEL STORAGE TYPE SLEEP APPLIANCE TYPE SPLINT EXTRA FINAL RETAINERS UPPER LOWER TANDEM TYPE TOOTH POSITIONER LOWER Essix RetainerTO OPEN UPPER TO CLOSE TYPE TWIN BLOCK™ STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE MODELS PRINT NAME DIGITAL MODEL STORAGE EAS®
COMMENTS
PHONE NUMBER
BONDED RPE LABIAL WIRE NANCE SPRINGS E ARCH
MJX® MSX® NO IPR for(SOAPED Reset STUDY MODELS FOR PRESENTATION)
LOWER COLOR
LHA
CIRCUMFERENTIAL ADAMS PENDULUM PENDEX ARROW FINGER WILLIAMS WILSON™ TYPE 3X3 QCM CIRCUMFERENTIAL TRANS PALATALDiagram LHA 2 TYPE FINGER MUSHROOM BONDED RETAINER (3x3) FLEA UPPER RESET 21 12 LOWER THUMB BLUE GRASS 21 12
Reset TeethRETAINER to Ideal HAWLEY SPRING 3 2 1 TONGUE HABIT APPLIANCE TYPE R HERBST® UPPER LOWER2 HAWLEY Reset Teeth Circled 3LOWER 1 UPPER INDIRECT BONDING Diagram 2 CLASP BALL BUCCAL SHIELD EXPANSION MARA ARROW LOWER UPPER SAGITTAL 3X3 LABIAL WIRE LOWER UPPER SCHWARZ FINGER SPRINGS DMAX® MAX® SERIES 2000® IPR INSTRUCTIONS UPPER HAWLEY SPRING RETAINER MJX® MSX® TYPE HERBST® TB-SAG® EAS® Diagram 1 Enamel Reduction LOWER UPPER INDIRECT BONDING TYPE SLEEP APPLIANCE BUCCAL SHIELD EXPANSION MARA as Needed in Laboratory SPLINT Reduce Teeth TYPE LOWER UPPER SAGITTAL Yellow IPR card from Laboratory Noting Changes Included UPPER TANDEM LOWER UPPER SCHWARZ TYPE Prior to Impressions TOOTH POSITIONER IPR Done Clinically DMAX® MAX® SERIES 2000® TO CLOSE TO OPEN TWIN BLOCK™
Diagram 1
LOWER TYPE
WILSON™
UPPER LOWER BONDED RETAINER (3x3)
OPEN BITE CLOSE BITE BIONATOR THUMB HABIT APPLIANCE (Concerning Number ofLOWER Trays) Contact OfficeTONGUE UPPER EZ-ALIGN® UPPER LOWER HAWLEY UPPER LOWER EZ-2000® CLASP BALL BANDED RPE DISTAL JET™ FIXED
RESETS
R
TRANS PALATAL
SIGNATURE
PRINT NAME
MARGINALS HERE
®
®
NO POSTAGE NECESSARY NO POSTAGE IF MAILED NECESSARY IN THE IF MAILED UNITED STATES IN THE
10403 International Plaza Drive SerieS 2000® PreScriPtion P.O. Box 99 • St. Ann, Missouri 63074
10403 International Plaza Drive
57251
57251
57251
(800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 P.O. Box 99 • St. Ann, Missouri 63074 info@dynaflex.com • www.dynaflex.com ®
UNITED STATES
(800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 IF NEW ACCOUNT: info@dynaflex.com • www.dynaflex.com
BUSINESS REPLY LABEL
IF NEW ACCOUNT: 10403 International Plaza Drive DOCTOR P.O. Box 99 • St. Ann, Missouri 63074 ADDRESS (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 DOCTOR info@dynaflex.com • www.dynaflex.com CITY STATE ZIP ADDRESS IF NEW ACCOUNT: EMAIL CITY STATE ZIP DOCTOR ACCT. # OFC #
BUSINESS REPLY LABEL
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO POSTAGE WILL BE PAID BY ADDRESSEE
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO POSTAGE WILL BE PAID BY ADDRESSEE
BUSINESS P.O. Box 99 REPLY LABEL
EMAIL ADDRESS
ACCT. # OFC # STATE CITY RX FORMS ARE AVAILABLE AT
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO
St. Ann, Missouri 63074-9910
POSTAGE WILL BE PAID BY ADDRESSEE
P.O. Box 99
ZIP
www.dynaflex.com
EMAIL PATIENT’S NAME ACCT. # RX FORMS OFC ARE# AVAILABLE
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
St. Ann,PROVIDE MissouriDATE 63074-9910 PLEASE WANTED TO AVOID DELAYS
AGE
DATE SENT
DATE WANTED IN LAB 3-5 DAYS
FIRST CASE
SEND MORE RXS P.O. Box 99 AT www.dynaflex.com PLEASE PROVIDE DATE WANTED TO AVOID DE SEND BOXES St. Ann, Missouri 63074-9910 PATIENT’S NAME AGE DATE SENT DATE WANTED FIRST CAS OPEN BITE CLOSE BITE NEUTRAL BIONATOR REMOVE RETURN 321AVOID 123 DELAYS SEND MORE RX FORMS ARE AVAILABLEMODELS AT www.dynaflex.com PLEASE PROVIDE TO BRACKETS UPPER LOWER DATE WANTED RESET SEND BOX EZ-ALIGN® 321 123 PATIENT’S NAME AGE DATE SENT DATE WANTED FIRST CASE UPPER LOWER EZ-2000® OPEN BITE CLOSE BITE NEUTRAL BIONATOR REMOVE RETURN SEND MORE RXS UPPER COLOR 321 123 DISTAL JET™ PENDULUM PENDEX FIXED EZ-ALIGN® BANDED RPE SEND BOXES BRACKETS MODELS UPPER LOWER RESET
RETURN MODELS
321 123
BONDED RPE WILLIAMS WILSON™ TYPE BIONATOR EZ-2000® OPEN BITE UPPERCLOSE BITE LOWERNEUTRAL 321 123 NANCE TRANS PALATAL LHA TYPE UPPER LOWER EZ-ALIGN® BANDED RPE DISTALRESET JET™ PENDEX FIXED 321PENDULUM 123 E ARCH BONDED RETAINER (3x3) FLEA UPPER LOWER EZ-2000® BONDED RPE WILLIAMS WILSON™ TYPE TONGUE THUMB BLUE GRASS HABIT BANDED RPE DISTAL JET™ PENDULUM PENDEX FIXEDAPPLIANCE NANCELOWER TRANSESSIX™ PALATAL LHA TYPE UPPER RETAINER HAWLEY DMJ-2000® MJX-2000® BONDED RPE WILLIAMS WILSON™ TYPE
UPPER
UPPER COLOR
LOwER
BONDED RETAINER (3x3) FLEA CIRCUMFERENTIAL ADAMS TRANS PALATAL LHA TYPE TONGUE THUMBFINGER BLUE GRASS HABIT APPLIANCE ARROW E ARCH BONDED RETAINER (3x3) FLEA UPPER LOWER 3 X 3 LABIAL WIRE QCM CIRCUMFERENTIAL HAWLEY TONGUE THUMB BLUE GRASS ESSIX™ RETAINER CLASP NANCE
MAX-2000®
ALLEGRA MARKETING, PRINT, MAIL
314-429-4848
UPPER COLOR
REMOVE UPPER COLOR BRACKETS
Series 2000® Appliances MSX-2000®
HABIT APPLIANCE DMAX-2000® SAL-2000® ADAMS SPRINGS CLASPFINGER BALL MUSHROOM CIRCUMFER UPPER LOWER ESSIX™ RETAINER HAWLEY 21 12 UPPER RESET LOWER HAWLEY SPRING RETAINER ARROW FINGER CLASP BALL CIRCUMFERENTIAL ADAMS SAG-2000® MSC-2000® 21 12 TYPE HERBST® 3 X 3 FINGER LABIALARROW WIRE CIRCUMFERENTIAL LOWER CUSTOM BASE PROVIDE BRACKETS UPPER INDIRECT BONDING TB SAG-2000® 3X3 LABIAL WIRE FINGERCIRCUMFERENTIAL SPRINGS MUSHROOM QCM BUCCAL SHIELD EXPANSION MARA FINGER SPRINGS UPPERMUSHROOM LOWER RESET 21 HAWLEY SPRING RETAINER SAN-2000® LOWER UPPER 21 12 SAGITTAL 21 LOWER RESET HAWLEY SPRING RETAINER TYPE UPPER HERBST® 21 12 LOWER UPPER SCHWARZ TYPE HERBST® LOWER CUSTOM BASE PROVIDE BRA UPPER INDIRECT BONDING DMJ® DMAX® SAL® BRACKETS MAX® SERIES LOWER CUSTOM BASE PROVIDE UPPER INDIRECT 2000® BONDING
R RR
MARA
BUCCAL SHIELD
EXPANSION
SAG® MJX® SAN® MSX® BUCCAL SHIELD EXPANSION MARA EAS-2000® Lower ________ Upper ________ LOWERMSC® UPPER SAGITTAL TB-SAG® CS-2000® EAS® LOWER UPPER SAGITTAL LOWER UPPER SCHWARZ TYPE SLEEP APPLIANCE LOWER SCHWARZ CS-2000®UPPER Lower ________ Upper ________ DMJ® DMAX®DMJ® MAX® DMAX® TYPE SPLINT SAL® MAX® SERIESSERIES 2000® 2000® LOWER TANDEM SAG® MJX® MSX® EZ-2000®UPPER Lower ________ Upper ________ SAG® MJX® SAN® MSX® TYPE TOOTH POSITIONER MSC® TB-SAG® EAS® TB-SAG® MSC® CS-2000® EAS® TO OPEN TYPE TO CLOSE TYPE TWIN TYPE SLEEP BLOCK™ APPLIANCE SLEEP APPLIANCE STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE MODELS DUPLICATION CASTS TYPE OF SPLINTSPLINT TYPE DIGITAL MODEL STORAGE UPPER LOWER TANDEM UPPER LOWER
LOWER COLOR
TANDEM DIGITAL MODEL STORAGE
COMMENTS
LOWER COLOR
DIGITAL MODEL STORAGE
SIGNATURE
PRINT NAME
MARGINALS HERE PHONE NUMBER
SIGNATURE
PRINT NAME
PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
PHONE NUMBER
SAL® SAN® CS-2000®
TYPE TOOTH POSITIONER TYPE TOOTH POSITIONER TO CLOSE TO OPEN TYPE TWIN BLOCK™ MODELS TO OPEN TO CLOSE TYPE TWINRETURN BLOCK™ STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE MODELS STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE MODELS DIGITAL MODEL STORAGE
LOWER COLOR COMMENTS COMMENTS PHONE NUMBER
E ARCH BALL
SIGNATURE
PRINT NAME
MARGINALS HERE
MARGINALS HERE
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
Herbst® PrescriPtion
57251
10403 International Plaza Drive P.O. Box 99 • St. Ann, Missouri 63074 (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 info@dynaflex.com • www.dynaflex.com
IF NEW ACCOUNT: BUSINESS REPLY LABEL
®
DOCTOR
57251
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO DOCTOR
ADDRESS
10403 International Plaza Drive CITY STATE ZIP P.O. Box 99 • St. Ann, Missouri 63074 (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 EMAIL info@dynaflex.com • www.dynaflex.com ACCT. # OFC # IF NEW ACCOUNT:
ADDRESS ADDRESSEE CITY EMAIL ACCT. #
NO POSTAGE NECESSARY IF MAILED IN THE ZIP STATE UNITED STATES
RX FORMS ARE AVAILABLE AT
DOCTOR
RX FORMS ARE AVAILABLE AT ADDRESS PATIENT’S NAME CITY
www.dynaflex.com
AGE
STATE
ZIP
B
F
OFC #
P.O. Box 99 St. Ann, Missouri 63074-9910
BUSINESS REPLY LABEL
PATIENT’S NAME
www.dynaflex.com
AGE
PLEASE PROVIDE DATEMO WANTED TO AVOID DELAYS FIRST CLASS PERMIT NO. 8722, ST. LOUIS, DATE SENT DATE WANTED FIRST CASE IN LAB 3-5 DAYS POSTAGE WILL BE PAID BY ADDRESSEE BIONATOR REMOVE RETURN BRACKETS
MODELS SEND MORE RXS
EZ-ALIGN® EZ-2000® FIXED
SEND BOXES
UPPER COLOR
314-429-4848
57251
POSTAGE WILL BE PAID BY
®
10403 International Plaza Drive P.O. Box 99 • St. Ann, Missouri 63074 (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 info@dynaflex.com • www.dynaflex.com
IF NEW ACCOUNT:
