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id=\u0022chk-exclude-tooth-11-uns-label\u0022 title=\u0022Exclude Tooth 11 (UNS) \u0022\u003EExclude Tooth 11 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 11 (UNS) (11)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-9-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 9 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-9-uns\u0022 id=\u0022chk-include-tooth-9-uns-label\u0022 title=\u0022Include Tooth 9 (UNS) \u0022\u003EInclude Tooth 9 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-9-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 9 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-9-uns\u0022 id=\u0022chk-exclude-tooth-9-uns-label\u0022 title=\u0022Exclude Tooth 9 (UNS) \u0022\u003EExclude Tooth 9 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 9 (UNS) (10)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-8-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 8 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-8-uns\u0022 id=\u0022chk-include-tooth-8-uns-label\u0022 title=\u0022Include Tooth 8 (UNS) \u0022\u003EInclude Tooth 8 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-8-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 8 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-8-uns\u0022 id=\u0022chk-exclude-tooth-8-uns-label\u0022 title=\u0022Exclude Tooth 8 (UNS) \u0022\u003EExclude Tooth 8 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 8 (UNS) (9)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-upper-arch\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Upper arch\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-upper-arch\u0022 id=\u0022chk-include-upper-arch-label\u0022 title=\u0022Include Upper arch \u0022\u003EInclude Upper arch \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-upper-arch\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Upper arch\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-upper-arch\u0022 id=\u0022chk-exclude-upper-arch-label\u0022 title=\u0022Exclude Upper arch \u0022\u003EExclude Upper arch \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EUpper arch (7)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-head\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Head\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-head\u0022 id=\u0022chk-include-head-label\u0022 title=\u0022Include Head \u0022\u003EInclude Head \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-head\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Head\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-head\u0022 id=\u0022chk-exclude-head-label\u0022 title=\u0022Exclude Head \u0022\u003EExclude Head \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EHead (6)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-13-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 13 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-13-uns\u0022 id=\u0022chk-include-tooth-13-uns-label\u0022 title=\u0022Include Tooth 13 (UNS) \u0022\u003EInclude Tooth 13 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-13-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 13 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-13-uns\u0022 id=\u0022chk-exclude-tooth-13-uns-label\u0022 title=\u0022Exclude Tooth 13 (UNS) \u0022\u003EExclude Tooth 13 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 13 (UNS) (6)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-2-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 2 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-2-uns\u0022 id=\u0022chk-include-tooth-2-uns-label\u0022 title=\u0022Include Tooth 2 (UNS) \u0022\u003EInclude Tooth 2 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-2-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 2 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-2-uns\u0022 id=\u0022chk-exclude-tooth-2-uns-label\u0022 title=\u0022Exclude Tooth 2 (UNS) \u0022\u003EExclude Tooth 2 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 2 (UNS) (5)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-5-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 5 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-5-uns\u0022 id=\u0022chk-include-tooth-5-uns-label\u0022 title=\u0022Include Tooth 5 (UNS) \u0022\u003EInclude Tooth 5 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-5-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 5 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-5-uns\u0022 id=\u0022chk-exclude-tooth-5-uns-label\u0022 title=\u0022Exclude Tooth 5 (UNS) \u0022\u003EExclude Tooth 5 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 5 (UNS) (5)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-7-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 7 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-7-uns\u0022 id=\u0022chk-include-tooth-7-uns-label\u0022 title=\u0022Include Tooth 7 (UNS) \u0022\u003EInclude Tooth 7 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-7-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 7 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-7-uns\u0022 id=\u0022chk-exclude-tooth-7-uns-label\u0022 title=\u0022Exclude Tooth 7 (UNS) \u0022\u003EExclude Tooth 7 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 7 (UNS) (5)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-15-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 15 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-15-uns\u0022 id=\u0022chk-include-tooth-15-uns-label\u0022 title=\u0022Include