Complete Dentistry commercial suite with PMS depth.

Add plan lifecycle, visit stages with chair/recovery points, primary dentition charting, imaging void, revenue reports, perio exams, lab cases, and recalls. Co-authored-by: Cursor <cursoragent@cursor.com>
2026-07-18 17:11:15 +00:00
parent e227f8705f
commit ce782382c5
37 changed files with 2458 additions and 204 deletions
@@ -4,16 +4,24 @@ namespace App\Http\Controllers\Care;

 use App\Http\Controllers\Care\Concerns\ScopesToAccount;
 use App\Http\Controllers\Controller;
+use App\Models\DentalImage;
+use App\Models\DentalLabCase;
+use App\Models\DentalPlanItem;
+use App\Models\DentalRecall;
 use App\Models\Visit;
 use App\Services\Care\Dentistry\DentalAnalyticsService;
 use App\Services\Care\Dentistry\DentalCatalog;
 use App\Services\Care\Dentistry\DentalChartService;
 use App\Services\Care\Dentistry\DentalImagingService;
+use App\Services\Care\Dentistry\DentalLabCaseService;
+use App\Services\Care\Dentistry\DentalPerioService;
 use App\Services\Care\Dentistry\DentalProcedureService;
+use App\Services\Care\Dentistry\DentalRecallService;
 use App\Services\Care\Dentistry\DentalTreatmentPlanService;
 use App\Services\Care\Dentistry\DentalVisitNoteService;
 use App\Services\Care\SpecialtyModuleService;
 use App\Services\Care\SpecialtyShellService;
+use App\Services\Care\SpecialtyVisitStageService;
 use Illuminate\Http\RedirectResponse;
 use Illuminate\Http\Request;
 use Illuminate\View\View;
@@ -279,10 +287,13 @@ class DentistryWorkspaceController extends Controller
        $member = $this->member($request);
        $branchScope = app(\App\Services\Care\OrganizationResolver::class)->branchScope($member);

+        $from = $request->query('from');
+        $to = $request->query('to');
+
        return view('care.specialty.dentistry.reports', [
            'moduleKey' => 'dentistry',
            'definition' => $modules->definition('dentistry'),
-            'report' => $analytics->report($organization, $this->ownerRef($request), $branchScope),
+            'report' => $analytics->report($organization, $this->ownerRef($request), $branchScope, $from, $to),
            'modalities' => DentalCatalog::modalities(),
            'currency' => config('care.billing.currency', 'GHS'),
            'shellNav' => $shell->navItems('dentistry'),
@@ -316,4 +327,460 @@ class DentistryWorkspaceController extends Controller
            'conditions' => DentalCatalog::conditions(),
        ]);
    }
+
+    public function setDentition(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        DentalChartService $charts,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'dentition' => ['required', 'string', 'in:adult,primary,mixed'],
+        ]);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+        $visit->loadMissing('patient');
+        $chart = $charts->chartForPatient($organization, $visit->patient, $owner);
+
+        try {
+            $charts->setDentition(
+                $chart,
+                $validated['dentition'],
+                $owner,
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'odontogram'])
+            ->with('success', 'Dentition updated.');
+    }
+
+    public function updatePlanItem(
+        Request $request,
+        Visit $visit,
+        DentalPlanItem $item,
+        SpecialtyModuleService $modules,
+        DentalTreatmentPlanService $plans,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'procedure_code' => ['required', 'string', 'max:64'],
+            'tooth_code' => ['nullable', 'string', 'max:8'],
+            'surfaces' => ['nullable', 'array'],
+            'surfaces.*' => ['string', 'max:2'],
+            'priority' => ['nullable', 'integer', 'min:1', 'max:100'],
+            'notes' => ['nullable', 'string', 'max:2000'],
+        ]);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+        $visit->loadMissing('patient');
+        $plan = $plans->activePlanForPatient($organization, $visit->patient, $owner);
+        abort_unless($plan && $item->treatment_plan_id === $plan->id, 404);
+
+        try {
+            $plans->updateItem($item, $organization, $validated, $owner, $this->actorRef($request));
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'plan'])
+            ->with('success', 'Plan item updated.');
+    }
+
+    public function cancelPlanItem(
+        Request $request,
+        Visit $visit,
+        DentalPlanItem $item,
+        SpecialtyModuleService $modules,
+        DentalTreatmentPlanService $plans,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+        $visit->loadMissing('patient');
+        $plan = $plans->activePlanForPatient($organization, $visit->patient, $owner);
+        abort_unless($plan && $item->treatment_plan_id === $plan->id, 404);
+
+        try {
+            $plans->cancelItem($item, $owner, $this->actorRef($request));
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'plan'])
+            ->with('success', 'Plan item cancelled.');
+    }
+
+    public function rejectPlan(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        DentalTreatmentPlanService $plans,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'rejection_reason' => ['nullable', 'string', 'max:2000'],
+        ]);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+        $visit->loadMissing('patient');
+        $plan = $plans->activePlanForPatient($organization, $visit->patient, $owner);
+        if (! $plan) {
+            return back()->with('error', 'No open treatment plan.');
+        }
+
+        try {
+            $plans->rejectPlan(
+                $plan,
+                $owner,
+                $validated['rejection_reason'] ?? null,
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'plan'])
+            ->with('success', 'Treatment plan rejected.');
+    }
+
+    public function cancelPlan(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        DentalTreatmentPlanService $plans,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+        $visit->loadMissing('patient');
+        $plan = $plans->activePlanForPatient($organization, $visit->patient, $owner);
+        if (! $plan) {
+            return back()->with('error', 'No open treatment plan.');
+        }
+
+        try {
+            $plans->cancelPlan($plan, $owner, $this->actorRef($request));
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'plan'])
+            ->with('success', 'Treatment plan cancelled.');
+    }
+
+    public function voidImage(
+        Request $request,
+        Visit $visit,
+        DentalImage $image,
+        SpecialtyModuleService $modules,
+        DentalImagingService $imaging,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $visit->loadMissing('patient');
+        abort_unless(
+            $image->organization_id === $organization->id
+            && ($image->visit_id === $visit->id || $image->patient_id === $visit->patient_id),
+            404,
+        );
+
+        try {
+            $imaging->void($image, $this->ownerRef($request), $this->actorRef($request));
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'imaging'])
+            ->with('success', 'Image removed.');
+    }
+
+    public function setStage(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyVisitStageService $stages,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'dentistry',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'overview'])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function savePerio(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        DentalPerioService $perio,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'sites' => ['nullable', 'array'],
+            'sites.*.tooth_code' => ['required', 'string', 'max:8'],
+            'sites.*.surface' => ['required', 'string', 'max:8'],
+            'sites.*.probing_mm' => ['nullable', 'integer', 'min:0', 'max:20'],
+            'sites.*.bleeding' => ['nullable', 'boolean'],
+            'sites.*.plaque' => ['nullable', 'boolean'],
+            'sites.*.recession_mm' => ['nullable', 'integer', 'min:0', 'max:20'],
+            'notes' => ['nullable', 'string', 'max:5000'],
+        ]);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+        $visit->loadMissing('patient');
+
+        try {
+            $perio->saveExam(
+                $organization,
+                $visit->patient,
+                $owner,
+                $validated['sites'] ?? [],
+                $visit,
+                $validated['notes'] ?? null,
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'perio'])
+            ->with('success', 'Perio exam saved.');
+    }
+
+    public function createLabCase(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        DentalLabCaseService $labCases,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'case_type' => ['required', 'string', 'in:crown,bridge,denture,veneer,ortho,other'],
+            'lab_name' => ['nullable', 'string', 'max:255'],
+            'tooth_codes' => ['nullable', 'array'],
+            'tooth_codes.*' => ['string', 'max:8'],
+            'due_at' => ['nullable', 'date'],
+            'notes' => ['nullable', 'string', 'max:2000'],
+            'status' => ['nullable', 'string', 'in:draft,ordered,sent,received,fitted,cancelled'],
+        ]);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+        $visit->loadMissing('patient');
+
+        try {
+            $labCases->create(
+                $organization,
+                $visit->patient,
+                $owner,
+                $validated,
+                $visit,
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'lab'])
+            ->with('success', 'Lab case created.');
+    }
+
+    public function transitionLabCase(
+        Request $request,
+        Visit $visit,
+        DentalLabCase $labCase,
+        SpecialtyModuleService $modules,
+        DentalLabCaseService $labCases,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'status' => ['required', 'string', 'in:draft,ordered,sent,received,fitted,cancelled'],
+        ]);
+
+        $organization = $this->organization($request);
+        $visit->loadMissing('patient');
+        abort_unless(
+            $labCase->organization_id === $organization->id
+            && $labCase->patient_id === $visit->patient_id,
+            404,
+        );
+
+        try {
+            $labCases->transition(
+                $labCase,
+                $validated['status'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'lab'])
+            ->with('success', 'Lab case updated.');
+    }
+
+    public function scheduleRecall(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        DentalRecallService $recalls,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'due_on' => ['required', 'date'],
+            'reason' => ['nullable', 'string', 'max:255'],
+            'notes' => ['nullable', 'string', 'max:2000'],
+        ]);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+        $visit->loadMissing('patient');
+
+        try {
+            $recalls->schedule(
+                $organization,
+                $visit->patient,
+                $owner,
+                $validated,
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'recalls'])
+            ->with('success', 'Recall scheduled.');
+    }
+
+    public function completeRecall(
+        Request $request,
+        Visit $visit,
+        DentalRecall $recall,
+        SpecialtyModuleService $modules,
+        DentalRecallService $recalls,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $visit->loadMissing('patient');
+        abort_unless(
+            $recall->organization_id === $organization->id
+            && $recall->patient_id === $visit->patient_id,
+            404,
+        );
+
+        try {
+            $recalls->complete(
+                $recall,
+                $this->ownerRef($request),
+                $visit,
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'recalls'])
+            ->with('success', 'Recall completed.');
+    }
+
+    public function cancelRecall(
+        Request $request,
+        Visit $visit,
+        DentalRecall $recall,
+        SpecialtyModuleService $modules,
+        DentalRecallService $recalls,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertDentistryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $visit->loadMissing('patient');
+        abort_unless(
+            $recall->organization_id === $organization->id
+            && $recall->patient_id === $visit->patient_id,
+            404,
+        );
+
+        try {
+            $recalls->cancel($recall, $this->ownerRef($request), $this->actorRef($request));
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $visit, 'tab' => 'recalls'])
+            ->with('success', 'Recall cancelled.');
+    }
 }
@@ -197,6 +197,31 @@ class SpecialtyModuleController extends Controller
        }

