Application of desensitizing medicaments
Bone graft with mesh or membrane
Children's medical consultation
Delivery of Dental Prostheses
Dental cleaning with fluoride
Dental consultation with x-ray and cleaning
Dental control and prophylaxis
Dental implant, per tooth
Dental x-rays (fin, occlusal, periapical)
Diastema closure with resins
Diastema closures with resins
Drainage of abscess, intraoral
Endodontics in temporary works (pulpotomy, pulpectomies)
Evolution for brake treatment
Exodontia indicated by Orthodontics
Extraction of wisdom teeth
Extraction of wisdom tooth (nonsurgical)
Extraction of wisdom tooth (surgical)
Fabrication of mouthguard
Filling (Permanent Tooth)
General consultation with dental cleaning
Gingivectomy or gingivoplasty, per tooth
Impacted tooth extraction
Incision and drainage of abscess, intraoral tissue
Initial Physical Therapy Evaluation
Inlay, porcelain/ceramic, 1 surface
Internal bleaching, per tooth
Local anesthesia not in conjunction with operative or surgical procedures
Lower bracket installation
Opening of Clinical History
Orthodontic traction of impacted part
Pediatric Chrome Steel Crowns
Pediatric Chrome Steel Crowns
Periodontal maintenance (non-invasive)
Periodontal scaling & root planing, per quadrant
Permanent tooth extraction
Porcelain crown, per tooth
Porcelain veener, per tooth
Printing of crowns and bridges
Reevaluation Consultation
Root canal therapy, anterior, excluding final restoration
Root canal therapy, biradicular
Root canal therapy, molar, excluding final restoration
Superior Bracket Installation
Teeth Whitening with Lamp (in the clinic)
Temporal tooth extraction
Temporary Restorations (glass ionomer, zinc oxide, basic restorations)
Tooth bleaching without lamp (clinical)
Topical application of fluoride, child
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