Tooth 15 (UNS) \u0022\u003EInclude Tooth 15 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-15-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 15 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-15-uns\u0022 id=\u0022chk-exclude-tooth-15-uns-label\u0022 title=\u0022Exclude Tooth 15 (UNS) \u0022\u003EExclude Tooth 15 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 15 (UNS) (4)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-3-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 3 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-3-uns\u0022 id=\u0022chk-include-tooth-3-uns-label\u0022 title=\u0022Include Tooth 3 (UNS) \u0022\u003EInclude Tooth 3 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-3-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 3 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-3-uns\u0022 id=\u0022chk-exclude-tooth-3-uns-label\u0022 title=\u0022Exclude Tooth 3 (UNS) \u0022\u003EExclude Tooth 3 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 3 (UNS) (4)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-6-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 6 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-6-uns\u0022 id=\u0022chk-include-tooth-6-uns-label\u0022 title=\u0022Include Tooth 6 (UNS) \u0022\u003EInclude Tooth 6 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-6-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 6 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-6-uns\u0022 id=\u0022chk-exclude-tooth-6-uns-label\u0022 title=\u0022Exclude Tooth 6 (UNS) \u0022\u003EExclude Tooth 6 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 6 (UNS) (4)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-root\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth root\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-root\u0022 id=\u0022chk-include-tooth-root-label\u0022 title=\u0022Include Tooth root \u0022\u003EInclude Tooth root \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-root\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth root\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-root\u0022 id=\u0022chk-exclude-tooth-root-label\u0022 title=\u0022Exclude Tooth root \u0022\u003EExclude Tooth root \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth root (4)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-maxillary-sinus\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Maxillary sinus\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-maxillary-sinus\u0022 id=\u0022chk-include-maxillary-sinus-label\u0022 title=\u0022Include Maxillary sinus \u0022\u003EInclude Maxillary sinus \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-maxillary-sinus\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Maxillary sinus\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-maxillary-sinus\u0022 id=\u0022chk-exclude-maxillary-sinus-label\u0022 title=\u0022Exclude Maxillary sinus \u0022\u003EExclude Maxillary sinus \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EMaxillary sinus (3)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-14-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 14 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-14-uns\u0022 id=\u0022chk-include-tooth-14-uns-label\u0022 title=\u0022Include Tooth 14 (UNS) \u0022\u003EInclude Tooth 14 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-14-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 14 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-14-uns\u0022 id=\u0022chk-exclude-tooth-14-uns-label\u0022 title=\u0022Exclude Tooth 14 (UNS) \u0022\u003EExclude Tooth 14 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 14 (UNS) (3)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-29-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 29 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-29-uns\u0022 id=\u0022chk-include-tooth-29-uns-label\u0022 title=\u0022Include Tooth 29 (UNS) \u0022\u003EInclude Tooth 29 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-29-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 29 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-29-uns\u0022 id=\u0022chk-exclude-tooth-29-uns-label\u0022 title=\u0022Exclude Tooth 29 (UNS) \u0022\u003EExclude Tooth 29 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 29 (UNS) (3)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-30-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 30 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-30-uns\u0022 id=\u0022chk-include-tooth-30-uns-label\u0022 title=\u0022Include Tooth 30 (UNS) \u0022\u003EInclude Tooth 30 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-30-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 30 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-30-uns\u0022 id=\u0022chk-exclude-tooth-30-uns-label\u0022 title=\u0022Exclude Tooth 30 (UNS) \u0022\u003EExclude Tooth 30 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 30 (UNS) (3)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-31-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 31 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-31-uns\u0022 id=\u0022chk-include-tooth-31-uns-label\u0022 title=\u0022Include Tooth 31 (UNS) \u0022\u003EInclude Tooth 31 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-31-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 31 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-31-uns\u0022 id=\u0022chk-exclude-tooth-31-uns-label\u0022 title=\u0022Exclude Tooth 31 (UNS) \u0022\u003EExclude