        $visit = $visit->fresh() ?? $appointment->visit;
+        if ($visit) {
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $nextStage = $stageService->stageOnConsultationStart($module);
+            if ($nextStage && ! $visit->specialty_stage) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        $module,
+                        $nextStage,
+                        $owner,
+                        $owner,
+                    );
+                    $visit = $visit->fresh();
+                } catch (\InvalidArgumentException) {
+                    // Stage map may be empty for some modules.
+                }
+            } elseif ($nextStage && $visit->specialty_stage === 'waiting') {
+                try {
+                    $stageService->setStage($organization, $visit, $module, $nextStage, $owner, $owner);
+                    $visit = $visit->fresh();
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
        $clinical = app(SpecialtyClinicalRecordService::class);
        $shellTabs = app(SpecialtyShellService::class)->workspaceTabs($module);
        $preferredTab = $module === 'dentistry'
@@ -512,6 +537,7 @@ class SpecialtyModuleController extends Controller
        $dentalChart = null;
        $dentalTeethMap = [];
        $dentalPlan = null;
+        $dentalPlanHistory = collect();
        $dentalProcedures = collect();
        $dentalImages = collect();
        $dentalVisitNote = null;
@@ -521,6 +547,14 @@ class SpecialtyModuleController extends Controller
        $dentalStatuses = [];
        $dentalSurfaces = [];
        $dentalModalities = [];
+        $dentalDentitions = [];
+        $dentalPerioExam = null;
+        $dentalPerioSurfaces = [];
+        $dentalLabCases = collect();
+        $dentalLabCaseTypes = [];
+        $dentalLabCaseStatuses = [];
+        $dentalRecalls = collect();
+        $dentalStageCodes = [];
        $activeTab = (string) $request->query('tab', array_key_first($shell->workspaceTabs($module)) ?: 'overview');
        $clinical = app(SpecialtyClinicalRecordService::class);

@@ -576,10 +610,14 @@ class SpecialtyModuleController extends Controller
                $chartService = app(\App\Services\Care\Dentistry\DentalChartService::class);
                $planService = app(\App\Services\Care\Dentistry\DentalTreatmentPlanService::class);
                $analytics = app(\App\Services\Care\Dentistry\DentalAnalyticsService::class);
+                $perioService = app(\App\Services\Care\Dentistry\DentalPerioService::class);
+                $labService = app(\App\Services\Care\Dentistry\DentalLabCaseService::class);
+                $recallService = app(\App\Services\Care\Dentistry\DentalRecallService::class);

                $dentalChart = $chartService->chartForPatient($organization, $workspaceVisit->patient, $owner);
                $dentalTeethMap = $chartService->teethMap($dentalChart);
                $dentalPlan = $planService->activePlanForPatient($organization, $workspaceVisit->patient, $owner);
+                $dentalPlanHistory = $planService->plansForPatient($organization, $workspaceVisit->patient, $owner);
                $dentalProcedures = \App\Models\DentalProcedure::owned($owner)
                    ->where('visit_id', $workspaceVisit->id)
                    ->orderByDesc('id')
@@ -600,11 +638,20 @@ class SpecialtyModuleController extends Controller
                    ->where('visit_id', $workspaceVisit->id)
                    ->first();
                $dentalCatalog = $shell->provisionedServices($organization, 'dentistry');
-                $dentalRows = \App\Services\Care\Dentistry\DentalCatalog::odontogramRows();
+                $dentition = $dentalChart->dentition ?: \App\Services\Care\Dentistry\DentalCatalog::DENTITION_ADULT;
+                $dentalRows = \App\Services\Care\Dentistry\DentalCatalog::odontogramRows($dentition);
                $dentalConditions = \App\Services\Care\Dentistry\DentalCatalog::conditions();
                $dentalStatuses = \App\Services\Care\Dentistry\DentalCatalog::toothStatuses();
                $dentalSurfaces = \App\Services\Care\Dentistry\DentalCatalog::surfaces();
                $dentalModalities = \App\Services\Care\Dentistry\DentalCatalog::modalities();
+                $dentalDentitions = \App\Services\Care\Dentistry\DentalCatalog::dentitions();
+                $dentalPerioExam = $perioService->latestForPatient($organization, $workspaceVisit->patient, $owner);
+                $dentalPerioSurfaces = \App\Services\Care\Dentistry\DentalCatalog::perioSurfaces();
+                $dentalLabCases = $labService->casesForPatient($organization, $workspaceVisit->patient, $owner);
+                $dentalLabCaseTypes = \App\Services\Care\Dentistry\DentalCatalog::labCaseTypes();
+                $dentalLabCaseStatuses = \App\Services\Care\Dentistry\DentalCatalog::labCaseStatuses();
+                $dentalRecalls = $recallService->recallsForPatient($organization, $workspaceVisit->patient, $owner);
+                $dentalStageCodes = collect($shell->stages('dentistry'))->pluck('code')->all();

                $clinicalAlerts = array_merge(
                    $clinicalAlerts,
@@ -664,6 +711,7 @@ class SpecialtyModuleController extends Controller
            'dentalChart' => $dentalChart,
            'dentalTeethMap' => $dentalTeethMap,
            'dentalPlan' => $dentalPlan,
+            'dentalPlanHistory' => $dentalPlanHistory,
            'dentalProcedures' => $dentalProcedures,
            'dentalImages' => $dentalImages,
            'dentalVisitNote' => $dentalVisitNote,
@@ -673,6 +721,14 @@ class SpecialtyModuleController extends Controller
            'dentalStatuses' => $dentalStatuses,
            'dentalSurfaces' => $dentalSurfaces,
            'dentalModalities' => $dentalModalities,
+            'dentalDentitions' => $dentalDentitions,
+            'dentalPerioExam' => $dentalPerioExam,
+            'dentalPerioSurfaces' => $dentalPerioSurfaces,
+            'dentalLabCases' => $dentalLabCases,
+            'dentalLabCaseTypes' => $dentalLabCaseTypes,
+            'dentalLabCaseStatuses' => $dentalLabCaseStatuses,
+            'dentalRecalls' => $dentalRecalls,
+            'dentalStageCodes' => $dentalStageCodes,
            'queueStubs' => $modules->queueStubsFor($organization, $module),
            'branchId' => $branchId,
            'branchLabel' => $branchLabel,
@@ -16,7 +16,7 @@ class DentalChart extends Model

    protected $fillable = [
        'uuid', 'owner_ref', 'organization_id', 'patient_id',
-        'notation', 'charted_at', 'charted_by',
+        'notation', 'dentition', 'charted_at', 'charted_by',
    ];

    protected function casts(): array
@@ -5,11 +5,12 @@ namespace App\Models;
 use App\Models\Concerns\BelongsToOwner;
 use Illuminate\Database\Eloquent\Model;
 use Illuminate\Database\Eloquent\Relations\BelongsTo;
+use Illuminate\Database\Eloquent\SoftDeletes;
 use Illuminate\Support\Str;

 class DentalImage extends Model
 {
-    use BelongsToOwner;
+    use BelongsToOwner, SoftDeletes;

    public const MODALITY_PA = 'pa';

@@ -0,0 +1,72 @@
+<?php
+
+namespace App\Models;
+
+use App\Models\Concerns\BelongsToOwner;
+use Illuminate\Database\Eloquent\Model;
+use Illuminate\Database\Eloquent\Relations\BelongsTo;
+use Illuminate\Support\Str;
+
+class DentalLabCase extends Model
+{
+    use BelongsToOwner;
+
+    public const STATUS_DRAFT = 'draft';
+
+    public const STATUS_ORDERED = 'ordered';
+
+    public const STATUS_SENT = 'sent';
+
+    public const STATUS_RECEIVED = 'received';
+
+    public const STATUS_FITTED = 'fitted';
+
+    public const STATUS_CANCELLED = 'cancelled';
+
+    protected $table = 'care_dental_lab_cases';
+
+    protected $fillable = [
+        'uuid', 'owner_ref', 'organization_id', 'patient_id', 'visit_id', 'plan_item_id',
+        'tooth_codes', 'case_type', 'lab_name', 'status',
+        'ordered_at', 'due_at', 'received_at', 'notes', 'created_by',
+    ];
+
+    protected function casts(): array
+    {
+        return [
+            'tooth_codes' => 'array',
+            'ordered_at' => 'datetime',
+            'due_at' => 'date',
+            'received_at' => 'datetime',
+        ];
+    }
+
+    protected static function booted(): void
+    {
+        static::creating(function (DentalLabCase $case) {
+            if (! $case->uuid) {
+                $case->uuid = (string) Str::uuid();
+            }
+        });
+    }
+
+    public function getRouteKeyName(): string
+    {
+        return 'uuid';
+    }
+
+    public function patient(): BelongsTo
+    {
+        return $this->belongsTo(Patient::class, 'patient_id');
+    }
+
+    public function visit(): BelongsTo
+    {
+        return $this->belongsTo(Visit::class, 'visit_id');
+    }
+
+    public function planItem(): BelongsTo
+    {
+        return $this->belongsTo(DentalPlanItem::class, 'plan_item_id');
+    }
+}
@@ -0,0 +1,57 @@
+<?php
+
+namespace App\Models;
+
+use App\Models\Concerns\BelongsToOwner;
+use Illuminate\Database\Eloquent\Model;
+use Illuminate\Database\Eloquent\Relations\BelongsTo;
+use Illuminate\Database\Eloquent\Relations\HasMany;
+use Illuminate\Support\Str;
+
+class DentalPerioExam extends Model
+{
+    use BelongsToOwner;
+
+    protected $table = 'care_dental_perio_exams';
+
+    protected $fillable = [
+        'uuid', 'owner_ref', 'organization_id', 'patient_id', 'visit_id',
+        'exam_date', 'examiner', 'notes',
+    ];
+
+    protected function casts(): array
+    {
+        return [
+            'exam_date' => 'date',
+        ];
+    }
+
+    protected static function booted(): void
+    {
+        static::creating(function (DentalPerioExam $exam) {
+            if (! $exam->uuid) {
+                $exam->uuid = (string) Str::uuid();
+            }
+        });
+    }
+
+    public function getRouteKeyName(): string
+    {
+        return 'uuid';
+    }
+
+    public function patient(): BelongsTo
+    {
+        return $this->belongsTo(Patient::class, 'patient_id');
+    }
+
+    public function visit(): BelongsTo
+    {
+        return $this->belongsTo(Visit::class, 'visit_id');
+    }
+
+    public function sites(): HasMany
+    {
+        return $this->hasMany(DentalPerioSite::class, 'perio_exam_id');
+    }
+}
@@ -0,0 +1,29 @@
+<?php
+
+namespace App\Models;
+
+use Illuminate\Database\Eloquent\Model;
+use Illuminate\Database\Eloquent\Relations\BelongsTo;
+
+class DentalPerioSite extends Model
+{
+    protected $table = 'care_dental_perio_sites';
+
+    protected $fillable = [
+        'perio_exam_id', 'tooth_code', 'surface',
+        'probing_mm', 'bleeding', 'plaque', 'recession_mm',
+    ];
+
+    protected function casts(): array
+    {
+        return [
+            'bleeding' => 'boolean',
+            'plaque' => 'boolean',
+        ];
+    }
+
+    public function exam(): BelongsTo
+    {
+        return $this->belongsTo(DentalPerioExam::class, 'perio_exam_id');
+    }
+}
@@ -0,0 +1,59 @@
+<?php
+
+namespace App\Models;
+
+use App\Models\Concerns\BelongsToOwner;
+use Illuminate\Database\Eloquent\Model;
+use Illuminate\Database\Eloquent\Relations\BelongsTo;
+use Illuminate\Support\Str;
+
+class DentalRecall extends Model
+{
+    use BelongsToOwner;
+
+    public const STATUS_SCHEDULED = 'scheduled';
+
+    public const STATUS_DUE = 'due';
+
+    public const STATUS_COMPLETED = 'completed';
+
+    public const STATUS_CANCELLED = 'cancelled';
+
+    protected $table = 'care_dental_recalls';
+
+    protected $fillable = [
+        'uuid', 'owner_ref', 'organization_id', 'patient_id',
+        'due_on', 'reason', 'status', 'linked_visit_id', 'notes', 'created_by',
+    ];
+
+    protected function casts(): array
+    {
+        return [
+            'due_on' => 'date',
+        ];
+    }
+
+    protected static function booted(): void
+    {
+        static::creating(function (DentalRecall $recall) {
+            if (! $recall->uuid) {
+                $recall->uuid = (string) Str::uuid();
+            }
+        });
+    }
+
+    public function getRouteKeyName(): string
+    {
+        return 'uuid';
+    }
+
+    public function patient(): BelongsTo
+    {
+        return $this->belongsTo(Patient::class, 'patient_id');
+    }
+
+    public function linkedVisit(): BelongsTo
+    {
+        return $this->belongsTo(Visit::class, 'linked_visit_id');
+    }
+}
@@ -21,11 +21,16 @@ class DentalTreatmentPlan extends Model

    public const STATUS_COMPLETED = 'completed';

