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ISOI FELLOWSHIP APPLICATION

ISOI FELLOWSHIP APPLICATION. NAME: ADDRESS: MOBILE NO:. CASE NO 1. Name of the Patient: Type of case:- ( Single / Multiple / Full Maxilla / Full mandible) Procedure: ( Surgical / Flapless / CT guided .. Etc ) Implant: ( Name & company, diameter & length of implant)

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ISOI FELLOWSHIP APPLICATION

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  1. ISOI FELLOWSHIP APPLICATION NAME: ADDRESS: MOBILE NO:

  2. CASE NO 1 • Name of the Patient: • Type of case:- ( Single / Multiple / Full Maxilla / Full mandible) • Procedure: ( Surgical / Flapless / CT guided .. Etc) • Implant: ( Name & company, diameter & length of implant) • Eg- Implant , XYZ company, manufacturer , Place, • Diameter, length, type of implant surface)

  3. PHOTOGRAHS TO BE SUBMITTED • FRONTAL • PROTRUSIVE • OCCLUSAL, MAXILLARY • OCCLUSAL, MANDIBULAR • LEFT LATERAL • RIGHT LATERAL • LEFT WORKING • RIGHT WORKING

  4. CASE1 , PHOTOS 1-4, CLOCKWISE, DATE OF PHOTOS

  5. CASE1 , PHOTOS 5-8, CLOCKWISE, DATE OF PHOTOS

  6. RADIOGRAPHS • PRE-OP OPG • POST - OP OPG OR POST –OP IOPA • (for single tooth implant within 3 days • of surgery) • POST-PROSTHETICS ( with prosthesis in place) • OPG after 1 year of prosthetic placement

  7. CASE 1 - RADIOGRAPH VIEWS View 1 – Date of photo View 2 – Date of photo View 4 – Date of photo View 3 – Date of photo

  8. REPEAT THE SLIDES FOR CASES 2-10 • Do not add extra slides • Please be specific for all the cases with respect to number of slides and the content

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