OPEN BITE CLOSE BITE NEUTRAL BIONATOR P.O. Box 99 321 123 UPPER LOWER RESET EZ-ALIGN® St. Ann, Missouri 63074-9910 321 123 Banded heRBst Bite Relationship UPPER LOWER EZ-2000® HABIT APPLIANC UPPER COLOR Use Enclosed wax bite for ap Standard Herbst AT www.dynaflex.com BANDED RPE PROVIDE DISTAL JET™ PENDULUMTO AVOID PENDEX DELAYS RX FORMS AREBanded AVAILABLE PLEASE DATE WANTED FIXED HAWLEY
REMOVE OFC # BRACKETS
RETURN MODELS
ACCT. #
PATIENT’S NAMEBanded Herbst Cantilever
position for Class 1
Reinforce Bands REMOVE
BRACKETS cRoWn heRBst
RETURN MODELS
CrownCOLOR Cantilever UPPER Dischinger Cantilever
R
Smith Type II
Space Closing Herbst
otheR heRBst designs acrylic Splint Herbst Band/Crown Combination
R
heRBst MechanisMs Standard Rod & Tube Hanks Telescope (HTH) Mini-Scope with apple Core
TONGUE UPPER UPPER UPPER CLASP BANDED RPE
Other ______________
NANCE SPRINGS E ARCH
HAWLEY SPRING RETAINER TONGUE HABIT APPLIANCE WiRe HERBST® accessoRies TYPE UPPER HAWLEY UPPER INDIRECT BONDING Lower Lingual arch CLASP EXPANSION MARA Upper Transpalatal arch UPPER SAGITTAL LABIAL WIRE UPPER SCHWARZ aRchWiRe tuBes SPRINGS SERIES 2000® .018 MAX®.022 Upper aW Tubes HAWLEY SPRING RETAINER MSX® TYPE Extend aW to 2nd Bicuspid HERBST® EAS® INDIRECT BONDING Lower aWAPPLIANCE Tubes .018 UPPER TYPE .022 SLEEP EXPANSION MARA TYPE SPLINT Center Occlusal Gingival UPPER SAGITTAL UPPER TANDEM UPPER SCHWARZ TYPE TOOTH POSITIONER cRoWn accessoRies MAX® SERIES 2000® TO OPEN TWIN BLOCK™
____mm ____qty
MaxiMuM Bite opening SIGNATURE
DATE WANTED WILSON™ WILLIAMS
TYPE
SEND MORE RXS
LHA
BONDED RETAINER CLOSE BITE THUMB LOWER LOWER LOWER BALL DISTAL JET™ ARROW WILLIAMS 3X3 TRANS PALATAL FINGER BONDED RETAINER UPPER THUMB
(3x3) FLEA NEUTRAL BLUE GRASS 321 123 RESET 321 123 ESSIX™ RETAINER
TYPE
SEND BOXES
R
HAWLEY SPRI HERBST® INDIRECT BONDIN MARA CIRCUMFERENTIAL ADAMS SAGITTAL PENDULUM PENDEX FINGER SCHWARZ WILSON™ TYPE SERIES 2000®
CIRCUMFERENTIAL LHA TYPE MUSHROOM (3x3) FLEA RESET LOWER BLUE GRASS
QCM
21 12 21 12
SLEEP APPLIANC SPLINT TANDEM LOWER ESSIX™ RETAINER LOWER CUSTOM BASE PROVIDE BRACKETS TOOTH POSITION CIRCUMFERENTIALTWIN BLOCK™ BALL ADAMS BUCCAL SHIELD STUDY MODEL ARROW FINGER LOWER COLOR LOWER
cRoWns
Bands
Rollo Bands
3X3 QCM COMMENTS CIRCUMFERENTIAL LOWER FINGER MUSHROOM DynaFlex provide DMJ® -per Diagram DMAX® SAL® Below UPPER LOWER RESET 21 12 SAG® MJX®Crowns, Bands SAN® or Rollo Bands 21 12 TB-SAG® enclosed perMSC® Diagram PHONE-NUMBER LOWER CUSTOM BASE
ciRcle BUCCAL SHIELD LOWER 7 6 LOWER 7 6
5/e 5/e
CS-2000® Below SIGNATURE
PROVIDE BRACKETS
cRoWns to Be seated
DMJ® DMAX® TO CLOSE TYPE SAG® to MJX® ciRcle Bands
SAL®
MARGINALS HERE PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES) SIGNATURE
MARGIN
4/d d/4 e/5 6 7 LOWER PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2 4/d d/4 e/5 6 7
COMMENTS
PHONE NUMBER
FIRST CASE
TRANS PALATAL
SAN® Be MODELS seated STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE MSC® TB-SAG® CS-2000® DIGITAL MODEL 7 STORAGE 6 5/e 4/d d/4 e/5 6 TYPE addSLEEP Vent Holes APPLIANCE 7 6 5/e 4/d d/4 e/5 6 TYPE addSPLINT Vertical Slits UPPER LOWER TANDEM ciRcle occlusal Rests TYPE TOOTH POSITIONER cRoWn accessoRies TO TYPE BLOCK™ UpperTO OPEN 7 CLOSE 6 5/e 4/d d/4 e/5 6 addTWIN Ball Clasps Lower STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE 7 NAME 6 5/e 4/d d/4 MODELS e/5 6 PRINT DIGITAL MODEL STORAGE
add Lingual Seating LugsEAS®
advancement Shims COMMENTS
LOWER COLOR
HABIT APPLIANCE EZ-ALIGN® HAWLEYoptions expansion EZ-2000® Slimline 12mm (2 arm) FIXED
MSX®
Offset COLOR Lower Rods LOWER
_______________mm
E ARCH
position anterior Edge to OPEN EdgeBITE BIONATOR
Remove Occlusal from Crowns
Flip-Lock
PHONE NUMBER
MolarsNANCE
BONDED RPE Standard 12mm Screw (4LABIAL arm) upper WIRE
Hilgers Smith Type I
AGE SENT RPE Use Lines on ModelsDATE for ap BONDED
ALLEGRA MARKETING, PRINT, MAIL
314-429-4848
ALLEGRA MARKETING, PRINT, MAIL ALLEGRA MARKETING, PRINT, MAIL 314-429-4848
®
PRINT NAME
MARGINALS HERE PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
7 7
7 7
314-429-4848
ALLEGRA MARKETING, ALLEGRA PRINT, MARKETING, MAIL 314-429-4848 PRINT, MAIL
®
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
Positioner
57251
10403 International Plaza Drive P.O. Box 99 • St. Ann, Missouri 63074 (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 info@dynaflex.com • www.dynaflex.com IF NEW ACCOUNT:
®
BUSINESS REPLY LABEL
DOCTOR
57251
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO
ADDRESS 10403 International Plaza Drive P.O. Box 99 • St. Ann, Missouri 63074 CITY STATE• FAX (314) ZIP 429-7575 (800) 489-4020 • (314) 426-4020 info@dynaflex.com • www.dynaflex.com EMAIL IF NEW# ACCOUNT: ACCT. OFC #
POSTAGE WILL BE PAID BY ADDRESSEE
P.O. Box 99
St. Ann, Missouri 63074-9910 BUSINESS REPLY LABEL
DOCTOR
RXADDRESS FORMS ARE AVAILABLE AT PATIENT’S NAME CITY
STATE
www.dynaflex.com ZIP
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
AGE
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO
PLEASE PROVIDE DATE POSTAGE WILL BE PAID BY ADDRESSEE DATE SENT
WANTED TO AVOID DELAYS
DATE WANTED IN LAB 7-10 DAYS
FIRST CASE SEND MORE RXS
EMAIL ACCT. #
OFC #
BIONATOR EZ-ALIGN® RX FORMS ARE AVAILABLE AT www.dynaflex.com Full Set-up: Reset all teeth (Positioner and bases) EZ-2000® UPPER COLOR PATIENT’S NAME FIXED AGE REMOVE BRACKETS call to discuss case
RETURN MODELS
P.O. Box 99 OPEN BITE CLOSE BITE St. Ann, Missouri 63074-9910
SEND BOXES
NEUTRAL
321 123 4 PoSitioneR MateRial SelectionS LOWER RESET 321 123 1. Vinyl: color DATE WANTED TO AVOID DELAYS UPPER LOWER PLEASE PROVIDE DATEBANDED SENT RPE DATEJET™ WANTED PENDULUM FIRST CASE DISTAL PENDEX Clear SEND MORE RXS BONDED RPE WILLIAMS WILSON™ TYPE Partial Set-up: Mark teeth on diagram R 88 77 66 55 44 33 22 11 11 22 33 44 55 66 77 88 L Blue SEND BOXES NANCE TRANS PALATAL LHA TYPE Red OPEN BITE CLOSE BITE NEUTRAL BIONATOR REMOVE RETURN Diagnostic Set-up E ARCH BONDED RETAINER (3x3) 321 FLEA 123 BRACKETS MODELS pink UPPER LOWER RESET EZ-ALIGN® 321 123 TONGUE THUMB BLUE GRASS HABITWhip-mix APPLIANCE articulated Set-up Sam Denar HanauEZ-2000® UPPER LOWER purple UPPER LOWER ESSIX™ RETAINER HAWLEY UPPER COLOR BANDED RPE DISTAL PENDULUM PENDEX FIXED Green JET™ no Set-up necessary (fabricate positioner only) CLASP BALL CIRCUMFERENTIAL ADAMS BONDED RPE WILLIAMS WILSON™ TYPE Orange ARROW FINGER Space closure NANCE TRANS PALATAL LHA TYPE 3X3 LABIAL WIRE QCM CIRCUMFERENTIAL Close all Compromise Leave space between E ARCH BONDED RETAINER (3x3) FLEA 2. RubbeR Black
occlusal Plane: overbite: overjet: arch Form:
R R Flat 1-2mm
Curve of Spee Increase
0-1 mm Normal
1-2mm Tapered
UPPER
SPRINGS
FINGER
MUSHROOM
SPRINGS
FINGER
MUSHROOM
TONGUE THUMB BLUE GRASS APPLIANCE Cuspid RiseHABIT Same as SPRING model UPPER LOWER RESET 21 12 HAWLEY RETAINER 3. Multi-Functional Silicone: UPPER LOWER ESSIX™ RETAINER 21 12 HAWLEY TYPE Decrease HERBST® Same as model CLASP BALL CIRCUMFERENTIAL ADAMS Light Medium LOWER CUSTOM BASE Heavy PROVIDE BRACKETS UPPER INDIRECT BONDING Other Same as model ARROW FINGER BUCCAL SHIELD EXPANSION MARA 3X3 LABIAL WIRE QCM CIRCUMFERENTIAL 4. IMpak: Ovoid SAGITTAL Same as model LOWER UPPER
LOWER UPPER SCHWARZ UPPER LOWER RESET 21 12 SPRING RETAINER upper: Narrow Expand HAWLEY Same as model DMJ® DMAX® SAL® MAX® SERIES 2000® 21 12 TYPE thickness: Normal Other HERBST® arch Width: SAG® MJX® SAN® MSX® lower: Narrow Expand INDIRECT Same asBONDING model LOWER CUSTOM BASE PROVIDE BRACKETS UPPER TB-SAG® CS-2000® EAS® Height: Normal OtherMSC® BUCCAL SHIELD EXPANSION MARA Fit Upper to Lower TYPE SLEEP APPLIANCE breathing Pathways: Yes No LOWER UPPER SAGITTAL TYPE SPLINT LOWER UPPER SCHWARZ upper: Labial Lingual TANDEM Same as model UPPER LOWER anterior DMAX® MAX® SERIES 2000® positioner Distal to: 1st DMJ® 2nd SAL® 3rd molars TOOTH POSITIONER endTYPE Root torque: lower: Labial Lingual Same as model SAG® MJX® SAN® MSX® TO CLOSE TO OPEN TYPE TWIN BLOCK™ MSC® TB-SAG® CS-2000® EAS® FOR PRESENTATION)3 2 1 DUPLICATE STUDY MODELS (SOAPED MODELS Mesh coverings: 1 2 3 TYPE upper SLEEP APPLIANCE LOWER COLOR R l Wax in lingual DIGITAL MODEL STORAGE 3 2 1 1 2 3 1-1 2-2 3SPLINT -3 4-4 TYPE Retainer: lower COMMENTS UPPER TANDEM 8 7 6 5 4 LOWER 4 5 6 7 8 ball clasps: R l TYPE TOOTH POSITIONER 8 7 6 5 4 4 5 6 7 8 TO CLOSE TO OPEN TYPE 8 7 6 5 4 3 2 1 1 2 3 TWIN 4 5 BLOCK™ 6 7 8 Wax in Pontics 8 7 6 5 4 3 2 1 1 2 3 4 5 6 7 8 STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE MODELS where necessary: Drs. x-ray Hinge axis tracing LOWER COLOR DIGITAL MODEL STORAGE
PHONE NUMBER COMMENTS
SIGNATURE
PRINT NAME
MARGINALS HERE PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES) PHONE NUMBER
SIGNATURE
PRINT NAME