+    public const STATUS_REJECTED = 'rejected';
+
+    public const STATUS_CANCELLED = 'cancelled';
+
    protected $table = 'care_dental_treatment_plans';

    protected $fillable = [
        'uuid', 'owner_ref', 'organization_id', 'patient_id', 'visit_id',
-        'status', 'title', 'estimate_minor', 'accepted_at', 'completed_at', 'created_by',
+        'status', 'title', 'estimate_minor', 'accepted_at', 'completed_at',
+        'rejected_at', 'rejection_reason', 'created_by',
    ];

    protected function casts(): array
@@ -33,6 +38,7 @@ class DentalTreatmentPlan extends Model
        return [
            'accepted_at' => 'datetime',
            'completed_at' => 'datetime',
+            'rejected_at' => 'datetime',
        ];
    }

@@ -24,7 +24,7 @@ class Visit extends Model

    protected $fillable = [
        'uuid', 'owner_ref', 'organization_id', 'branch_id', 'patient_id',
-        'status', 'checked_in_at', 'completed_at', 'checked_in_by',
+        'status', 'specialty_stage', 'checked_in_at', 'completed_at', 'checked_in_by',
    ];

    protected function casts(): array
@@ -207,13 +207,16 @@ class CareQueueProvisioner
                CareQueueContexts::CONSULTATION,
                $priorByKey,
            ),
-            CareQueueContexts::isSpecialty($context) => $this->practitionerPoints(
-                $organization,
-                $branch,
-                $context,
-                $priorByKey,
-                data_get($organization->settings, "specialty_module_provisioning.{$context}.department_ids", []),
-            ),
+            CareQueueContexts::isSpecialty($context) => array_values(array_merge(
+                $this->practitionerPoints(
+                    $organization,
+                    $branch,
+                    $context,
+                    $priorByKey,
+                    data_get($organization->settings, "specialty_module_provisioning.{$context}.department_ids", []),
+                ),
+                $this->specialtyStagePoints($organization, $branch, $context, $priorByKey),
+            )),
            $context === CareQueueContexts::TRIAGE => $this->memberRolePoints(
                $organization,
                $branch,
@@ -276,6 +279,52 @@ class CareQueueProvisioner
        return $points;
    }

+    /**
+     * Fixed stage points for specialty modules that define distinct queue_point values
+     * (e.g. dentistry waiting / chair / recovery).
+     *
+     * @param  \Illuminate\Support\Collection<string, array<string, mixed>>  $priorByKey
+     * @return list<array<string, mixed>>
+     */
+    protected function specialtyStagePoints(
+        Organization $organization,
+        Branch $branch,
+        string $context,
+        $priorByKey,
+    ): array {
+        if ($context !== 'dentistry') {
+            return [];
+        }
+
+        $stages = app(SpecialtyShellService::class)->stages($context);
+        $seen = [];
+        $points = [];
+        foreach ($stages as $stage) {
+            $queuePoint = $stage['queue_point'] ?? null;
+            if (! is_string($queuePoint) || $queuePoint === '' || isset($seen[$queuePoint])) {
+                continue;
+            }
+            $seen[$queuePoint] = true;
+            $key = CareQueueContexts::pointExternalKey($context, $branch->id, 'stage', $queuePoint);
+            $prior = $priorByKey->get($key, []);
+            $label = (string) ($stage['label'] ?? ucfirst($queuePoint));
+            $points[] = [
+                'kind' => 'stage',
+                'stage' => $queuePoint,
+                'ref_id' => 0,
+                'name' => $label,
+                'destination' => $label,
+                'staff_ref' => null,
+                'staff_display_name' => null,
+                'external_key' => $key,
+                'counter_uuid' => $prior['counter_uuid'] ?? null,
+                'synced' => false,
+            ];
+        }
+
+        return $points;
+    }
+
    /**
     * @param  list<int|string>|null  $departmentIds
     * @param  \Illuminate\Support\Collection<string, array<string, mixed>>  $priorByKey
@@ -1026,6 +1026,39 @@ class DemoTenantSeeder
                // Billing may be constrained in partial seeds — chart/plan still valuable.
            }
        }
+
+        $perio = app(\App\Services\Care\Dentistry\DentalPerioService::class);
+        if (! \App\Models\DentalPerioExam::owned($ownerRef)->where('patient_id', $appointment->patient_id)->exists()) {
+            $perio->saveExam($organization, $appointment->patient, $ownerRef, [
+                ['tooth_code' => '16', 'surface' => 'B', 'probing_mm' => 3, 'bleeding' => true, 'plaque' => false],
+                ['tooth_code' => '16', 'surface' => 'L', 'probing_mm' => 2, 'bleeding' => false, 'plaque' => true],
+            ], $appointment->visit, 'Demo perio chart', $ownerRef);
+        }
+
+        $lab = app(\App\Services\Care\Dentistry\DentalLabCaseService::class);
+        if (! \App\Models\DentalLabCase::owned($ownerRef)->where('patient_id', $appointment->patient_id)->exists()) {
+            $lab->create($organization, $appointment->patient, $ownerRef, [
+                'case_type' => 'crown',
+                'lab_name' => 'Demo Dental Lab',
+                'tooth_codes' => ['16'],
+                'status' => 'ordered',
+                'due_at' => now()->addDays(14)->toDateString(),
+                'notes' => 'Demo crown case',
+            ], $appointment->visit, $ownerRef);
+        }
+
+        $recalls = app(\App\Services\Care\Dentistry\DentalRecallService::class);
+        if (! \App\Models\DentalRecall::owned($ownerRef)->where('patient_id', $appointment->patient_id)->exists()) {
+            $recalls->schedule($organization, $appointment->patient, $ownerRef, [
+                'due_on' => now()->addMonths(6)->toDateString(),
+                'reason' => '6-month check',
+                'notes' => 'Demo recall',
+            ], $ownerRef);
+        }
+
+        if (! $appointment->visit->specialty_stage) {
+            $appointment->visit->update(['specialty_stage' => 'chair']);
+        }
    }

    /**
@@ -7,9 +7,11 @@ use App\Models\BillLineItem;
 use App\Models\DentalImage;
 use App\Models\DentalPlanItem;
 use App\Models\DentalProcedure;
+use App\Models\DentalRecall;
 use App\Models\DentalTreatmentPlan;
 use App\Models\Organization;
 use App\Models\Patient;
+use Carbon\Carbon;
 use Illuminate\Support\Collection;

 class DentalAnalyticsService
@@ -21,16 +23,21 @@ class DentalAnalyticsService
     *     revenue_by_code: Collection,
     *     unfinished_items: int,
     *     avg_chair_minutes: ?float,
-     *     imaging_by_modality: Collection
+     *     imaging_by_modality: Collection,
+     *     from: string,
+     *     to: string
     * }
     */
    public function report(
        Organization $organization,
        string $ownerRef,
        ?int $branchId = null,
+        ?string $from = null,
+        ?string $to = null,
    ): array {
        $todayStart = now()->startOfDay();
-        $monthStart = now()->startOfMonth();
+        $rangeFrom = $from ? Carbon::parse($from)->startOfDay() : now()->startOfMonth();
+        $rangeTo = $to ? Carbon::parse($to)->endOfDay() : now()->endOfDay();

        $procBase = DentalProcedure::owned($ownerRef)
            ->where('organization_id', $organization->id)
@@ -44,7 +51,7 @@ class DentalAnalyticsService
            ->get();

        $proceduresMonth = (clone $procBase)
-            ->where('performed_at', '>=', $monthStart)
+            ->whereBetween('performed_at', [$rangeFrom, $rangeTo])
            ->selectRaw('procedure_code, label, count(*) as total, sum(amount_minor) as amount_minor')
            ->groupBy('procedure_code', 'label')
            ->orderByDesc('total')
@@ -53,7 +60,7 @@ class DentalAnalyticsService
        $revenueByCode = BillLineItem::query()
            ->where('owner_ref', $ownerRef)
            ->where('source_type', 'dental_procedure')
-            ->where('created_at', '>=', $monthStart)
+            ->whereBetween('created_at', [$rangeFrom, $rangeTo])
            ->selectRaw('description, sum(total_minor) as amount_minor, count(*) as total')
            ->groupBy('description')
            ->orderByDesc('amount_minor')
@@ -77,7 +84,7 @@ class DentalAnalyticsService
            ->where('status', Appointment::STATUS_COMPLETED)
            ->whereNotNull('started_at')
            ->whereNotNull('completed_at')
-            ->where('completed_at', '>=', $monthStart)
+            ->whereBetween('completed_at', [$rangeFrom, $rangeTo])
            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId));

        $avgChair = null;
@@ -88,7 +95,7 @@ class DentalAnalyticsService

        $imaging = DentalImage::owned($ownerRef)
            ->where('organization_id', $organization->id)
-            ->where('captured_at', '>=', $monthStart)
+            ->whereBetween('captured_at', [$rangeFrom, $rangeTo])
            ->selectRaw('modality, count(*) as total')
            ->groupBy('modality')
            ->orderByDesc('total')
@@ -101,6 +108,8 @@ class DentalAnalyticsService
            'unfinished_items' => $unfinished,
            'avg_chair_minutes' => $avgChair,
            'imaging_by_modality' => $imaging,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
        ];
    }

@@ -150,6 +159,24 @@ class DentalAnalyticsService
            }
        }

+        $overdue = DentalRecall::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('patient_id', $patient->id)
+            ->whereIn('status', [DentalRecall::STATUS_SCHEDULED, DentalRecall::STATUS_DUE])
+            ->where('due_on', '<', now()->toDateString())
+            ->orderBy('due_on')
+            ->limit(3)
+            ->get();
+
+        foreach ($overdue as $recall) {
+            $reason = $recall->reason ?: 'Recall';
+            $alerts[] = [
+                'code' => 'dental.recall.overdue',
+                'severity' => 'warning',
+                'message' => "Overdue recall ({$reason}) due {$recall->due_on->format('d M Y')}.",
+            ];
+        }
+
        return $alerts;
    }
 }
@@ -3,10 +3,16 @@
 namespace App\Services\Care\Dentistry;

 /**
- * FDI adult dentition helpers and catalog labels for dentistry.
+ * FDI adult + primary dentition helpers and catalog labels for dentistry.
 */
 class DentalCatalog
 {
+    public const DENTITION_ADULT = 'adult';
+
+    public const DENTITION_PRIMARY = 'primary';
+
+    public const DENTITION_MIXED = 'mixed';
+
    /** @return list<string> */
    public static function adultToothCodes(): array
    {
@@ -21,15 +27,52 @@ class DentalCatalog
        return $codes;
    }

