Endodontic Referral Form

Dr Ieuan Treharne is a special interest endodontist with a PGCert and currently undertaking his MSc in endodontics. Accepting referrals for:

Simple and complex endodontics
Re-root canal fillings
Perforation repairs
Open apices
Curved canals
Internal root resorption
Long canals
Post removal

Our prices are as follows:

30 minute consultation - £50 (deductible from treatment)
Root canal treatment incisor and canine - £400
Root canal treatment premolar - £500
Root canal treatment molar - £600
Re-root canal treatment (in addition to fee for root canal) - £50
Post or instrument removal (in addition to fee for root canal) - £100

All patients will be returned to your care with a temporary restoration/core build-up ready for cuspal coverage and a permanent option (unless specified on the form) and we operate completely non-judgementally to previous failed attempts.

Referrer Details

Dentist Name

GDC Number

Practice Name & Address

Telephone Number

Email Address

Patient Details

Patient Title

Patient Name

Patient Address

Date of Birth

Phone Number

Email Address

Relevant Medical History (Include conditions, medications, allergies)

Upload any radiographs or documents

Upload File

Case Details

Would you like us to place a permanent or temporary restoration?

Place a permanent restoration

Return with a temporary restoration

If the tooth is not restorable would you like Vitruvian Dental Studio to offer a dental implant option?

Yes

Additional information (optional)

Thanks for sending your referral! We will be in touch soon

Endodontic Referral Form

Dr Ieuan Treharne is a special interest endodontist with a PGCert and currently undertaking his MSc in endodontics. Accepting referrals for:

​

Simple and complex endodontics

Re-root canal fillings

Perforation repairs

Open apices

Curved canals

Internal root resorption

Long canals

Post removal

​

Our prices are as follows:

​

30 minute consultation - £50 (deductible from treatment)

Root canal treatment incisor and canine - £400

Root canal treatment premolar - £500

Root canal treatment molar - £600

Re-root canal treatment (in addition to fee for root canal) - £50

Post or instrument removal (in addition to fee for root canal) - £100

​

All patients will be returned to your care with a temporary restoration/core build-up ready for cuspal coverage and a permanent option (unless specified on the form) and we operate completely non-judgementally to previous failed attempts.

Referrer Details

Patient Details

Upload any radiographs or documents