MARGINALS HERE PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
3D.Ortho PRESCRIPTION
LEADING THE WAY
41
800.489.4020 > 314.426.4428
DynaFlex Dorsal® Available in 3 Different Materials
DynaFlex Dorsal® Acrylic The DynaFlex Dorsal® Device has evolved into one of the most popular choices for snoring and obstructive sleep apnea. The two piece construction allows for maximum patient comfort and lateral jaw movement. The Dorsal fins on the mandibular appliance interface with inclines built into the facial of the upper appliance to dictate a specific mandibular position. The device is fabricated with adjustable screws in the maxillary appliance to allow for further mandibular advancement. “ Predictability, reliability and service are 3 words to describe my experience working with DynaFlex®.” Dr. Kenneth A. Mogell, D.M.D., Diplomate, ABDSM
New Low Profile Design 22% Less Bulk
Sleep Dentist - Boca Raton, Broward County & Palm Beach
DynaFlex Dorsal® Comfort-Fit The DynaFlex Dorsal is constructed from our new “comfort fit” material. The DynaFlex Dorsal Comfort Fit is 19% thinner reducing buccal bulk in the vestibule areas for increased patient acceptance. Many of our doctors are reporting improved night time wear with the new comfort fit design. The soft inner lining provides superior night time retention. The outer durable acrylic covering is designed for long lasting wear. The great news . . . the comfort fit design can be requested at no additional charge. “ It is a pleasure to have oral appliances made that fit well and require few adjustments” Dr. Larry Z. Lockerman, D.D.S., Diplomate, ABDSM UMass Memorial Medical Center
DynaFlex Dorsal® Accu-Fit* Custom Thermal Acrylic
Fits first time, every time! The Accu-Fit design is the newest device added to the Dorsal family of sleep appliances for treating patients with sleep apnea. The unique custom thermal acrylic liner allows the appliance to fit at the first delivery appointment without acrylic or wire adjustments. The Accu-Fit design is ideal for patients who will require future dental work (restorations, crowns or bridges). The new design eliminates costly remakes after dental work. The thermal acrylic liner is remolded in hot water (160 degrees) to fit the patient’s arch after dental restorations. Patent Pending
*
“From personal experience, the ability to re-adapt the Accu-Fit to restorative changes sets it apart from similar sleep appliances.” Dr. Neil Zane, D.D.S. New York Center for Neuromuscular Dentistry Custom Thermal Acrylic Liner
Fax: 314.429.7575 > www.dynaflex.com
42
Adjustable Herbst® Appliance The Adjustable Herbst® is a two piece construction held together with two inseparable hinged mechanisms on the buccal of the upper and lower appliances. The hinged mechanisms are designed with advancement screws to allow for titration and advancement of the mandible. The Adjustable Herbst® is designed for incremental advancement of the mandible to the desired position. The advancement screws have a 5mm range with an adjustment ratio of 16:1 or 16 quarter turns to one millimeter.
“ DynaFlex® has been very helpful in meeting our specific needs. As a full time oral appliance practice, having a single source for our most frequently used appliance designs is a real bonus.” Dr. John M. McCrillis, D.D.S., Diplomate, ABDSM Louisville Dental Sleep Medicine
EMA® The Elastic Mandibular Advancement appliance is the smallest of our obstruction sleep apnea appliances. The individual trays are constructed of 2mm vacuum form material and are held together with straps of varying lengths and flexibility. These straps provide unsurpassed lateral movement and comfort as well as dictating the amount of mandibular advancement. These straps are positioned between the teeth and cheek leaving the palate free from obstruction.
TAP® 1, TAP® 3 & TAP® 3 Elite Thornton Adjustable Positioner The two piece Tap® appliances are fully adjustable on a horizontal plane, providing dentists the ability to locate the ideal mandibular position for their patient. This custom appliance is fabricated with separate upper and lower trays. The maxillary component utilizes an adjustable screw and hook which interfaces with a lower socket or lower lingual bar to hold the mandible in the desired position.