+    /** @return list<string> */
+    public static function primaryToothCodes(): array
+    {
+        $codes = [];
+        foreach ([55, 54, 53, 52, 51, 61, 62, 63, 64, 65] as $n) {
+            $codes[] = (string) $n;
+        }
+        foreach ([85, 84, 83, 82, 81, 71, 72, 73, 74, 75] as $n) {
+            $codes[] = (string) $n;
+        }
+
+        return $codes;
+    }
+
+    /** @return list<string> */
+    public static function toothCodesForDentition(string $dentition): array
+    {
+        return match ($dentition) {
+            self::DENTITION_PRIMARY => self::primaryToothCodes(),
+            self::DENTITION_MIXED => array_values(array_unique(array_merge(
+                self::adultToothCodes(),
+                self::primaryToothCodes(),
+            ))),
+            default => self::adultToothCodes(),
+        };
+    }
+
    /**
     * @return array{upper: list<string>, lower: list<string>}
     */
-    public static function odontogramRows(): array
+    public static function odontogramRows(?string $dentition = self::DENTITION_ADULT): array
    {
-        return [
-            'upper' => ['18', '17', '16', '15', '14', '13', '12', '11', '21', '22', '23', '24', '25', '26', '27', '28'],
-            'lower' => ['48', '47', '46', '45', '44', '43', '42', '41', '31', '32', '33', '34', '35', '36', '37', '38'],
-        ];
+        return match ($dentition) {
+            self::DENTITION_PRIMARY => [
+                'upper' => ['55', '54', '53', '52', '51', '61', '62', '63', '64', '65'],
+                'lower' => ['85', '84', '83', '82', '81', '71', '72', '73', '74', '75'],
+            ],
+            self::DENTITION_MIXED => [
+                'upper' => ['18', '17', '16', '55', '54', '53', '52', '51', '61', '62', '63', '64', '65', '26', '27', '28'],
+                'lower' => ['48', '47', '46', '85', '84', '83', '82', '81', '71', '72', '73', '74', '75', '36', '37', '38'],
+            ],
+            default => [
+                'upper' => ['18', '17', '16', '15', '14', '13', '12', '11', '21', '22', '23', '24', '25', '26', '27', '28'],
+                'lower' => ['48', '47', '46', '45', '44', '43', '42', '41', '31', '32', '33', '34', '35', '36', '37', '38'],
+            ],
+        };
    }

    /** @return list<string> */
@@ -38,6 +81,22 @@ class DentalCatalog
        return ['M', 'O', 'D', 'B', 'L', 'I'];
    }

+    /** @return list<string> */
+    public static function perioSurfaces(): array
+    {
+        return ['MB', 'B', 'DB', 'ML', 'L', 'DL'];
+    }
+
+    /** @return array<string, string> */
+    public static function dentitions(): array
+    {
+        return [
+            self::DENTITION_ADULT => 'Adult',
+            self::DENTITION_PRIMARY => 'Primary',
+            self::DENTITION_MIXED => 'Mixed',
+        ];
+    }
+
    /** @return array<string, string> */
    public static function conditions(): array
    {
@@ -75,6 +134,32 @@ class DentalCatalog
        ];
    }

+    /** @return array<string, string> */
+    public static function labCaseTypes(): array
+    {
+        return [
+            'crown' => 'Crown',
+            'bridge' => 'Bridge',
+            'denture' => 'Denture',
+            'veneer' => 'Veneer',
+            'ortho' => 'Ortho appliance',
+            'other' => 'Other',
+        ];
+    }
+
+    /** @return array<string, string> */
+    public static function labCaseStatuses(): array
+    {
+        return [
+            'draft' => 'Draft',
+            'ordered' => 'Ordered',
+            'sent' => 'Sent to lab',
+            'received' => 'Received',
+            'fitted' => 'Fitted',
+            'cancelled' => 'Cancelled',
+        ];
+    }
+
    /** @return array<string, array{label: string, amount_minor: int, type: string}> */
    public static function defaultServices(): array
    {
@@ -98,6 +183,27 @@ class DentalCatalog

    public static function isValidToothCode(string $code): bool
    {
-        return in_array($code, self::adultToothCodes(), true);
+        return in_array($code, self::toothCodesForDentition(self::DENTITION_MIXED), true);
+    }
+
+    public static function toothCssClass(string $status, array $conditions = []): string
+    {
+        if (in_array($status, ['missing', 'extracted'], true) || in_array('missing', $conditions, true)) {
+            return 'bg-slate-200 text-slate-500 line-through';
+        }
+        if ($status === 'implant' || in_array('implant', $conditions, true)) {
+            return 'bg-sky-100 text-sky-800 ring-1 ring-sky-300';
+        }
+        if (in_array('caries', $conditions, true) || in_array('fracture', $conditions, true)) {
+            return 'bg-amber-100 text-amber-900 ring-1 ring-amber-400';
+        }
+        if (in_array('filled', $conditions, true) || in_array('crown', $conditions, true) || in_array('root_canal', $conditions, true)) {
+            return 'bg-emerald-50 text-emerald-800 ring-1 ring-emerald-300';
+        }
+        if (in_array('watch', $conditions, true)) {
+            return 'bg-violet-50 text-violet-800 ring-1 ring-violet-300';
+        }
+
+        return 'bg-white text-slate-800 ring-1 ring-slate-200';
    }
 }
@@ -22,7 +22,9 @@ class DentalChartService
            ->first();

        if ($chart) {
-            return $chart;
+            $this->ensureTeethForDentition($chart);
+
+            return $chart->fresh('teeth');
        }

        return DB::transaction(function () use ($organization, $patient, $ownerRef) {
@@ -31,24 +33,78 @@ class DentalChartService
                'organization_id' => $organization->id,
                'patient_id' => $patient->id,
                'notation' => 'fdi',
+                'dentition' => DentalCatalog::DENTITION_ADULT,
                'charted_at' => now(),
                'charted_by' => $ownerRef,
            ]);

-            foreach (DentalCatalog::adultToothCodes() as $code) {
-                DentalTooth::create([
-                    'dental_chart_id' => $chart->id,
-                    'tooth_code' => $code,
-                    'status' => DentalTooth::STATUS_PRESENT,
-                    'surfaces' => [],
-                    'conditions' => [],
-                ]);
-            }
+            $this->seedTeeth($chart, DentalCatalog::DENTITION_ADULT);

            return $chart->fresh('teeth');
        });
    }

+    public function setDentition(
+        DentalChart $chart,
+        string $dentition,
+        string $ownerRef,
+        ?string $actorRef = null,
+    ): DentalChart {
+        if (! array_key_exists($dentition, DentalCatalog::dentitions())) {
+            throw new \InvalidArgumentException("Invalid dentition [{$dentition}].");
+        }
+
+        $chart->update([
+            'dentition' => $dentition,
+            'charted_at' => now(),
+            'charted_by' => $actorRef ?? $ownerRef,
+        ]);
+
+        $this->ensureTeethForDentition($chart->fresh());
+
+        AuditLogger::record(
+            $ownerRef,
+            'dental.chart.dentition_set',
+            $chart->organization_id,
+            $actorRef,
+            DentalChart::class,
+            $chart->id,
+            ['dentition' => $dentition],
+        );
+
+        return $chart->fresh('teeth');
+    }
+
+    protected function ensureTeethForDentition(DentalChart $chart): void
+    {
+        $dentition = $chart->dentition ?: DentalCatalog::DENTITION_ADULT;
+        $needed = DentalCatalog::toothCodesForDentition($dentition);
+        $existing = $chart->teeth()->pluck('tooth_code')->all();
+        $missing = array_diff($needed, $existing);
+        foreach ($missing as $code) {
+            DentalTooth::create([
+                'dental_chart_id' => $chart->id,
+                'tooth_code' => $code,
+                'status' => DentalTooth::STATUS_PRESENT,
+                'surfaces' => [],
+                'conditions' => [],
+            ]);
+        }
+    }
+
+    protected function seedTeeth(DentalChart $chart, string $dentition): void
+    {
+        foreach (DentalCatalog::toothCodesForDentition($dentition) as $code) {
+            DentalTooth::create([
+                'dental_chart_id' => $chart->id,
+                'tooth_code' => $code,
+                'status' => DentalTooth::STATUS_PRESENT,
+                'surfaces' => [],
+                'conditions' => [],
+            ]);
+        }
+    }
+
    /**
     * @param  array{status?: string, surfaces?: list<string>, conditions?: list<string>, notes?: ?string}  $data
     */
@@ -71,6 +71,20 @@ class DentalImagingService
        return $image->fresh('attachment');
    }

