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

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Evaluation of the clinical effectiveness and safety of the MASTERBOND 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 aware that your personal data will not be collected, processed or disseminated without your knowledge and consent. It will only be used to confirm that the survey has been completed by an authorised person.

Address of the dental clinic/practice

Medical Representative's initials

If applicable
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Evaluation of the clinical effectiveness and safety of the MASTERBOND medical device

Since when have you been using the MASTERBOND medical device ?

Select one answer

How often do you use MASTERBOND in your practice?

Select one answer

How would you assess the volume (4 ml) of material in the MASTERBOND package?

Select one answer

Have you ever used the MASTERBOND medical device on:

Select one answer in each line

For which clinical indications do you use the MASTERBOND medical device?

Please mark the indications for which you have used the product (you can mark any number of indications):

In what other indications do you use MASTERBOND?*

How would you assess the clinical effectiveness of the MASTERBOND product in terms of the clinical indications listed in the Instructions for Use of the medical device?

1 – very low, 5– very high

What other indications?*

Please provide your indications and evaluation on a scale of 1-5.

How do you assess the clinical effectiveness of the medical device MASTERBOND compared to other bonding systems of a similar type?

Select one answer

What are the main factors, in your opinion, that most strongly affect the clinical effectiveness of bonding systems?

Select up to 3 answer

How do you assess the following usability features and properties of the MASTERBOND bonding system?

(1 – very low 5 – very high)

How would you assess the information contained on the MASTERBOND 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.

What information is missing or unclear?*

Has it ever happened during your professional practice that MASTERBOND:

Select one answer in each line

What kind of allergic reaction did MASTERBOND cause?*

Have you ever observed any adverse reactions after using MASTERBOND?

The answer YES must be explained.

What adverse reactions have been observed?*

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

The answer NO should be explained.

Why not?*

Which type or generation of bonding system do you think is optimal?

Select one answer

Other type of bonding system (which one?)*

Please specify what other type of bonding system you use

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

Which factor do you usually consider when deciding to purchase a bonding system?

Select one answer

Where do you usually obtain information about ARKONA products?

Select one or more answers
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