43
800.489.4020 > 314.426.4020
E0486 Medicare Verified
*
SLEEP APNEA APPLIANCES
These devices have both FDA Clearance and Medicare E0486 Verification.
Adjustable Herbst速
Adjustable Herbst
Medicare Tap速 1
Medicare Tap速 3 Elite
Double bar modification required to meet Medicare specifications.
*
Reference the red box on your prescription for Medicare Appliances.
Fax: 314.429.7575 > www.dynaflex.com
44
®
®
57251
57251
57251 7251
57251
ALLEGRA MARKETING, PRINT,MARKETING, MAIL 314-429-4848 ALLEGRA PRINT, MAIL
314-429-4848
7251
NO POSTAGE NECESSARY NO POSTAGE IF MAILED NECESSARY IN THE IF MAILED UNITED STATES IN THE
10403 International Plaza Drive P.O. Box10403 99 • St. Ann, Missouri 63074 International Plaza Drive (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 P.O. Box 99 • St. Ann, Missouri 63074 info@dynaflex.com • www.dynaflex.com ® ®
UNITED STATES
(800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 ®
NO POSTAGE NO POSTAGE NECESSARY NECESSARY NO POSTAGE IF MAILED IF MAILED NECESSARY IN THEIN THE UNITED STATESSTATES IF MAILED UNITED
IF NEW ACCOUNT: info@dynaflex.com • www.dynaflex.com
IF NEW ACCOUNT: 10403 DOCTOR 10403International InternationalPlaza PlazaDrive Drive P.O. 99 Ann, 63074 P.O. Box Box10403 99••St. St. Ann,Missouri Missouri 63074 International Plaza Drive ADDRESS (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 DOCTOR (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 P.O. Box 99 • St. Ann, Missouri 63074 info@dynaflex.com • •www.dynaflex.com ® info@dynaflex.com www.dynaflex.com CITY STATE (800) 489-4020 • (314) 426-4020 ZIP • FAX (314) 429-7575 ADDRESS IF NEW ACCOUNT: IF NEW ACCOUNT: info@dynaflex.com • www.dynaflex.com EMAIL CITY STATE ZIP DOCTOR IF NEW ACCOUNT: 10403 Plaza Drive ACCT. # OFC International #
Anti-snoring & sleep ApneA
DOCTOR EMAILP.O. Box 99 • St. Ann, Missouri 63074 ADDRESS ADDRESS (800) 489-4020 • (314) 426-4020 • FAX (314) 429-7575 DOCTOR ACCT. # OFC # STATE info@dynaflex.com • www.dynaflex.com CITY ZIP STATE ZIP RXCITY FORMS ARE AVAILABLE AT www.dynaflex.com ADDRESS IF NEW ACCOUNT: EMAIL PATIENT’S NAME AGE EMAIL CITY STATE ZIP ACCT. # OFC # AVAILABLE RX FORMS ARE AT DOCTOR ACCT. # OFC # PATIENT’S NAME EMAIL ADDRESS BIONATOR REMOVE RETURN
BUSINESS REPLY LABEL
BUSINESS REPLY LABEL
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO POSTAGE WILL BE PAID BY ADDRESSEE
IN THE UNITED STATES
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO
NO POSTAGE NECESSARY IF MAILED IN THE UNITED STATES
POSTAGE WILL BE PAID BY ADDRESSEE
BUSINESS LABEL P.O. Box 99 REPLY BUSINESS REPLY LABEL FIRST CLASS PERMIT NO. 8722, ST. LOUIS, MO
St.FIRST Ann,CLASS Missouri 63074-9910 PERMIT NO. 8722, ST. LOUIS, MO
BUSINESS REPLY LABEL
POSTAGE WILL BE PAID BY ADDRESSEE
P.O.WILL BoxBE99 POSTAGE PAID BY ADDRESSEE
CLASS PERMIT NO.WANTED 8722, ST. LOUIS, MO St.FIRST Ann,PROVIDE Missouri 63074-9910 PLEASE DATE TO AVOID DELAYS
WILLWANTED BE PAID BY ADDRESSEE DATE SENT POSTAGE DATE
P.O. Box 99 www.dynaflex.com PLEASE PROVIDE DATE BUSINESS REPLY LABEL 99 63074-9910 St. P.O. Ann, Box Missouri
FIRST CASE
SEND MORE RXS WANTED TO AVOID DELAYS SEND BOXES
FIRST CLASS PERMIT NO. 8722, ST. LOUIS, AGE DATE SENT DATE MO WANTED St. Ann, Missouri 63074-9910 OPEN BITE
CLOSE BITE
NEUTRAL
BALL TRANS PALATAL
ADAMS LHA TYPE
FIRST CASE
SEND MORE RXS
POSTAGE WILL BE PAID BY ADDRESSEE