Tooth 31 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 31 (UNS) (3)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-4-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 4 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-4-uns\u0022 id=\u0022chk-include-tooth-4-uns-label\u0022 title=\u0022Include Tooth 4 (UNS) \u0022\u003EInclude Tooth 4 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-4-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 4 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-4-uns\u0022 id=\u0022chk-exclude-tooth-4-uns-label\u0022 title=\u0022Exclude Tooth 4 (UNS) \u0022\u003EExclude Tooth 4 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 4 (UNS) (3)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-dental-pulp-cavity\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Dental pulp cavity\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-dental-pulp-cavity\u0022 id=\u0022chk-include-dental-pulp-cavity-label\u0022 title=\u0022Include Dental pulp cavity \u0022\u003EInclude Dental pulp cavity \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-dental-pulp-cavity\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Dental pulp cavity\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-dental-pulp-cavity\u0022 id=\u0022chk-exclude-dental-pulp-cavity-label\u0022 title=\u0022Exclude Dental pulp cavity \u0022\u003EExclude Dental pulp cavity \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EDental pulp cavity (2)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-face-anatomy\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Face (anatomy)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-face-anatomy\u0022 id=\u0022chk-include-face-anatomy-label\u0022 title=\u0022Include Face (anatomy) \u0022\u003EInclude Face (anatomy) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-face-anatomy\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Face (anatomy)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-face-anatomy\u0022 id=\u0022chk-exclude-face-anatomy-label\u0022 title=\u0022Exclude Face (anatomy) \u0022\u003EExclude Face (anatomy) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EFace (anatomy) (2)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-incisors\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Incisors\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-incisors\u0022 id=\u0022chk-include-incisors-label\u0022 title=\u0022Include Incisors \u0022\u003EInclude Incisors \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-incisors\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Incisors\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-incisors\u0022 id=\u0022chk-exclude-incisors-label\u0022 title=\u0022Exclude Incisors \u0022\u003EExclude Incisors \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EIncisors (2)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-19-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 19 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-19-uns\u0022 id=\u0022chk-include-tooth-19-uns-label\u0022 title=\u0022Include Tooth 19 (UNS) \u0022\u003EInclude Tooth 19 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-19-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 19 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-19-uns\u0022 id=\u0022chk-exclude-tooth-19-uns-label\u0022 title=\u0022Exclude Tooth 19 (UNS) \u0022\u003EExclude Tooth 19 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 19 (UNS) (2)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-23-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 23 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-23-uns\u0022 id=\u0022chk-include-tooth-23-uns-label\u0022 title=\u0022Include Tooth 23 (UNS) \u0022\u003EInclude Tooth 23 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-23-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 23 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-23-uns\u0022 id=\u0022chk-exclude-tooth-23-uns-label\u0022 title=\u0022Exclude Tooth 23 (UNS) \u0022\u003EExclude Tooth 23 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 23 (UNS) (2)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-24-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 24 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-24-uns\u0022 id=\u0022chk-include-tooth-24-uns-label\u0022 title=\u0022Include Tooth 24 (UNS) \u0022\u003EInclude Tooth 24 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-24-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 24 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-24-uns\u0022 id=\u0022chk-exclude-tooth-24-uns-label\u0022 title=\u0022Exclude Tooth 24 (UNS) \u0022\u003EExclude Tooth 24 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 24 (UNS) (2)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-27-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 27 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-27-uns\u0022 id=\u0022chk-include-tooth-27-uns-label\u0022 title=\u0022Include Tooth 27 (UNS) \u0022\u003EInclude Tooth 27 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-27-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 27 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-27-uns\u0022 id=\u0022chk-exclude-tooth-27-uns-label\u0022 title=\u0022Exclude Tooth 27 (UNS) \u0022\u003EExclude Tooth 27 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 27 (UNS) (2)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-28-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 28 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-28-uns\u0022 id=\u0022chk-include-tooth-28-uns-label\u0022 title=\u0022Include Tooth 28 (UNS) \u0022\u003EInclude Tooth 28 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-28-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 28 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-28-uns\u0022 id=\u0022chk-exclude-tooth-28-uns-label\u0022 title=\u0022Exclude Tooth 28 (UNS) \u0022\u003EExclude Tooth 28 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 28 (UNS) (2)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-32-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 32 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-32-uns\u0022 id=\u0022chk-include-tooth-32-uns-label\u0022 title=\u0022Include Tooth 32 (UNS) \u0022\u003EInclude Tooth 32 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-32-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 32 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-32-uns\u0022 id=\u0022chk-exclude-tooth-32-uns-label\u0022 title=\u0022Exclude Tooth 32 (UNS) \u0022\u003EExclude Tooth 32 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 32 (UNS) (2)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-artificial-crowns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Artificial crowns\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-artificial-crowns\u0022 id=\u0022chk-include-artificial-crowns-label\u0022 title=\u0022Include Artificial crowns \u0022\u003EInclude Artificial crowns \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-artificial-crowns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Artificial crowns\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-artificial-crowns\u0022 id=\u0022chk-exclude-artificial-crowns-label\u0022 title=\u0022Exclude Artificial crowns \u0022\u003EExclude Artificial crowns \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EArtificial crowns (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-bicuspids\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Bicuspids\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-bicuspids\u0022 id=\u0022chk-include-bicuspids-label\u0022 title=\u0022Include Bicuspids \u0022\u003EInclude Bicuspids \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-bicuspids\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Bicuspids\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-bicuspids\u0022 id=\u0022chk-exclude-bicuspids-label\u0022 title=\u0022Exclude Bicuspids \u0022\u003EExclude Bicuspids \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EBicuspids (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-cuspids\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Cuspids\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-cuspids\u0022 id=\u0022chk-include-cuspids-label\u0022 title=\u0022Include Cuspids \u0022\u003EInclude Cuspids \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-cuspids\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Cuspids\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-cuspids\u0022 id=\u0022chk-exclude-cuspids-label\u0022 title=\u0022Exclude Cuspids \u0022\u003EExclude Cuspids \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ECuspids (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-dental-enamel\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Dental enamel\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-dental-enamel\u0022 id=\u0022chk-include-dental-enamel-label\u0022 title=\u0022Include Dental enamel \u0022\u003EInclude Dental enamel \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-dental-enamel\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Dental enamel\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-dental-enamel\u0022 id=\u0022chk-exclude-dental-enamel-label\u0022 title=\u0022Exclude Dental enamel \u0022\u003EExclude Dental enamel \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EDental enamel (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-dentin\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Dentin\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-dentin\u0022 id=\u0022chk-include-dentin-label\u0022 title=\u0022Include Dentin \u0022\u003EInclude Dentin \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-dentin\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Dentin\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-dentin\u0022 id=\u0022chk-exclude-dentin-label\u0022 title=\u0022Exclude Dentin \u0022\u003EExclude Dentin \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EDentin (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-lower-arch\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Lower arch\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-lower-arch\u0022 id=\u0022chk-include-lower-arch-label\u0022 title=\u0022Include Lower arch \u0022\u003EInclude Lower arch \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-lower-arch\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Lower arch\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-lower-arch\u0022 id=\u0022chk-exclude-lower-arch-label\u0022 title=\u0022Exclude Lower arch \u0022\u003EExclude Lower arch \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ELower arch (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-molars\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Molars\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-molars\u0022 id=\u0022chk-include-molars-label\u0022 title=\u0022Include Molars \u0022\u003EInclude Molars \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-molars\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Molars\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-molars\u0022 id=\u0022chk-exclude-molars-label\u0022 title=\u0022Exclude Molars \u0022\u003EExclude Molars \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EMolars (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-neck\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Neck\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-neck\u0022 id=\u0022chk-include-neck-label\u0022 title=\u0022Include Neck \u0022\u003EInclude Neck \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-neck\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Neck\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-neck\u0022 id=\u0022chk-exclude-neck-label\u0022 title=\u0022Exclude Neck \u0022\u003EExclude Neck \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ENeck (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-periodontium\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Periodontium\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-periodontium\u0022 id=\u0022chk-include-periodontium-label\u0022 title=\u0022Include Periodontium \u0022\u003EInclude Periodontium \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-periodontium\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Periodontium\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-periodontium\u0022 id=\u0022chk-exclude-periodontium-label\u0022 title=\u0022Exclude Periodontium \u0022\u003EExclude Periodontium \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003EPeriodontium (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-skin\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Skin\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-skin\u0022 id=\u0022chk-include-skin-label\u0022 title=\u0022Include Skin \u0022\u003EInclude Skin \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-skin\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Skin\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-skin\u0022 id=\u0022chk-exclude-skin-label\u0022 title=\u0022Exclude Skin \u0022\u003EExclude Skin \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ESkin (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-1-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 1 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-1-uns\u0022 id=\u0022chk-include-tooth-1-uns-label\u0022 title=\u0022Include Tooth 1 (UNS) \u0022\u003EInclude Tooth 1 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-1-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 1 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-1-uns\u0022 id=\u0022chk-exclude-tooth-1-uns-label\u0022 title=\u0022Exclude Tooth 1 (UNS) \u0022\u003EExclude Tooth 1 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 1 (UNS) (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-20-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 20 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-20-uns\u0022 id=\u0022chk-include-tooth-20-uns-label\u0022 title=\u0022Include Tooth 20 (UNS) \u0022\u003EInclude Tooth 20 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-20-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 20 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-20-uns\u0022 id=\u0022chk-exclude-tooth-20-uns-label\u0022 title=\u0022Exclude Tooth 20 (UNS) \u0022\u003EExclude Tooth 20 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 20 (UNS) (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022even\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-25-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 25 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-25-uns\u0022 id=\u0022chk-include-tooth-25-uns-label\u0022 title=\u0022Include Tooth 25 (UNS) \u0022\u003EInclude Tooth 25 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-25-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 25 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-25-uns\u0022 id=\u0022chk-exclude-tooth-25-uns-label\u0022 title=\u0022Exclude Tooth 25 (UNS) \u0022\u003EExclude Tooth 25 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 25 (UNS) (1)\u003C\/td\u003E \u003C\/tr\u003E\n \u003Ctr class=\u0022odd\u0022\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-0-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-include-tooth-26-uns\u0022 name=\u0022f[0][]\u0022 value=\u0022parts_treated_facet:Tooth 26 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-include-tooth-26-uns\u0022 id=\u0022chk-include-tooth-26-uns-label\u0022 title=\u0022Include Tooth 26 (UNS) \u0022\u003EInclude Tooth 26 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd style=\u0022text-align: center; width: 70px;\u0022\u003E\u003Cdiv class=\u0022form-item form-type-checkbox form-item-f-\u0022\u003E\n \u003Cinput type=\u0022checkbox\u0022 class=\u0022checkbox-with-label form-checkbox\u0022 id=\u0022chk-exclude-tooth-26-uns\u0022 name=\u0022f[]\u0022 value=\u0022-parts_treated_facet:Tooth 26 (UNS)\u0022 \/\u003E \u003Clabel class=\u0022option\u0022 for=\u0022chk-exclude-tooth-26-uns\u0022 id=\u0022chk-exclude-tooth-26-uns-label\u0022 title=\u0022Exclude Tooth 26 (UNS) \u0022\u003EExclude Tooth 26 (UNS) \u003C\/label\u003E\n \n\u003C\/div\u003E\n\u003C\/td\u003E\u003Ctd\u003ETooth 26 (UNS) (1)\u003C\/td\u003E \u003C\/tr\u003E\n\u003C\/tbody\u003E\n\u003C\/table\u003E\n\u003Cscript\u003EjQuery.lazrfacet_term_select_form(\u0027#lazr-facet-term-select\u0027);\u003C\/script\u003E\u003C\/form\u003E"}]