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Evaluation of the clinical effectiveness and safety of the NEXT medical device

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Evaluation of the clinical effectiveness and safety of the NEXT medical device

Please be informed that your data obtained as a result of previous contacts with ARKONA Laboratorium Farmakologii Stomatologicznej Grzegorz Kalbarczyk (hereinafter referred to as ARKONA) is stored in the ARKONA Contractor Database, which is the administrator of your personal data. Details regarding ARKONA's personal data protection policy are available at https://arkonadent.com/wp-content/uploads/2020/10/arkonadent.com-polityka-prywatnosci.pdf. If you would like to obtain detailed information about the rules and purposes of ARKONA's processing of your personal data, please contact us at the following e-mail address: polityka.prywatnosci@arkonadent.com or at the postal address Nasutów 99C, 21-025 Niemce, Poland.

Doctor's personal details, professional licence number

Please provide your first name, surname and professional licence number. Please be advised that your personal data will not be collected, processed or disseminated without your knowledge and consent. It will be used solely to confirm that the survey has been completed by an authorised person.

Address of dental clinic/practice

Email address of the doctor or medical practice

Medical Representative initials

if applicable
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Evaluation of the clinical effectiveness and safety of the NEXT medical device

Since when have you been using the NEXT medical device?

Select one answer

How often do you use NEXT in your practice?

Select one answear

Which NEXT shades do you use in your practice?

Select one or more answers

Do you think that the above-mentioned number of NEXT composite shades is

Select one answer

Please specify which shades are missing*:

What type of NEXT product packaging do you use?

Select one or more answers

How do you assess the volume (0.2 g) of material in the NEXT blister pack?

Select one answer

How do you assess the volume (0.07 g) of material in the NEXT blister pack?

Select one answer

Would you use NEXT composite in syringes if it were available in ARKONA's offer?

Select one answer

For which clinical indications do you use the NEXT medical device? Please select the indications for which you have used the device:

You can select any number of options.

Have you ever used the NEXT medical device on:

Select one answer in each line

How would you assess the clinical effectiveness of NEXT in terms of the clinical indications for which it is used?

1 – very low, 5 – very high

What other indications?*

Please provide your indications and rating from 1 to 5.

How long do you expect the NEXT new filling/work to last in the patient's mouth?

Select one answer

How would you assess the durability of NEXT composite in the patient's mouth compared to other composite materials of a similar type?

Select one answer

In your opinion, what are the main factors that most influence the durability of composites in the patient's mouth?

You can select a minimum 1 and a maximum 3 answers.

How would you assess the following functional characteristics and features of NEXT composite?

(1 – very low, 5 – very high)

How would you assess the consistency of NEXT composite when placing:

Select one answer in each line

How would you assess the information contained on the NEXT label or in the instructions for use (indications, method of use, contraindications, side effects, warnings, etc.), i.e. is it complete, sufficient and understandable?

The answer NO should be justified by explaining what information is missing or unclear.

During the last 3 years of your professional practice, has it ever happened that NEXT:

Select one answer in each line

What kind of allergic reaction did NEXT cause?*

Have you ever noticed any adverse reactions after using NEXT?

The answer YES must be explained. What side effects have been observed?

What adverse reactions have been observed?*

Do you consider the NEXT to be safe for the clinical indications described in the instructions for use?

The answer NO should be justified

Why not?*

What factors do you usually consider or would consider when deciding to purchase this type of composite?

Select one answer

Do you have any comments, suggestions, ideas or concerns regarding the NEXT medical device that would help us improve our product?

Where do you usually obtain information about ARKONA products?

Select one or more answers
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