Application of desensitizing medicaments
$50.00
Bondings, per tooth
$200.00
Crown (temporary tooth)
$150.00
Dental cleaning with fluoride
Dental implant, per tooth
Dental x-rays (fin, occlusal, periapical)
Diastema closure with resins
$100.00
Diastema closures with resins
Digital radiovisiography
$60.00
Drainage of abscess, intraoral
Endodontics in temporary works (pulpotomy, pulpectomies)
Extraction of wisdom tooth (nonsurgical)
$100.00
Extraction of wisdom tooth (surgical)
¢135000.00
Fabrication of mouthguard
$150.00
Gingivectomy or gingivoplasty, per tooth
Impacted tooth extraction
$150.00
Incision and drainage of abscess, intraoral tissue
$150.00
Inlay, porcelain/ceramic, 1 surface
Limited oral evaluation
$60.00
Orthodontic records (diagnostic cast, x-rays, photographs)
$100.00
Periodontal maintenance (non-invasive)
¢75000.00
Periodontal scaling & root planing, per quadrant
¢50000.00
Periodontal surgery
¢100000.00
Permanent tooth extraction
$75.00
Porcelain crown, per tooth
Resin-based filling
$50.00
Root canal therapy, anterior, excluding final restoration
Root canal therapy, biradicular
Teeth Whitening with Lamp (in the clinic)
$350.00
Temporary Restorations (glass ionomer, zinc oxide, basic restorations)
Tooth bleaching without lamp (clinical)
$300.00
Topical application of fluoride, child