321AVOID 123 DELAYS ACCT. #ARE AVAILABLE OFC # STATE P.O.PROVIDE Box 99 RXCITY FORMS AT www.dynaflex.com PLEASE TO BRACKETS MODELS UPPER LOWER DATE WANTED RESET ZIP SEND BOXES EZ-ALIGN® 321 123 St. Ann,PROVIDE Missouri 63074-9910 RX FORMSNAME ARE AVAILABLE AT www.dynaflex.com PLEASE DATE WANTED TO AVOID DELAYS PATIENT’S AGE DATE SENT DATE WANTED FIRST CASE UPPER LOWER EZ-2000® OPEN BITE CLOSE BITE NEUTRAL EMAIL BIONATOR REMOVE RETURN SEND MORE RXS CASE PATIENT’S NAME AGE DATE SENT DATEWanted: WANTEDIN LAB 7-10 DAYS FIRST UPPER COLOR Date 321 123 BANDED RPE JET™ PENDULUM PENDEX FIXED EZ-ALIGN® SEND BOXES BRACKETS MODELS SEND MORE RXS LOWER RESET ACCT. # OFC P.O. Box 99UPPERDISTAL RX FORMS ARE# AVAILABLE AT www.dynaflex.com PLEASE PROVIDE DATE WANTED TO AVOID DE 321 BOXES 123 RPE WILLIAMS TYPE SEND St.BONDED Ann,BITE Missouri 63074-9910 OPEN CLOSE BITE LOWERWILSON™ NEUTRAL BIONATOR REMOVE NAME RETURN UPPERSENT EZ-2000® AGE PATIENT’S DATE DATE WANTED FIRST CASE 321 123 NANCE PALATAL TYPE UPPER COLOR BRACKETS MODELS less than 5 days in lab OPEN BITE TRANS CLOSE BITE LHA NEUTRAL BIONATOR UPPER LOWER RESET REMOVE RETURN EZ-ALIGN® Service BANDED RPE Rush DISTAL JET™Additional PENDULUM PENDEX SEND MORE FIXED 321 123 $100 321 123 E ARCH RETAINER (3x3)WANTED FLEA RX FORMS ARE AVAILABLEMODELS AT www.dynaflex.com PLEASE BONDED PROVIDE DATE TO AVOID DELAYS SEND BOXE BRACKETS UPPER LOWER RESET UPPER LOWER EZ-ALIGN® EZ-2000® RPEDATEWILLIAMS WILSON™ TYPE 321 123 UPPER NAME COLOR PATIENT’S AGE DATE SENTBONDED WANTED FIRST CASE DynaFlex Dorsal TONGUE THUMB BLUE GRASS HABIT APPLIANCE BANDED RPE DISTAL JET™ PENDULUM PENDEX UPPER LOWER FIXED EZ-2000® OPEN BITE TRANS CLOSE BITE LHA TYPE NEUTRAL BIONATOR REMOVE RETURN SEND MORE RXS NANCE PALATAL (FDA: K103076) UPPER COLOR UPPER LOWER ESSIX™ RETAINER HAWLEY 321 123 BONDED RPE RPEWILLIAMS TYPE BANDED DISTAL JET™ WILSON™ PENDULUM PENDEX FIXED EZ-ALIGN® SEND BOXES BRACKETS MODELS UPPER LOWER Shorten Lingual E ARCH BONDED RETAINER (3x3) RESET FLEA
REMOVE UPPER COLOR BRACKETS
RETURN MODELS
UPPER COLOR
R R R R
123
TAP® 1 (FDA: K972061) EXPANSION MARA
BUCCAL SHIELD
21 12
TYPE MJX® MSX® HERBST® Adjustable Herbst® ARROW 3SAG® X 3 FINGER SAN® LABIAL WIRE Q CIRCUMFERENTIAL BUCCAL SHIELD EXPANSION MARA Triple Laminate LOWERMSC®(FDA: UPPERTB-SAG® SAGITTAL CS-2000® EAS® LOWER CUSTOM BASE PROVIDE BRACKETS UPPER INDIRECT BONDING K103076) LOWER UPPER 3X3 LABIAL WIRE QCM CIRCUMFERENTIAL SAGITTAL FINGER SPRINGS MUSHROOM ® ThermAcryl LOWER UPPER SCHWARZ TYPEEXPANSION BUCCAL SLEEP APPLIANCE MARA LOWER UPPER Acrylic SCHWARZ FINGER SHIELD SPRINGS MUSHROOM LOWER UPPER RESET 21 HAWLEY TYPE SPRING RETAINER ® DMJ® DMAX®DMJ® SAL® MAX® SERIES 2000® SPLINT ThermAcryl Plus LOWER UPPER 21 12 SAGITTAL 21 DMAX® SAL® MAX® SERIES 2000® LOWERFit RESET HAWLEY SPRING RETAINER TYPE UPPER Comfort HERBST® UPPER 21 12 TANDEM SAG® SAN® MSX® MJX®LOWERMJX® LOWER UPPER SCHWARZ SAG® SAN® MSX® TYPE HERBST® LOWER Accu-Fit (add’l $50) CUSTOM BASE PROVIDE BRAC UPPER INDIRECT BONDING TYPE TOOTH POSITIONER MSC® TB-SAG® CS-2000® EAS® DMAX® MAX® SERIES LOWER UPPER TAP® 3 EAS® (FDA: K062951)TB-SAG® INDIRECT 2000® BONDING
DMJ® SAL® BRACKETS MSC® CS-2000® *Patent Pending BASE CUSTOM PROVIDE
BUCCAL SHIELD TO CLOSE TO OPEN TYPEEXPANSION TYPE MARA TWIN BLOCK™ Accu-Fit TYPE SAG® Plus (add’l $65) MJX® SAN® MSX® SLEEP APPLIANCE SLEEP APPLIANCE BUCCAL SHIELD EXPANSION MARA Triple Laminate *Patent Pending STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE MODELS LOWER UPPER SAGITTAL TYPE SPLINT MSC® TYPE TB-SAG® CS-2000® EAS® SPLINT LOWER UPPER ® SAGITTAL ThermAcryl DIGITAL MODEL STORAGE LOWER UPPER LOWER UPPER TANDEM SCHWARZ TYPE UPPER TAP 1 (FDA: K972061) LOWER SLEEP APPLIANCE TANDEM LOWER UPPER SCHWARZ ThermAcryl® Plus TYPETYPE TOOTH POSITIONER DMAX® SAL® SERIES 2000® SPLINT Triple Laminate DMJ® TOOTH POSITIONER DMJ® SAL® MAX® TYPEMAX® DMAX® SERIES 2000® TO CLOSE TO OPEN TYPE LOWER ® TWIN BLOCK™ TANDEM MJX®ThermAcryl SAN® MSX® MJX® TO CLOSE TWIN BLOCK™ UPPER SAG® TYPE SAG® SAN® MSX® TO OPEN STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE MODELS TAPMODELS 3 Elite (FDA: K062951) TYPE ® TOOTH POSITIONER TB-SAG® CS-2000® EAS® (SOAPED FORTB-SAG® PRESENTATION) STUDY MODELS MSC® DUPLICATE CS-2000® EAS® ThermAcryl PlusMSC® DIGITAL MODEL STORAGE TO CLOSE TO OPEN TYPE Triple Laminate
