Dental Sharpening/Retip/Repair Order Form

Sharpening Per End Qty

Elevators/Root Tip Picks $3.60

Elevators (Reshape) $5.50

Surgical Curettes - Small $2.00

Perio Files - Small $3.50

Bone Files/Rasps $3.60

Extraction Forceps $8.00

Aspirator Tips (Reshape – Polish) $9.00

Handpiece – High Speed Overhaul $69.99

Handpiece – Slow Speed starting at…. $69.99

Scissors (Micro – Spring) $15.00

*** Please mark (X) one box***Orders without instructions will be sharpened/retipped/repair as needed.

Retip as Needed

Do Not Retip (Return)

Instructions Included

Scalers Sickle/Curette/Explorers $3.50

Chisels/Hatchets/Margin Trimmers $5.00

Elevators/Root Tip Picks $10.00

Large Elevators/Periosteal $12.00

Surgical Curettes - Small $5.00

Perio Files - Small $8.25

Perio Files - Large $10.00

Needle Holders (carbide inserts) $35.00

Probe $7.00

Plugger/Burnisher $3.50

Replacement Rest Pad Band Remover $4.50

*** Please mark (X) one box***Orders without instructions will be sharpened/retipped/repair as needed.

Do not replace damaged/cracked/odd size/plastichandles if unable to retip (return)Replace damaged/cracked/odd size/plastichandles

Handle Replacement if Needed – Preferred Size

#2 Replacement Handle 6.35mm $5.50

#4 Replacement Handle 7.93mm $5.75

#6 Replacement Handle 9.52mm $6.00

Dr./Practice: Contact:

Address: Suite:

City: State Zip:

Phone: Fax: Email:

#4/#6 Mirror Handle 7.93/9.52mm $8.50

Excavators/Cleoid Discoid $2.60

Carvers $2.60

Rongeurs $25.00

Excavators/Cleoid Discoid $5.25

Carvers $7.00

Mirror Heads #4 & #5 $2.50

Scalers Sickle/Curette/Explorers $1.50

Chisels/Hatchets/Margin Trimmers $1.50

Needle Holders (Align – Serrate) $12.00

Mathieus/Hemostats (Align – Serrate) $12.00

Wire Cutters Distal End/Ligature $18.00

Bird Beak/Utility/How/Forming Pliers $12.00

Bracket/Band Removers/Debond Plier $12.00

Plastic Fillings $7.00

Composites $7.00

Cord Packers $7.00

Bird Beak/Utility/How/Forming Pliers $35.00

Bracket/Band Removers/Debond Plier $35.00

Gingivectomy/Periodontal Knives $13.00 Gingivectomy/Periodontal Knives $13.00

Bone/Oschenbein Chisels $11.00

Scissors (Plain Edge) $10.00

Scissors (Serrated – Suture) $12.00

Wire Cutters D.E/LIG (wire hold $40.00) $35.00