| Dental Appliances/Prostheses | Dental Appliances/Prostheses | Class I
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| Denture reliner, hard | Denture reliner, hard |
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| Denture clasp, metal, custom-made | Denture clasp, metal, custom-made |
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| Complete upper denture | Complete upper denture |
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| Complete lower denture | Complete lower denture |
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| Overdenture | Overdenture |
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| Partial denture | Partial denture |
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| Orthodontic retainer | Orthodontic retainer |
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| Dental occlusal splint, custom-made | Dental occlusal splint, custom-made |
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| Mandible-repositioning sleep-disordered breathing orthosis | Mandible-repositioning sleep-disordered breathing orthosis |
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| Mouthguard, reusable | Mouthguard, reusable |
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