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IV. LIMITATIONS: The benefits as outlined are subject to the following limitations: (a) X-rays: Complete mouth x-rays are provided only once in a three (3) year period, unless special need is shown. Supplementary bite-wing x-rays are provided upon request but not more than once every six {6) months. (b) Crowns, Jacketsand Gold Restorations: Replacement will be made only after five {5) years have elapsed following any prior provision of crowns, jackets or gold restorations under any CDS program. {c) Pnssthodontics: Prosthodontic appliances (inCluding but not limited to: fixed bridges, partial or complete dentures) will be replaced only after five (5) years have elapsed following any prior provision of such appliances under any CDS program, except when CDS determines that there is such extensive loss of remaining teeth or change in supporting tissues that the existing appliance cannot be made satisfactory. Replacement will be made of a prosthodontic appliance not provided under a CDS program only if it is unsatisfactory and cannot be made satisfactory, (d) Optional: In all cases in which the patient selects a more expensive plan of treatment than is customarily provided, CDS will pay the applicable percentage of the lesser fee. The patient is responsible for the remainder of the dentist's fee. (1) Partial Dentures. CDS will provide a standard cast chrome or acrylic partial denture or will allow the cost of such procedure toward a more complicated or precision appliance that patient and dentist may choose to use, Any denture for which a charge is made which exceeds the customary fee shall be considered an optional service. (2) Complete Dentures. If in the construction of a denture the patient and dentist decide on personalized restorations or employ specialized techniques as opposed to standard procedures, CDS will allow an appropriate amount for the standard denture toward such treatment and the patient must bear the difference in cost. Any denture for which a charge is made which exceeds the customary fee shall be considered an optional service, (3) Implants. If implants are utilized, CDS will allow the cost of a standard complete or partial denture toward the cost of implants and appliances constructed in association therewith. CDS will not provide surgical removal of implants. If CDS makes an allowance toward the cost of implants, CDS will not pay for any replacement appliance placed within five (5) years thereafter, -2- 3-76-S