LOWER COLOR
®
COMMENTS
®
LOWER COLOR
LOWER COLOR
Color: COMMENTS
LOWER COLOR
CIRCUMFERENTIAL 321
Accu-Fit Plus (add’lLABIAL $65) EARROW FINGER RETAINER 3 X 3 BONDED WIRE QCM CIRCUMFERENTIAL ARCH (3x3) FLEA CIRCUMFERENTIAL BALL *Patent Pending CLASP AddADAMS Reinforcement NANCE TRANS PALATAL LHA TYPE LOWER CUSTOM BASE PROVIDE BRACKETS UPPER INDIRECT BONDING 3X3 LABIAL WIRE QCM CIRCUMFERENTIAL FINGER SPRINGS MUSHROOM TONGUE THUMBFINGER BLUE GRASS HABIT APPLIANCE ARROW TM E ARCH BONDED BUCCAL SHIELD RETAINER EXPANSION MARA AirPlus FINGER SPRINGS Add(3x3) Hooks LOWER FLEA RESET 21 12 UPPERMUSHROOM HAWLEY SPRING RETAINER UPPER LOWER ESSIX™ RETAINER 3 X 3 LABIAL WIRE QCM CIRCUMFERENTIAL (includes reverse fins & shorten lingual) HAWLEY LOWER UPPER TONGUE THUMB SAGITTAL 21 12 HABIT APPLIANCE LOWERBLUE GRASS RESET 21 12 HAWLEY SPRING RETAINER TYPE UPPER HERBST® FINGER SPRINGS MUSHROOM 21 12 CLASP BALL CIRCUMFERE ADAMS LOWER UPPER SCHWARZ LOWER ESSIX™ RETAINER HAWLEY TYPEUPPER HERBST® LOWER CUSTOM BASE UPPER 21 12BRACKETS INDIRECT BONDING UPPER RESET PROVIDE LOWER Medicare E0486 Verified HAWLEY SPRING RETAINER DMJ® DMAX® SAL® FINGER MAX® SERIES 2000® ARROW CLASP BALL CIRCUMFERENTIAL LOWER CUSTOM ADAMS BASE PROVIDE BRACKETS UPPER INDIRECT BONDING
RR
COMMENTS PHONE NUMBER
AcrylicCLASP NANCE
BONDED RPE WILLIAMS TYPE OPEN BITE CLOSE THUMB BITE LOWERWILSON™ NEUTRAL BIONATOR UPPER TONGUE BLUE GRASS EZ-2000® HABIT APPLIANCE ARROW FINGER E ARCH BONDED RETAINER (3x3) FLEA 321 123 Open Screws _____mm NANCE TRANS PALATAL LHA TYPE Comfort FitUPPER LOWER RESET EZ-ALIGN® UPPER RETAINER 3 X3 LABIAL WIRE CIRCUMFERENTIAL BANDED RPELOWER DISTAL JET™ ESSIX™ PENDEX HAWLEY FIXED 321PENDULUM 123QCM TONGUE THUMB BLUE GRASS HABIT APPLIANCE E ARCH BONDED RETAINER (3x3) FLEA UPPER LOWER No advancement screws required EZ-2000® Accu-Fit * FINGER SPRINGS MUSHROOM CLASP BALL CIRCUMFERENTIAL ADAMS BONDED RPE WILLIAMS WILSON™ TYPE (add’l $50) UPPER LOWER ESSIX™ RETAINER HAWLEY TONGUE THUMB GRASS HABIT 21 12 *Patent Pending BANDED RPE DISTAL JET™ LOWERBLUE PENDULUM FIXEDAPPLIANCE UPPER RESET PENDEX HAWLEY SPRING RETAINER ARROW CLASP BALL CIRCUMFERENTIAL ADAMS Reverse Fin FINGER NANCE TRANS PALATAL LHA TYPE UPPER LOWER ESSIX™ RETAINER HAWLEY RPE WILLIAMS WILSON™ TYPE 21 12 * TYPEBONDED HERBST®
SIGNATURE
Add anterior platform on appliance to
COMMENTS disclude posterior teeth
TWIN TYPE DIGITAL TYPE MODEL STORAGE SLEEP BLOCK™ APPLIANCE SLEEP APPLIANCE ® TAP®DUPLICATE 3 Elite (FDA: K062951) STUDY MODELS (SOAPED FOR PRESENTATION) MODELS ThermAcryl TYPE SPLINTSPLINT PRINT NAME TYPE MODEL STORAGE ® Triple Laminate UPPER LOWER TANDEM ThermAcrylDIGITAL Plus UPPER LOWER
TANDEM
TYPE TOOTH POSITIONER ThermAcryl® TYPE TOOTH POSITIONER MARGINALS HERETO OPEN ® TO CLOSE TYPE TWIN BLOCK™ ThermAcryl PlusTYPE Open anterior to allow tongue space TO CLOSE EMABLOCK™ (FDA: K971794) TO OPEN TWIN STUDY MODELS (SOAPED FOR PRESENTATION) DUPLICATE MODELS PHONE NUMBER SIGNATURE PRINT NAME Add occlusal platform for posterior support MODELS (SOAPED FOR PRESENTATION) PT1= ORIGINAL (RETURN TO DYNAFLEX) /STUDY PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES) DUPLICATE MODELS LOWER COLOR DIGITAL MODEL STORAGE PHONE NUMBER SIGNATURE PRINT NAME LOWER COLOR
DIGITAL MODEL STORAGE
COMMENTS COMMENTS PHONE NUMBER
SIGNATURE
MARGINALS HERE
PRINT NAME
MARGINALS HERE
PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
MARGINALS HERE PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES) PHONE NUMBER
SIGNATURE
PRINT NAME
PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
PHONE NUMBER
SIGNATURE
PRINT NAME
MARGINALS HERE
MARGINALS HERE
PT1= ORIGINAL (RETURN TO DYNAFLEX) / PT2= DOCTOR’S COPY (RETAIN FOR YOUR FILES)
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