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Presurgical panograph or a full-mouth radiographic series.Post-surgical (within one week of surgery) panograph or a post surgical periapical radiograph for a single-tooth-implant Post-prosthetic (with prosthesis or bar superstructure in place); either panographic or periapical radiographs are acceptableCompleted case radiograph (taken within 12 months of the candidates oral/case examination date.)For grafting cases, two additional radiographs are required: cross sectional cone beam radiograph of the augmentation site BEFORE the augmentations placement and cross sectional cone beam radiograph of the augmentation site AFTER the augmentations placementRadiographsRequired Radiographs

Candidate number:Case Type:Patient:

Date Radiograph was taken:

Presurgical View
{01/01/2000}

Date Radiograph was taken:

Post-Surgical View
{01/01/2000}

Date Radiograph was taken:

Post-Prosthetic View
{01/01/2000}

Date Radiograph was taken:

Completed case radiograph (taken within 12 months of the candidates oral/case examination date.)
{01/01/2000}

Date Radiograph was taken:

Augmentation site BEFORE placement
{01/01/2000}

Date Radiograph was taken:

Augmentation site AFTER placement
{01/01/2000}