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Glidewell Direct

AveoTSD Anti-Snoring Device AveoTSD Patient Sizing Kit

Capture Impression Materials

Inclusive Mini Implant System

Inclusive Scanning Abutments

Erkopress 300 Tp/Tp-ci Erkoform-3 Erkoform-3d Thermoforming Discs

Capture Products
		1- 888-303-3975

Please Note: This form is provided for our customers who wish to order Capture Clinic Packs online. Capture Clinic Packs are currently unavailable for order through our online Shopping Cart but will be available in a future release of the software. Thank you for your patience. For all other online orders, please click here to go back to the Glidewell Direct Shopping Cart.

CLINIC PACKS (mix and match, multiples of 20 only)*
*Each clinic pack contains (20) 50ml cartridges. Mix and match any viscosities. One clinic pack is $199.00 ($9.95 each cartridge); order two or more clinic packs, and it is $9.75 each cartridge. Does not include mixing tips.
DESCRIPTION	COLOR	CONTENTS	PRICE	QTY
Light body crown set		(1) 50ml cartridges, no mixing tips	$9.95
Light body bridge set		(1) 50ml cartridges, no mixing tips	$9.95
Medium body crown set		(1) 50ml cartridges, no mixing tips	$9.95
Medium body bridge set		(1) 50ml cartridges, no mixing tips	$9.95
Monophase crown set		(1) 50ml cartridges, no mixing tips	$9.95
Monophase bridge set		(1) 50ml cartridges, no mixing tips	$9.95
Heavy body crown set		(1) 50ml cartridges, no mixing tips	$9.95
Heavy body bridge set		(1) 50ml cartridges, no mixing tips	$9.95
Bite registration - hard bite		(1) 50ml cartridges, no mixing tips	$9.95
Bite registration - clear bite		(1) 50ml cartridges, no mixing tips	$9.95

LIGHT BODY
DESCRIPTION	COLOR	CONTENTS	PRICE	QTY
Crown set		(2) 50ml cartridges, 6mixing tips, 6 intraoral tips	$28.00
Bridge set		(2) 50ml cartridges, 6 mixing tips, 6 intraoral tips	$28.00

MEDIUM BODY
DESCRIPTION	COLOR	CONTENTS	PRICE	QTY
Crown set		(2) 50ml cartridges, 6 mixing tips, 6 intraoral tips	$28.00
Bridge set		(2) 50ml cartridges, 6 mixing tips, 6 intraoral tips	$28.00

MONOPHASE
DESCRIPTION	COLOR	CONTENTS	PRICE	QTY
Crown set		(2) 50ml cartridges, 6 mixing tips, 6 intraoral tips	$28.00
Bridge set		(2) 50ml cartridges, 6 mixing tips, 6 intraoral tips	$28.00

HEAVY BODY
DESCRIPTION	COLOR	CONTENTS	PRICE	QTY
Crown set		(2) 50ml cartridges, 6 mixing tips	$28.00
Bridge set		(2) 50ml cartridges, 6 mixing tips	$28.00

PUTTY
DESCRIPTION	COLOR	CONTENTS	PRICE	QTY
Soft putty		(1) 260ml base, (1) 260ml catalyst, 2 spoons	$49.00

BITE REGISTRATION
DESCRIPTION	COLOR	CONTENTS	PRICE	QTY
Hard bite registration		(2) 50ml cartridges, 12 mixing tips	$28.00
Clear bite registration		(2) 50ml cartridges, 12 mixing tips	$28.00

ACCESSORIES
DESCRIPTION	CONTENTS	PRICE	QTY
Intraoral Tips	100 tips	$29.00
Mixing Tips (small, pink)	48 tips	$29.00
Mixing Tips (large, teal)	48 tips	$29.00
Universaltray adhesive, Red (metal trays)	10 ml	$9.00
Special tray adhesive, Blue (custom trays and disposable)	10 ml	$12.00
Dispensing gun	(1) gun	$59.00

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CUSTOMER INFORMATION
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