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Temporary Crown & Bridge
By completing this survey, you give Pulpdent Corporation permission to use the information you provide below for quality assurance and compliance purposes.
1) How often do you personally make temporary crown or bridge?
0-2 times per
week
3-10 times per
week
More than 10 times per
week
*
2) Which Temporary material do you use regularly? (Please select only one for this survey)
(Required.)
Tuff-Temp Plus Provisional Veneer, Crown and Bridge Resin
Other , please specify
*
3) How long have you been using this material?
(Required.)
0-1
year
1-3
years
More than 3
years
4) What do you like most about this product?
*
5) Please rate the characteristics of the material you chose
(Required.)
Excellent
Good
Fair
Poor
N/A
Marginal Integrity
Excellent
Good
Fair
Poor
N/A
Flowability
Excellent
Good
Fair
Poor
N/A
Handling
Excellent
Good
Fair
Poor
N/A
Setting Time
Excellent
Good
Fair
Poor
N/A
Color Match
Excellent
Good
Fair
Poor
N/A
Finishing/ Polishing
Excellent
Good
Fair
Poor
N/A
Durability
Excellent
Good
Fair
Poor
N/A
Strength
Excellent
Good
Fair
Poor
N/A
6) For any answer of fair or poor, please explain:
*
7) Have your patients experienced any negative issues such as allergic reaction, post-op sensitivity, or infection after use of this material?
(Required.)
No
Yes, please specify
If yes, please rate the severity of the issue
Temporary mild
Temporary moderate
Temporary severe
Required medical attention
8) How often have you had to replace or repair a temporary crown done with this material?
0-5 times per
year
5-10 times per
year
More than 10 times per
year
9) If you have had to replace temporary crown done with this material, how many were replaced within;
Under 1st week of original placement (#)
1st- 2nd week of original placement (#)
Over 2nd week of original placement (#)
10) What are the main reasons you have had to replace or repair temporary crown done with this material?
Sensitivity
Broken crown
Other , please specify
Comments:
*
Are you a dental healthcare provider?
(Required.)
Yes
No
*
I give Pulpdent consent to follow up in 6 months
(Required.)
Yes
No
We ask that you provide your contact information so we may reach you if needed to ensure the safety of our products. Information will not be used for marketing e-mails or phone calls, apart from notifying eligibility parties for gift card giveaways.
Name
Company
Email Address
Phone Number
Internal use only