MAJOR TREATMENT. (a) inlays, onlays and crowns;
MAJOR TREATMENT. Rendered or prescribedby a Physician, Surgeon, Dentist or Oral Surgeon, or renderedby a Dental Mechanic. Procedure RESTORATIVE SERVICES Amalgam Restorations Retentive Pins Retentive Pins Inlays and Crowns Silicate Restorations Acrylic or Composite Restorations Metal Inlay Restorations PorcelainRestorations Crowns Other Restorative Services ENDODONTIC SERVICES Pulp Capping Pulpotomy (Pulpotomy) primary concurrent with restoration Root Canal Therapy Primary tooth one than one root Periapical Services Service) three roots Root Amputation Other Endodontic Procedures Hemisection Bleaching IntentionalRemoval, apical Filling and Reimplantation Endosseous Implants Emergency Procedures PERIODONTAL SERVICES Non-surgical Services Surgical Services Adjunctive Periodontal Services Periodonticmaintenanceadjustments repair to periodontal appliances per unit of time (Periodontal) Reline special periodontal appliances (including occlusal guards)-(direct) Reline special periodontal appliances (including occlusal guards) (processed) Fee Guide Code No. SERVICES (Partial Dentures) Maxillary, without clasps acrylic base Mandibular, without clasps, acrylic base Denture Adjustments Denture Repairs Denture Duplication, Relining SURGICAL SERVICES Removal of Erupted Tooth Surgical Removals Removal of Residual Roots Alveoloplasty (bone remodellingof ridge with soft tissue revision) Alveoloplasty Alveoloplasty not in conjunctionwith extraction’s arch Excision of pericoronal gingiva for retained teeth and/or Stomatoplasty simple independent procedure Gingivoplasty and/or Stomatoplasty Osteoplasty Surgical Excision Surgical Incision (Surgical) Removal of foreign body, skin or subcutaneous areolar tissue (Surgical) Removal of reaction producing foreign bodies, system Miscellaneous ANESTHESIA General anesthesia unit of time General anesthesia each additional unit of time Provisionfor facilities and drugs for general anesthesia (only in conjunctionwith a separate anesthetist) per unit of time first unit of time Each additional unit of time PROSTHODONTICS REMOVABLE Complete Dentures Removable Partial Dentures PROSTHODONTICS FIXED Metal -Acid etch bonded per abutment tooth -pontic extra Retainers Crowns (Prosthetic Services) splinting Splintingfor extensive or complicated restorativedentistry Splinting Retentive Pins in Abutments ORTHODONTIC COVERAGE Effective date of ratification-the coverage will be added to Dental Plan provisions effective for treatments commencing from date of ratificati...
MAJOR TREATMENT. Rendered or prescribed by a Physician, Surgeon, Dentist or Oral Surgeon, or rendered by a Dental Mechanic. Procedure RESTORATIVE SERVICES Amalgam Restorations Retentive Pins Retentive Pins Inlays and Crowns Restorations Acrylic or Composite Restorations Metal Inlay Restorations Porcelain Restorations Crowns Other Restorative Services ENDODONTIC SERVICES Pulp Capping Pulpotomy (Pulpotomy) primary concurrent with restoration Root Canal Therapy Primary tooth one than one root Periapical Services Service) three roots Root ati on Other Endodontic Procedures Hemisection Intentional Removal, apical Filling and Reimplantation Endosseous Implants Emergency Procedures Fee Guide Code No.
MAJOR TREATMENT. The Plan pays for 50% of eligible expenses for the following services:
MAJOR TREATMENT. (a) inlays, and crowns; fixed bridgework; complete dentures; partial dentures;
MAJOR TREATMENT inlays, and crowns; fixed bridgework; complete dentures; partial dentures: repair or recementing of crowns, inlays, bridgework and dentures; periodontics: surgical services, post-surgical treatment, adjunctive procedures, post treatment evaluation. major surgery; examinations: prosthodontic oral examination, temporal mandibularjoint x-rays, diagnostic casts, prosthodontic evaluation. Covered Dental Expenses do not include and no payment will be made for: treatment furnished without charge or paid for directly or in directly by any government or for which a government prohibits payment of benefits, cosmetic treatment, experimental treatment, dietary planning, oral hygiene instructions, congenital or developmental malformation: treatment received from a dental or medical department maintained by the employer, a mutual benefit association, labour union, trustee or similar type of group; laboratory charges related to prosthodontic appliances which are in excess of of the total fixed fee for the procedure stated in the applicable fee guide; installation of an initial appliance (fixed bridgework, removable partial or complete denture) replacing natural teeth which were extracted prior to the effective date of coverage for the participant or dependent, unless necessitated by the extraction of additional natural teeth after the effective date of coverage for the participant or dependent; replacement of existing dentures or bridgework, crowns, inlay, or periodontal splinting unless:
