Candidate number: {AF 0700} Patient: {ABC} Case Type: {Single Tooth}

Required Radiographs: Presurgical panograph or a full-mouth radiographic series. Post-surgical panograph or a post-surgical periapical radiograph for a single-tooth-implant (within one week of surgery.) Post-prosthetic (with prosthesis or bar superstructure in place.) Completed case radiograph (taken within 12 months of the candidate’s oral/case examination date.)

Date Radiograph was taken: {01/01/2000} {Radiograph View} Date Radiograph was taken: {01/01/2000}