Up CD Dental Services Clinical Fees

UPCD DENTAL SERVICES CLINICAL FEES Registration fee: 7

PERIODONTICS (cleaning) Scaling and Polishing (basic cleaning) Periodontal Therapy (Non-surgical Scaling and Root Planing; deep cleaning)

ENDODONTICS (root canal) %&

''&uadra nt

+ncisors! ,anines! Preolars

''&*

.olars

&*

*fee for /rays not included

Periodontal Surgery *uadrant: upper left! " right! lo#er left! $ right

uadra nt

RESTORATIVE DENT (pasta) 0alga Restoration (sil1eretal-colored)

,oposite Restoration (tooth-colored) on preolars and olars

on incisors and canines! root area

ORAL SURGER (!"not) 3 (4' for additional surfaces)

RegularSiple /traction

,oplicated /traction 8lap operation 56 (46& for additional surfaces)

9dontectoy (#isdo tooth reo1al)

%& (45& for /ray)

 (45& for /ray)  (4'7 for panoraic /ray)

5-5& Special ,ase (.inor Surgery cases)

,a1ity 2ase*

&

,a1ity $iner*

5&

5&

*for deep ca1ities! e/tensi1e restorations

PROST#ODONTICS (p"stiso) Single ,ro#n

ORT#ODONTICS (!races) ''& (4lab fee)

8i/ed 2ridge (-unit) ,oplete entures (upper 0N lo#er)

.iniu total

37 (4lab fee)

+nitial payent (diag 4 ipressioncast)

6

"pon placeent of

'! '& 5!'&

7!

Single ,oplete enture (upper 9R lo#er) %3& Reo1able Partial enture Single RP "pper-$o#er RP

% (4lab fee)

5

Pit and 8issure Sealant

3

>lass +onoer Restoration on preolars and olars

%&

E0penses not incl"&e& in -in1 total2 restorations! e/tractions! scaling and polishing! root canal (go to "P, for these procedures)

7  2uild-up %& PulpectoyPulpotoy (root canal for
Strip-o? (coposite) cro#n Space aintainers 2and and loop Nance $ingual @olding 0rch Saddle Space .aintainer

'7

$ateral ,ephaloetric /ray

on incisors and canines

Stainless Steel ,ro#n

onthly fee (for ' onths or until balance is paid)

ORT#ODONTICS (!races)

' *+o, co-pre.ensi/e treat-ent)  Topical 8luoride 0pplication

3

/penses not included in in= total Panoraic /ray

63 (4lab fee)

PEDODONTICS ($or %i&s

brac
55 55

55 53& 7& 

Ainc 9/ide ugenol ,linic days: Bee
other bro
%