This form obtains the patient's consent regarding a porcelain restoration procedure; a procedure that involves attaching lifelike porcelain restorations, such as crowns, bridges, and veneers, for the patient.
Approval for Placement
I have had the opportunity to view the color and shape of the porcelain restorations under different lighting conditions. With the exception of the requested modifications noted, if any, I approve the restorations to be bonded in place. I understand that certain bite adjustments will likely be needed after bonding in the restorations, but that other changes (e.g., relating to the color and shape) after the bonding process would likely require cutting off the restorations, which may result in further reduction in tooth structure and an additional full fee under our current fee structure.
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