+    public function void(DentalImage $image, string $ownerRef, ?string $actorRef = null): void
+    {
+        $image->delete();
+
+        AuditLogger::record(
+            $ownerRef,
+            'dental.image.voided',
+            $image->organization_id,
+            $actorRef,
+            DentalImage::class,
+            $image->id,
+        );
+    }
+
    public function url(DentalImage $image): ?string
    {
        $path = $image->attachment?->file_path;
@@ -0,0 +1,100 @@
+<?php
+
+namespace App\Services\Care\Dentistry;
+
+use App\Models\DentalLabCase;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\Visit;
+use App\Services\Care\AuditLogger;
+use Illuminate\Support\Collection;
+
+class DentalLabCaseService
+{
+    /**
+     * @return Collection<int, DentalLabCase>
+     */
+    public function casesForPatient(Organization $organization, Patient $patient, string $ownerRef, int $limit = 30): Collection
+    {
+        return DentalLabCase::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('patient_id', $patient->id)
+            ->latest('id')
+            ->limit($limit)
+            ->get();
+    }
+
+    /**
+     * @param  array{case_type: string, lab_name?: ?string, tooth_codes?: list<string>, plan_item_id?: ?int, due_at?: ?string, notes?: ?string, status?: string}  $data
+     */
+    public function create(
+        Organization $organization,
+        Patient $patient,
+        string $ownerRef,
+        array $data,
+        ?Visit $visit = null,
+        ?string $actorRef = null,
+    ): DentalLabCase {
+        $type = (string) ($data['case_type'] ?? '');
+        if (! array_key_exists($type, DentalCatalog::labCaseTypes())) {
+            throw new \InvalidArgumentException("Invalid lab case type [{$type}].");
+        }
+
+        $status = (string) ($data['status'] ?? DentalLabCase::STATUS_DRAFT);
+        if (! array_key_exists($status, DentalCatalog::labCaseStatuses())) {
+            throw new \InvalidArgumentException("Invalid lab case status [{$status}].");
+        }
+
+        $toothCodes = array_values(array_filter(
+            $data['tooth_codes'] ?? [],
+            fn ($c) => DentalCatalog::isValidToothCode((string) $c),
+        ));
+
+        $case = DentalLabCase::create([
+            'owner_ref' => $ownerRef,
+            'organization_id' => $organization->id,
+            'patient_id' => $patient->id,
+            'visit_id' => $visit?->id,
+            'plan_item_id' => $data['plan_item_id'] ?? null,
+            'tooth_codes' => $toothCodes,
+            'case_type' => $type,
+            'lab_name' => $data['lab_name'] ?? null,
+            'status' => $status,
+            'ordered_at' => in_array($status, [DentalLabCase::STATUS_ORDERED, DentalLabCase::STATUS_SENT], true) ? now() : null,
+            'due_at' => $data['due_at'] ?? null,
+            'notes' => $data['notes'] ?? null,
+            'created_by' => $actorRef ?? $ownerRef,
+        ]);
+
+        AuditLogger::record($ownerRef, 'dental.lab.created', $organization->id, $actorRef, DentalLabCase::class, $case->id);
+
+        return $case;
+    }
+
+    public function transition(
+        DentalLabCase $case,
+        string $status,
+        string $ownerRef,
+        ?string $actorRef = null,
+    ): DentalLabCase {
+        if (! array_key_exists($status, DentalCatalog::labCaseStatuses())) {
+            throw new \InvalidArgumentException("Invalid lab case status [{$status}].");
+        }
+
+        $updates = ['status' => $status];
+        if (in_array($status, [DentalLabCase::STATUS_ORDERED, DentalLabCase::STATUS_SENT], true) && ! $case->ordered_at) {
+            $updates['ordered_at'] = now();
+        }
+        if (in_array($status, [DentalLabCase::STATUS_RECEIVED, DentalLabCase::STATUS_FITTED], true) && ! $case->received_at) {
+            $updates['received_at'] = now();
+        }
+
+        $case->update($updates);
+
+        AuditLogger::record($ownerRef, 'dental.lab.transitioned', $case->organization_id, $actorRef, DentalLabCase::class, $case->id, [
+            'status' => $status,
+        ]);
+
+        return $case->fresh();
+    }
+}
@@ -0,0 +1,94 @@
+<?php
+
+namespace App\Services\Care\Dentistry;
+
+use App\Models\DentalPerioExam;
+use App\Models\DentalPerioSite;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\Visit;
+use App\Services\Care\AuditLogger;
+use Illuminate\Support\Collection;
+use Illuminate\Support\Facades\DB;
+
+class DentalPerioService
+{
+    /**
+     * @return Collection<int, DentalPerioExam>
+     */
+    public function examsForPatient(Organization $organization, Patient $patient, string $ownerRef, int $limit = 10): Collection
+    {
+        return DentalPerioExam::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('patient_id', $patient->id)
+            ->with('sites')
+            ->latest('id')
+            ->limit($limit)
+            ->get();
+    }
+
+    public function latestForPatient(Organization $organization, Patient $patient, string $ownerRef): ?DentalPerioExam
+    {
+        return $this->examsForPatient($organization, $patient, $ownerRef, 1)->first();
+    }
+
+    /**
+     * @param  list<array{tooth_code: string, surface: string, probing_mm?: ?int, bleeding?: bool, plaque?: bool, recession_mm?: ?int}>  $sites
+     */
+    public function saveExam(
+        Organization $organization,
+        Patient $patient,
+        string $ownerRef,
+        array $sites,
+        ?Visit $visit = null,
+        ?string $notes = null,
+        ?string $actorRef = null,
+    ): DentalPerioExam {
+        return DB::transaction(function () use ($organization, $patient, $ownerRef, $sites, $visit, $notes, $actorRef) {
+            $exam = DentalPerioExam::create([
+                'owner_ref' => $ownerRef,
+                'organization_id' => $organization->id,
+                'patient_id' => $patient->id,
+                'visit_id' => $visit?->id,
+                'exam_date' => now()->toDateString(),
+                'examiner' => $actorRef ?? $ownerRef,
+                'notes' => $notes,
+            ]);
+
+            foreach ($sites as $row) {
+                $tooth = (string) ($row['tooth_code'] ?? '');
+                $surface = strtoupper((string) ($row['surface'] ?? ''));
+                if (! DentalCatalog::isValidToothCode($tooth) || ! in_array($surface, DentalCatalog::perioSurfaces(), true)) {
+                    continue;
+                }
+                if (($row['probing_mm'] ?? null) === null
+                    && empty($row['bleeding'])
+                    && empty($row['plaque'])
+                    && ($row['recession_mm'] ?? null) === null) {
+                    continue;
+                }
+
+                DentalPerioSite::create([
+                    'perio_exam_id' => $exam->id,
+                    'tooth_code' => $tooth,
+                    'surface' => $surface,
+                    'probing_mm' => isset($row['probing_mm']) ? (int) $row['probing_mm'] : null,
+                    'bleeding' => (bool) ($row['bleeding'] ?? false),
+                    'plaque' => (bool) ($row['plaque'] ?? false),
+                    'recession_mm' => isset($row['recession_mm']) ? (int) $row['recession_mm'] : null,
+                ]);
+            }
+
+            AuditLogger::record(
+                $ownerRef,
+                'dental.perio.saved',
+                $organization->id,
+                $actorRef,
+                DentalPerioExam::class,
+                $exam->id,
+            );
+
+            return $exam->fresh('sites');
+        });
+    }
+}
@@ -0,0 +1,100 @@
+<?php
+
+namespace App\Services\Care\Dentistry;
+
+use App\Models\DentalRecall;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\Visit;
+use App\Services\Care\AuditLogger;
+use Illuminate\Support\Collection;
+
+class DentalRecallService
+{
+    /**
+     * @return Collection<int, DentalRecall>
+     */
+    public function recallsForPatient(Organization $organization, Patient $patient, string $ownerRef, int $limit = 30): Collection
+    {
+        return DentalRecall::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('patient_id', $patient->id)
+            ->orderBy('due_on')
+            ->limit($limit)
+            ->get();
+    }
+
+    /**
+     * @param  array{due_on: string, reason?: ?string, notes?: ?string}  $data
+     */
+    public function schedule(
+        Organization $organization,
+        Patient $patient,
+        string $ownerRef,
+        array $data,
+        ?string $actorRef = null,
+    ): DentalRecall {
+        $dueOn = (string) ($data['due_on'] ?? '');
+        if ($dueOn === '') {
+            throw new \InvalidArgumentException('Recall due date is required.');
+        }
+
+        $status = DentalRecall::STATUS_SCHEDULED;
+        if (now()->startOfDay()->gte(\Carbon\Carbon::parse($dueOn)->startOfDay())) {
+            $status = DentalRecall::STATUS_DUE;
+        }
+
+        $recall = DentalRecall::create([
+            'owner_ref' => $ownerRef,
+            'organization_id' => $organization->id,
+            'patient_id' => $patient->id,
+            'due_on' => $dueOn,
+            'reason' => $data['reason'] ?? null,
+            'status' => $status,
+            'notes' => $data['notes'] ?? null,
+            'created_by' => $actorRef ?? $ownerRef,
+        ]);
+
+        AuditLogger::record($ownerRef, 'dental.recall.scheduled', $organization->id, $actorRef, DentalRecall::class, $recall->id);
+
+        return $recall;
+    }
+
+    public function complete(
+        DentalRecall $recall,
+        string $ownerRef,
+        ?Visit $visit = null,
+        ?string $actorRef = null,
+    ): DentalRecall {
+        $recall->update([
+            'status' => DentalRecall::STATUS_COMPLETED,
+            'linked_visit_id' => $visit?->id ?? $recall->linked_visit_id,
+        ]);
+
+        AuditLogger::record($ownerRef, 'dental.recall.completed', $recall->organization_id, $actorRef, DentalRecall::class, $recall->id);
+
+        return $recall->fresh();
+    }
+
+    public function cancel(DentalRecall $recall, string $ownerRef, ?string $actorRef = null): DentalRecall
+    {
+        $recall->update(['status' => DentalRecall::STATUS_CANCELLED]);
+
+        AuditLogger::record($ownerRef, 'dental.recall.cancelled', $recall->organization_id, $actorRef, DentalRecall::class, $recall->id);
+
+        return $recall->fresh();
+    }
+
+    /**
+     * @return Collection<int, DentalRecall>
+     */
+    public function openForPatient(Organization $organization, Patient $patient, string $ownerRef): Collection
+    {
+        return DentalRecall::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('patient_id', $patient->id)
+            ->whereIn('status', [DentalRecall::STATUS_SCHEDULED, DentalRecall::STATUS_DUE])
+            ->orderBy('due_on')
+            ->get();
+    }
+}
@@ -9,6 +9,7 @@ use App\Models\Patient;
 use App\Models\Visit;
 use App\Services\Care\AuditLogger;
 use App\Services\Care\SpecialtyShellService;
+use Illuminate\Support\Collection;

 class DentalTreatmentPlanService
 {
@@ -31,6 +32,20 @@ class DentalTreatmentPlanService
            ->first();
    }

+    /**
+     * @return Collection<int, DentalTreatmentPlan>
+     */
+    public function plansForPatient(Organization $organization, Patient $patient, string $ownerRef, int $limit = 20): Collection
+    {
+        return DentalTreatmentPlan::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('patient_id', $patient->id)
+            ->with('items')
+            ->latest('id')
+            ->limit($limit)
+            ->get();
+    }
+
    public function ensurePlan(
        Organization $organization,
        Patient $patient,
@@ -68,6 +83,8 @@ class DentalTreatmentPlanService
        string $ownerRef,
        ?string $actorRef = null,
    ): DentalPlanItem {
+        $this->assertPlanMutable($plan);
+
        $code = (string) ($data['procedure_code'] ?? '');
        $service = collect($this->shell->provisionedServices($organization, 'dentistry'))
            ->first(fn ($s) => ($s['code'] ?? '') === $code)
@@ -108,8 +125,104 @@ class DentalTreatmentPlanService
        return $item;
    }

+    /**
+     * @param  array{tooth_code?: ?string, surfaces?: list<string>, procedure_code?: string, priority?: int, notes?: ?string}  $data
+     */
+    public function updateItem(
+        DentalPlanItem $item,
+        Organization $organization,
+        array $data,
+        string $ownerRef,
+        ?string $actorRef = null,
+    ): DentalPlanItem {
+        if ($item->status === DentalPlanItem::STATUS_DONE) {
+            throw new \InvalidArgumentException('Completed plan items cannot be edited.');
+        }
+        if ($item->status === DentalPlanItem::STATUS_CANCELLED) {
+            throw new \InvalidArgumentException('Cancelled plan items cannot be edited.');
+        }
+
+        $plan = $item->plan;
+        $this->assertPlanMutable($plan);
+
+        $updates = [];
+        if (array_key_exists('procedure_code', $data) && $data['procedure_code']) {
+            $code = (string) $data['procedure_code'];
+            $service = collect($this->shell->provisionedServices($organization, 'dentistry'))
+                ->first(fn ($s) => ($s['code'] ?? '') === $code)
+                ?? DentalCatalog::defaultServices()[$code] ?? null;
+            if (! $service) {
+                throw new \InvalidArgumentException("Unknown dental procedure [{$code}].");
+            }
+            $updates['procedure_code'] = $code;
+            $updates['label'] = $service['label'];
+            $updates['estimate_minor'] = (int) ($service['amount_minor'] ?? 0);
+        }
+
+        if (array_key_exists('tooth_code', $data)) {
+            $tooth = $data['tooth_code'];
+            if ($tooth && ! DentalCatalog::isValidToothCode($tooth)) {
+                throw new \InvalidArgumentException("Invalid FDI tooth code [{$tooth}].");
+            }
+            $updates['tooth_code'] = $tooth ?: null;
+        }
+
+        if (array_key_exists('surfaces', $data)) {
+            $updates['surfaces'] = array_values(array_intersect(
+                array_map('strtoupper', $data['surfaces'] ?? []),
+                DentalCatalog::surfaces(),
+            ));
+        }
+
+        if (array_key_exists('priority', $data) && $data['priority'] !== null) {
+            $updates['priority'] = (int) $data['priority'];
+        }
+
+        if (array_key_exists('notes', $data)) {
+            $updates['notes'] = $data['notes'];
+        }
+
+        $item->update($updates);
+        $this->recalculateEstimate($plan);
+
+        AuditLogger::record($ownerRef, 'dental.plan.item_updated', $organization->id, $actorRef, DentalPlanItem::class, $item->id);
+
+        return $item->fresh();
+    }
+
+    public function cancelItem(
+        DentalPlanItem $item,
+        string $ownerRef,
+        ?string $actorRef = null,
+    ): DentalPlanItem {
+        if ($item->status === DentalPlanItem::STATUS_DONE) {
+            throw new \InvalidArgumentException('Completed plan items cannot be cancelled.');
+        }
+
+        $item->update(['status' => DentalPlanItem::STATUS_CANCELLED]);
+        $plan = $item->plan;
+        if ($plan) {
+            $this->recalculateEstimate($plan);
+            if ($plan->items()->whereNotIn('status', [DentalPlanItem::STATUS_DONE, DentalPlanItem::STATUS_CANCELLED])->doesntExist()
+                && $plan->items()->where('status', DentalPlanItem::STATUS_DONE)->exists()) {
+                $plan->update([
+                    'status' => DentalTreatmentPlan::STATUS_COMPLETED,
+                    'completed_at' => now(),
+                ]);
+            }
+        }
+
+        AuditLogger::record($ownerRef, 'dental.plan.item_cancelled', $plan?->organization_id, $actorRef, DentalPlanItem::class, $item->id);
+
+        return $item->fresh();
+    }
+
    public function accept(DentalTreatmentPlan $plan, string $ownerRef, ?string $actorRef = null): DentalTreatmentPlan
    {
+        if ($plan->status !== DentalTreatmentPlan::STATUS_DRAFT) {
+            throw new \InvalidArgumentException('Only draft plans can be accepted.');
+        }
+
        $plan->update([
            'status' => DentalTreatmentPlan::STATUS_ACCEPTED,
            'accepted_at' => now(),
@@ -123,6 +236,51 @@ class DentalTreatmentPlanService
        return $plan->fresh('items');
    }

+    public function rejectPlan(
+        DentalTreatmentPlan $plan,
+        string $ownerRef,
+        ?string $reason = null,
+        ?string $actorRef = null,
+    ): DentalTreatmentPlan {
+        if (! in_array($plan->status, [DentalTreatmentPlan::STATUS_DRAFT, DentalTreatmentPlan::STATUS_ACCEPTED], true)) {
+            throw new \InvalidArgumentException('Only draft or accepted plans can be rejected.');
+        }
+
+        $plan->update([
+            'status' => DentalTreatmentPlan::STATUS_REJECTED,
+            'rejected_at' => now(),
+            'rejection_reason' => $reason,
+        ]);
+        $plan->items()
+            ->whereNotIn('status', [DentalPlanItem::STATUS_DONE, DentalPlanItem::STATUS_CANCELLED])
+            ->update(['status' => DentalPlanItem::STATUS_CANCELLED]);
+
+        AuditLogger::record($ownerRef, 'dental.plan.rejected', $plan->organization_id, $actorRef, DentalTreatmentPlan::class, $plan->id);
+
+        return $plan->fresh('items');
+    }
+
+    public function cancelPlan(
+        DentalTreatmentPlan $plan,
+        string $ownerRef,
+        ?string $actorRef = null,
+    ): DentalTreatmentPlan {
+        if ($plan->status === DentalTreatmentPlan::STATUS_COMPLETED) {
+            throw new \InvalidArgumentException('Completed plans cannot be cancelled.');
+        }
+
+        $plan->items()
+            ->whereNotIn('status', [DentalPlanItem::STATUS_DONE, DentalPlanItem::STATUS_CANCELLED])
+            ->update(['status' => DentalPlanItem::STATUS_CANCELLED]);
+
+        $plan->update(['status' => DentalTreatmentPlan::STATUS_CANCELLED]);
+        $plan->delete();
+
+        AuditLogger::record($ownerRef, 'dental.plan.cancelled', $plan->organization_id, $actorRef, DentalTreatmentPlan::class, $plan->id);
+
+        return $plan;
+    }
+
    public function markItemDone(DentalPlanItem $item): DentalPlanItem
    {
        $item->update(['status' => DentalPlanItem::STATUS_DONE]);
@@ -146,4 +304,18 @@ class DentalTreatmentPlanService
            ->sum('estimate_minor');
        $plan->update(['estimate_minor' => $total]);
    }
+
+    protected function assertPlanMutable(?DentalTreatmentPlan $plan): void
+    {
+        if (! $plan) {
+            throw new \InvalidArgumentException('Plan not found.');
+        }
+        if (in_array($plan->status, [
+            DentalTreatmentPlan::STATUS_COMPLETED,
+            DentalTreatmentPlan::STATUS_REJECTED,
+            DentalTreatmentPlan::STATUS_CANCELLED,
+        ], true)) {
+            throw new \InvalidArgumentException('This treatment plan is closed.');
+        }
+    }
 }
@@ -259,14 +259,35 @@ class SpecialtyShellService
            ->whereNotIn('status', [Bill::STATUS_VOID])
            ->sum('amount_paid_minor');

-        $stages = collect($this->stages($moduleKey))->map(function (array $stage) use ($waiting, $inProgress, $completedToday) {
+        $stages = collect($this->stages($moduleKey))->map(function (array $stage) use (
+            $waiting,
+            $inProgress,
+            $completedToday,
+            $moduleKey,
+            $organization,
+            $ownerRef,
+            $visitIds,
+        ) {
            $code = (string) ($stage['code'] ?? '');
-            $count = match (true) {
-                in_array($code, ['waiting', 'arrival', 'request'], true) => $waiting,
-                in_array($code, ['in_care', 'chair', 'procedure', 'treatment', 'resus', 'crossmatch', 'issue', 'observation'], true) => $inProgress,
-                in_array($code, ['completed', 'disposition', 'transfusion', 'recovery'], true) => $completedToday,
-                default => 0,
-            };
+
+            if ($moduleKey === 'dentistry' && $visitIds->isNotEmpty()) {
+                $count = Visit::owned($ownerRef)
+                    ->where('organization_id', $organization->id)
+                    ->whereIn('id', $visitIds)
+                    ->where('specialty_stage', $code)
+                    ->when(
+                        $code !== 'completed',
+                        fn ($q) => $q->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS]),
+                    )
+                    ->count();
+            } else {
+                $count = match (true) {
+                    in_array($code, ['waiting', 'arrival', 'request'], true) => $waiting,
+                    in_array($code, ['in_care', 'chair', 'procedure', 'treatment', 'resus', 'crossmatch', 'issue', 'observation'], true) => $inProgress,
+                    in_array($code, ['completed', 'disposition', 'transfusion', 'recovery'], true) => $completedToday,
+                    default => 0,
+                };
+            }

            return [
                'code' => $code,
@@ -0,0 +1,137 @@
+<?php
+
+namespace App\Services\Care;
+
+use App\Models\Appointment;
+use App\Models\CareQueueTicket;
+use App\Models\Organization;
+use App\Models\Visit;
+use App\Services\Care\AuditLogger;
+
+/**
+ * Persist specialty visit stages (dentistry chair → recovery) and re-route queue tickets.
+ */
+class SpecialtyVisitStageService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+        protected CareQueueBridge $queueBridge,
+    ) {}
+
+    /**
+     * @return list<string>
+     */
+    public function allowedStages(string $moduleKey): array
+    {
+        return collect($this->shell->stages($moduleKey))
+            ->pluck('code')
+            ->filter()
+            ->values()
+            ->all();
+    }
+
+    public function setStage(
+        Organization $organization,
+        Visit $visit,
+        string $moduleKey,
+        string $stage,
+        string $ownerRef,
+        ?string $actorRef = null,
+    ): Visit {
+        $allowed = $this->allowedStages($moduleKey);
+        if (! in_array($stage, $allowed, true)) {
+            throw new \InvalidArgumentException("Invalid specialty stage [{$stage}] for {$moduleKey}.");
+        }
+
+        $previous = $visit->specialty_stage;
+        $visit->update(['specialty_stage' => $stage]);
+
+        if ($stage === 'completed' && $visit->status !== Visit::STATUS_COMPLETED) {
+            $visit->update([
+                'status' => Visit::STATUS_COMPLETED,
+                'completed_at' => $visit->completed_at ?? now(),
+            ]);
+        } elseif ($stage !== 'completed' && $visit->status === Visit::STATUS_OPEN) {
+            $visit->update(['status' => Visit::STATUS_IN_PROGRESS]);
+        }
+
+        $this->rerouteTicket($organization, $visit, $moduleKey, $stage);
+
+        AuditLogger::record(
+            $ownerRef,
+            'specialty.visit.stage',
+            $organization->id,
+            $actorRef,
+            Visit::class,
+            $visit->id,
+            ['module' => $moduleKey, 'from' => $previous, 'to' => $stage],
+        );
+
+        return $visit->fresh();
+    }
+
+    public function defaultOnCheckIn(string $moduleKey): ?string
+    {
+        $stages = $this->allowedStages($moduleKey);
+
+        return $stages[0] ?? null;
+    }
+
+    public function stageOnConsultationStart(string $moduleKey): ?string
+    {
+        $stages = $this->allowedStages($moduleKey);
+        foreach (['chair', 'in_care', 'exam', 'assessment'] as $preferred) {
+            if (in_array($preferred, $stages, true)) {
+                return $preferred;
+            }
+        }
+
+        return $stages[1] ?? ($stages[0] ?? null);
+    }
+
+    protected function rerouteTicket(
+        Organization $organization,
+        Visit $visit,
+        string $moduleKey,
+        string $stage,
+    ): void {
+        if (! $this->queueBridge->isEnabled($organization)) {
+            return;
+        }
+
+        $stageMeta = collect($this->shell->stages($moduleKey))
+            ->first(fn ($s) => ($s['code'] ?? '') === $stage);
+        $queuePoint = $stageMeta['queue_point'] ?? null;
+        if (! $queuePoint) {
+            return;
+        }
+
+        $appointment = $visit->appointment;
+        if (! $appointment instanceof Appointment) {
+            $appointment = Appointment::query()->where('visit_id', $visit->id)->first();
+        }
+        if (! $appointment?->queue_ticket_uuid) {
+            return;
+        }
+
+        $ticket = CareQueueTicket::query()
+            ->where('uuid', $appointment->queue_ticket_uuid)
+            ->first();
+        if (! $ticket) {
+            return;
+        }
+
+        $stub = app(CareQueueProvisioner::class)->resourcesFor($organization, $moduleKey, (int) $visit->branch_id);
+        $point = collect($stub['points'] ?? [])
+            ->first(fn ($p) => ($p['kind'] ?? '') === 'stage' && ($p['stage'] ?? '') === $queuePoint);
+
+        $ticket->update([
+            'metadata' => array_merge($ticket->metadata ?? [], [
+                'specialty_stage' => $stage,
+                'queue_point' => $queuePoint,
+                'point_external_key' => is_array($point) ? ($point['external_key'] ?? null) : null,
+                'point_name' => is_array($point) ? ($point['name'] ?? null) : null,
+            ]),
+        ]);
+    }
+}
@@ -118,10 +118,13 @@ return [
            'workspace_tabs' => [
                'overview' => 'Overview',
                'odontogram' => 'Chart',
+                'perio' => 'Perio',
                'plan' => 'Plan',
                'treat' => 'Treat',
+                'lab' => 'Lab',
                'notes' => 'Notes',
                'imaging' => 'Imaging',
+                'recalls' => 'Recalls',
                'orders' => 'Orders',
                'billing' => 'Billing',
                'documents' => 'Documents',
@@ -0,0 +1,155 @@
+<?php
+
+use Illuminate\Database\Migrations\Migration;
+use Illuminate\Database\Schema\Blueprint;
+use Illuminate\Support\Facades\Schema;
+
+return new class extends Migration
+{
+    public function up(): void
+    {
+        if (Schema::hasTable('care_visits') && ! Schema::hasColumn('care_visits', 'specialty_stage')) {
+            Schema::table('care_visits', function (Blueprint $table) {
+                $table->string('specialty_stage', 32)->nullable()->after('status')->index();
+            });
+        }
+
+        if (Schema::hasTable('care_dental_charts') && ! Schema::hasColumn('care_dental_charts', 'dentition')) {
+            Schema::table('care_dental_charts', function (Blueprint $table) {
+                $table->string('dentition', 16)->default('adult')->after('notation');
+            });
+        }
+
+        if (Schema::hasTable('care_dental_treatment_plans')) {
+            Schema::table('care_dental_treatment_plans', function (Blueprint $table) {
+                if (! Schema::hasColumn('care_dental_treatment_plans', 'rejected_at')) {
+                    $table->timestamp('rejected_at')->nullable()->after('completed_at');
+                }
+                if (! Schema::hasColumn('care_dental_treatment_plans', 'rejection_reason')) {
+                    $table->string('rejection_reason')->nullable()->after('rejected_at');
+                }
+            });
+        }
+
+        if (Schema::hasTable('care_dental_images') && ! Schema::hasColumn('care_dental_images', 'deleted_at')) {
+            Schema::table('care_dental_images', function (Blueprint $table) {
+                $table->softDeletes();
+            });
+        }
+
+        if (! Schema::hasTable('care_dental_perio_exams')) {
+            Schema::create('care_dental_perio_exams', function (Blueprint $table) {
+                $table->id();
+                $table->uuid('uuid')->unique();
+                $table->string('owner_ref', 64)->index();
+                $table->foreignId('organization_id')->constrained('care_organizations')->cascadeOnDelete();
+                $table->foreignId('patient_id')->constrained('care_patients')->cascadeOnDelete();
+                $table->foreignId('visit_id')->nullable()->constrained('care_visits')->nullOnDelete();
+                $table->date('exam_date')->nullable();
+                $table->string('examiner')->nullable();
+                $table->text('notes')->nullable();
+                $table->timestamps();
+
+                $table->index(['organization_id', 'patient_id'], 'care_den_perio_exams_org_pt_idx');
+            });
+        }
+
+        if (! Schema::hasTable('care_dental_perio_sites')) {
+            Schema::create('care_dental_perio_sites', function (Blueprint $table) {
+                $table->id();
+                $table->foreignId('perio_exam_id')->constrained('care_dental_perio_exams')->cascadeOnDelete();
+                $table->string('tooth_code', 8);
+                $table->string('surface', 8);
+                $table->unsignedTinyInteger('probing_mm')->nullable();
+                $table->boolean('bleeding')->default(false);
+                $table->boolean('plaque')->default(false);
+                $table->unsignedTinyInteger('recession_mm')->nullable();
+                $table->timestamps();
+
+                $table->unique(['perio_exam_id', 'tooth_code', 'surface'], 'care_den_perio_sites_unique');
+            });
+        }
+
+        if (! Schema::hasTable('care_dental_lab_cases')) {
+            Schema::create('care_dental_lab_cases', function (Blueprint $table) {
+                $table->id();
+                $table->uuid('uuid')->unique();
+                $table->string('owner_ref', 64)->index();
+                $table->foreignId('organization_id')->constrained('care_organizations')->cascadeOnDelete();
+                $table->foreignId('patient_id')->constrained('care_patients')->cascadeOnDelete();
+                $table->foreignId('visit_id')->nullable()->constrained('care_visits')->nullOnDelete();
+                $table->foreignId('plan_item_id')->nullable()->constrained('care_dental_plan_items')->nullOnDelete();
+                $table->json('tooth_codes')->nullable();
+                $table->string('case_type', 64);
+                $table->string('lab_name')->nullable();
+                $table->string('status', 32)->default('draft')->index();
+                $table->timestamp('ordered_at')->nullable();
+                $table->date('due_at')->nullable();
+                $table->timestamp('received_at')->nullable();
+                $table->text('notes')->nullable();
+                $table->string('created_by')->nullable();
+                $table->timestamps();
+
+                $table->index(['organization_id', 'status'], 'care_den_lab_cases_org_status_idx');
+                $table->index(['patient_id', 'status'], 'care_den_lab_cases_pt_status_idx');
+            });
+        }
+
+        if (! Schema::hasTable('care_dental_recalls')) {
+            Schema::create('care_dental_recalls', function (Blueprint $table) {
+                $table->id();
+                $table->uuid('uuid')->unique();
+                $table->string('owner_ref', 64)->index();
+                $table->foreignId('organization_id')->constrained('care_organizations')->cascadeOnDelete();
+                $table->foreignId('patient_id')->constrained('care_patients')->cascadeOnDelete();
+                $table->date('due_on');
+                $table->string('reason')->nullable();
+                $table->string('status', 32)->default('scheduled')->index();
+                $table->foreignId('linked_visit_id')->nullable()->constrained('care_visits')->nullOnDelete();
+                $table->text('notes')->nullable();
+                $table->string('created_by')->nullable();
+                $table->timestamps();
+
+                $table->index(['organization_id', 'due_on'], 'care_den_recalls_org_due_idx');
+                $table->index(['patient_id', 'status'], 'care_den_recalls_pt_status_idx');
+            });
+        }
+    }
+
+    public function down(): void
+    {
+        Schema::dropIfExists('care_dental_recalls');
+        Schema::dropIfExists('care_dental_lab_cases');
+        Schema::dropIfExists('care_dental_perio_sites');
+        Schema::dropIfExists('care_dental_perio_exams');
+
+        if (Schema::hasTable('care_dental_images') && Schema::hasColumn('care_dental_images', 'deleted_at')) {
+            Schema::table('care_dental_images', function (Blueprint $table) {
+                $table->dropSoftDeletes();
+            });
+        }
+
+        if (Schema::hasTable('care_dental_treatment_plans')) {
+            Schema::table('care_dental_treatment_plans', function (Blueprint $table) {
+                if (Schema::hasColumn('care_dental_treatment_plans', 'rejection_reason')) {
+                    $table->dropColumn('rejection_reason');
+                }
+                if (Schema::hasColumn('care_dental_treatment_plans', 'rejected_at')) {
+                    $table->dropColumn('rejected_at');
+                }
+            });
+        }
+
+        if (Schema::hasTable('care_dental_charts') && Schema::hasColumn('care_dental_charts', 'dentition')) {
+            Schema::table('care_dental_charts', function (Blueprint $table) {
+                $table->dropColumn('dentition');
+            });
+        }
+
+        if (Schema::hasTable('care_visits') && Schema::hasColumn('care_visits', 'specialty_stage')) {
+            Schema::table('care_visits', function (Blueprint $table) {
+                $table->dropColumn('specialty_stage');
+            });
+        }
+    }
+};
@@ -8,6 +8,18 @@
            <a href="{{ route('care.queue.index') }}" class="text-sm font-medium text-indigo-600">← Back to queue</a>
        </div>

+        <form method="GET" class="flex flex-wrap items-end gap-3 rounded-2xl border border-slate-200 bg-white p-4">
+            <div>
+                <label class="block text-xs font-medium text-slate-600">From</label>
+                <input type="date" name="from" value="{{ $report['from'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">To</label>
+                <input type="date" name="to" value="{{ $report['to'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <button type="submit" class="rounded-xl bg-indigo-600 px-4 py-2 text-sm font-semibold text-white">Apply</button>
+        </form>
+
        <div class="grid gap-4 sm:grid-cols-3">
            <div class="rounded-2xl border border-slate-200 bg-white p-4">
                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Unfinished plan items</p>
@@ -56,7 +68,21 @@
        </section>

        <section class="rounded-2xl border border-slate-200 bg-white p-5">
-            <h2 class="text-sm font-semibold text-slate-900">Imaging by modality (month)</h2>
+            <h2 class="text-sm font-semibold text-slate-900">Revenue by procedure (range)</h2>
+            <ul class="mt-3 space-y-1 text-sm">
+                @forelse ($report['revenue_by_code'] as $row)
+                    <li class="flex justify-between gap-3">
+                        <span>{{ $row->description }} × {{ $row->total }}</span>
+                        <span class="tabular-nums">{{ $currency }} {{ number_format($row->amount_minor / 100, 2) }}</span>
+                    </li>
+                @empty
+                    <li class="text-slate-500">No dental procedure revenue in this range.</li>
+                @endforelse
+            </ul>
+        </section>
+
+        <section class="rounded-2xl border border-slate-200 bg-white p-5">
+            <h2 class="text-sm font-semibold text-slate-900">Imaging by modality</h2>
            <ul class="mt-3 space-y-1 text-sm">
                @forelse ($report['imaging_by_modality'] as $row)
                    <li class="flex justify-between gap-3">
@@ -58,16 +58,24 @@
                    <a href="{{ $url }}" target="_blank" class="flex h-32 items-center justify-center text-sm font-medium text-indigo-600">Open file</a>
                @endif
                <div class="px-3 py-2 text-xs">
-                    <p class="font-semibold text-slate-800">{{ $dentalModalities[$image->modality] ?? $image->modality }}</p>
-                    <p class="text-slate-500">
-                        {{ $image->captured_at?->format('d M Y H:i') }}
-                        @if (! empty($image->tooth_codes))
-                            · {{ implode(', ', $image->tooth_codes) }}
-                        @endif
-                    </p>
-                    @if ($image->caption)
-                        <p class="mt-0.5 text-slate-600">{{ $image->caption }}</p>
-                    @endif
+                    <div class="flex items-start justify-between gap-2">
+                        <div>
+                            <p class="font-semibold text-slate-800">{{ $dentalModalities[$image->modality] ?? $image->modality }}</p>
+                            <p class="text-slate-500">
+                                {{ $image->captured_at?->format('d M Y H:i') }}
+                                @if (! empty($image->tooth_codes))
+                                    · {{ implode(', ', $image->tooth_codes) }}
+                                @endif
+                            </p>
+                            @if ($image->caption)
+                                <p class="mt-0.5 text-slate-600">{{ $image->caption }}</p>
+                            @endif
+                        </div>
+                        <form method="POST" action="{{ route('care.specialty.dentistry.images.void', [$workspaceVisit, $image]) }}" onsubmit="return confirm('Void this image?')">
+                            @csrf
+                            <button type="submit" class="text-rose-600 hover:underline">Void</button>
+                        </form>
+                    </div>
                </div>
            </div>
        @empty
@@ -0,0 +1,83 @@
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <h3 class="text-sm font-semibold text-slate-900">Lab cases</h3>
+    <p class="mt-0.5 text-xs text-slate-500">Track crowns, bridges, dentures, and other lab work.</p>
+
+    <ul class="mt-4 space-y-2 text-sm">
+        @forelse ($dentalLabCases ?? [] as $case)
+            <li class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+                <div class="flex flex-wrap items-start justify-between gap-2">
+                    <div>
+                        <p class="font-medium text-slate-800">
+                            {{ $dentalLabCaseTypes[$case->case_type] ?? $case->case_type }}
+                            @if ($case->lab_name) <span class="text-slate-500">· {{ $case->lab_name }}</span> @endif
+                        </p>
+                        <p class="text-xs text-slate-500">
+                            {{ $dentalLabCaseStatuses[$case->status] ?? $case->status }}
+                            @if (! empty($case->tooth_codes)) · {{ implode(', ', $case->tooth_codes) }} @endif
+                            @if ($case->due_at) · due {{ $case->due_at->format('d M Y') }} @endif
+                        </p>
+                    </div>
+                    @if ($case->status !== 'cancelled' && $case->status !== 'fitted')
+                        <form method="POST" action="{{ route('care.specialty.dentistry.lab-cases.status', [$workspaceVisit, $case]) }}" class="flex gap-1">
+                            @csrf
+                            <select name="status" class="rounded-lg border border-slate-200 px-2 py-1 text-xs">
+                                @foreach ($dentalLabCaseStatuses as $value => $label)
+                                    <option value="{{ $value }}" @selected($case->status === $value)>{{ $label }}</option>
+                                @endforeach
+                            </select>
+                            <button type="submit" class="rounded-lg bg-white px-2 py-1 text-xs font-semibold text-indigo-700 ring-1 ring-indigo-200">Update</button>
+                        </form>
+                    @endif
+                </div>
+            </li>
+        @empty
+            <li class="text-slate-500">No lab cases yet.</li>
+        @endforelse
+    </ul>
+
+    <form method="POST" action="{{ route('care.specialty.dentistry.lab-cases', $workspaceVisit) }}" class="mt-6 space-y-3 border-t border-slate-100 pt-4">
+        @csrf
+        <h4 class="text-sm font-semibold text-slate-900">New lab case</h4>
+        <div class="grid gap-3 sm:grid-cols-2">
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Type</label>
+                <select name="case_type" required class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                    @foreach ($dentalLabCaseTypes ?? [] as $value => $label)
+                        <option value="{{ $value }}">{{ $label }}</option>
+                    @endforeach
+                </select>
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Lab name</label>
+                <input type="text" name="lab_name" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Due date</label>
+                <input type="date" name="due_at" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Status</label>
+                <select name="status" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                    <option value="draft">Draft</option>
+                    <option value="ordered">Ordered</option>
+                </select>
+            </div>
+            <div class="sm:col-span-2">
+                <p class="text-xs font-medium text-slate-600">Teeth</p>
+                <div class="mt-2 flex max-h-24 flex-wrap gap-2 overflow-y-auto">
+                    @foreach (array_merge($dentalRows['upper'] ?? [], $dentalRows['lower'] ?? []) as $code)
+                        <label class="inline-flex items-center gap-1 rounded border border-slate-200 px-1.5 py-0.5 text-xs">
+                            <input type="checkbox" name="tooth_codes[]" value="{{ $code }}" class="rounded border-slate-300 text-indigo-600">
+                            {{ $code }}
+                        </label>
+                    @endforeach
+                </div>
+            </div>
+            <div class="sm:col-span-2">
+                <label class="block text-xs font-medium text-slate-600">Notes</label>
+                <input type="text" name="notes" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+        </div>
+        <button type="submit" class="btn-primary">Create lab case</button>
+    </form>
+</section>
@@ -1,16 +1,28 @@
@php
    $teethMap = $dentalTeethMap ?? [];
-    $selected = old('tooth_code', request('tooth', '16'));
+    $selected = old('tooth_code', request('tooth', ($dentalRows['upper'][0] ?? '16')));
    $selectedData = $teethMap[$selected] ?? ['status' => 'present', 'surfaces' => [], 'conditions' => [], 'notes' => null];
+    $dentition = $dentalChart->dentition ?? 'adult';
@endphp

 <section class="rounded-2xl border border-slate-200 bg-white p-5">
    <div class="flex flex-wrap items-start justify-between gap-3">
        <div>
            <h3 class="text-sm font-semibold text-slate-900">Odontogram (FDI)</h3>
-            <p class="mt-0.5 text-xs text-slate-500">Click a tooth to chart status, surfaces, and conditions. Changes are saved to the patient chart.</p>
+            <p class="mt-0.5 text-xs text-slate-500">Click a tooth to chart status, surfaces, and conditions.</p>
+        </div>
+        <div class="flex flex-wrap items-center gap-3">
+            <form method="POST" action="{{ route('care.specialty.dentistry.dentition', $workspaceVisit) }}" class="flex items-center gap-2">
+                @csrf
+                <label class="text-xs font-medium text-slate-600">Dentition</label>
+                <select name="dentition" onchange="this.form.submit()" class="rounded-lg border border-slate-200 px-2 py-1.5 text-sm">
+                    @foreach ($dentalDentitions ?? [] as $value => $label)
+                        <option value="{{ $value }}" @selected($dentition === $value)>{{ $label }}</option>
+                    @endforeach
+                </select>
+            </form>
+            <a href="{{ route('care.specialty.dentistry.print', $workspaceVisit) }}" target="_blank" class="text-sm font-medium text-indigo-600">Print</a>
        </div>
-        <a href="{{ route('care.specialty.dentistry.print', $workspaceVisit) }}" target="_blank" class="text-sm font-medium text-indigo-600">Print chart / plan</a>
    </div>

    <div class="mt-4 space-y-2">
@@ -20,20 +32,27 @@
                <div class="flex flex-wrap gap-1">
                    @foreach (($dentalRows[$rowKey] ?? []) as $code)
                        @php
-                            $t = $teethMap[$code] ?? ['status' => 'present', 'conditions' => []];
-                            $hasFinding = ($t['status'] ?? 'present') !== 'present' || ! empty($t['conditions']);
+                            $t = $teethMap[$code] ?? ['status' => 'present', 'surfaces' => [], 'conditions' => []];
+                            $baseClass = \App\Services\Care\Dentistry\DentalCatalog::toothCssClass($t['status'] ?? 'present', $t['conditions'] ?? []);
+                            $surfaces = $t['surfaces'] ?? [];
                        @endphp
                        <a
                            href="{{ route('care.specialty.workspace', ['module' => 'dentistry', 'visit' => $workspaceVisit, 'tab' => 'odontogram', 'tooth' => $code]) }}"
-                            @class([
-                                'inline-flex h-10 w-9 items-center justify-center rounded-lg border text-xs font-semibold tabular-nums transition',
-                                'border-indigo-400 bg-indigo-50 text-indigo-900 ring-2 ring-indigo-400' => $code === $selected,
-                                'border-amber-300 bg-amber-50 text-amber-900' => $hasFinding && $code !== $selected,
-                                'border-slate-200 bg-slate-50 text-slate-700 hover:border-slate-300' => ! $hasFinding && $code !== $selected,
-                            ])
+                            class="inline-flex flex-col items-center justify-center rounded-lg px-1 py-1 text-xs font-semibold tabular-nums transition {{ $code === $selected ? 'ring-2 ring-indigo-500' : '' }} {{ $baseClass }}"
                            title="Tooth {{ $code }}"
                        >
-                            {{ $code }}
+                            <span>{{ $code }}</span>
+                            @if (! empty($surfaces))
+                                <span class="mt-0.5 flex gap-0.5">
+                                    @foreach (['M','O','D','B','L','I'] as $s)
+                                        <span @class([
+                                            'h-1.5 w-1.5 rounded-full',
+                                            'bg-indigo-600' => in_array($s, $surfaces, true),
+                                            'bg-slate-300/60' => ! in_array($s, $surfaces, true),
+                                        ])></span>
+                                    @endforeach
+                                </span>
+                            @endif
                        </a>
                    @endforeach
                </div>
@@ -41,19 +60,13 @@
        @endforeach
    </div>

-    <form
-        method="POST"
-        action="{{ route('care.specialty.dentistry.tooth', $workspaceVisit) }}"
-        class="mt-6 grid gap-4 border-t border-slate-100 pt-4 sm:grid-cols-2"
-    >
+    <form method="POST" action="{{ route('care.specialty.dentistry.tooth', $workspaceVisit) }}" class="mt-6 grid gap-4 border-t border-slate-100 pt-4 sm:grid-cols-2">
        @csrf
        <input type="hidden" name="tooth_code" value="{{ $selected }}">
-
        <div>
            <label class="block text-xs font-medium text-slate-600">Selected tooth</label>
            <p class="mt-1 text-lg font-semibold tabular-nums text-slate-900">{{ $selected }}</p>
        </div>
-
        <div>
            <label class="block text-xs font-medium text-slate-600">Status</label>
            <select name="status" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
@@ -62,7 +75,6 @@
                @endforeach
            </select>
        </div>
-
        <div class="sm:col-span-2">
            <p class="text-xs font-medium text-slate-600">Surfaces</p>
            <div class="mt-2 flex flex-wrap gap-3">
@@ -75,7 +87,6 @@
                @endforeach
            </div>
        </div>
-
        <div class="sm:col-span-2">
            <p class="text-xs font-medium text-slate-600">Conditions</p>
            <div class="mt-2 flex flex-wrap gap-3">
@@ -88,12 +99,10 @@
                @endforeach
            </div>
        </div>
-
        <div class="sm:col-span-2">
            <label class="block text-xs font-medium text-slate-600">Notes</label>
            <textarea name="notes" rows="2" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $selectedData['notes'] ?? '' }}</textarea>
        </div>
-
        <div class="sm:col-span-2">
            <button type="submit" class="btn-primary">Save tooth</button>
        </div>
@@ -1,17 +1,56 @@
@php
    $plan = $dentalPlan;
    $openItems = $plan?->items?->whereIn('status', ['proposed', 'accepted']) ?? collect();
+    $currentStage = $workspaceVisit->specialty_stage;
+    $stageFlow = [
+        'waiting' => ['next' => 'chair', 'label' => 'Seat at chair'],
+        'chair' => ['next' => 'procedure', 'label' => 'Start procedure'],
+        'procedure' => ['next' => 'recovery', 'label' => 'Move to recovery'],
+        'recovery' => ['next' => 'completed', 'label' => 'Complete visit'],
+    ];
@endphp

 <section class="rounded-2xl border border-slate-200 bg-white p-5">
    <div class="flex flex-wrap items-start justify-between gap-3">
        <div>
            <h3 class="text-sm font-semibold text-slate-900">Overview</h3>
-            <p class="mt-0.5 text-xs text-slate-500">Visit summary and open treatment work.</p>
+            <p class="mt-0.5 text-xs text-slate-500">Visit stage, summary, and open treatment work.</p>
        </div>
        <a href="{{ route('care.specialty.dentistry.reports') }}" class="text-sm font-medium text-indigo-600">Dentistry reports</a>
    </div>

+    <div class="mt-4 rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+        <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Visit stage</p>
+        <p class="mt-1 text-sm font-medium text-slate-900">
+            {{ $currentStage ? ucfirst(str_replace('_', ' ', $currentStage)) : 'Not set' }}
+        </p>
+        <div class="mt-3 flex flex-wrap gap-2">
+            @foreach (['waiting', 'chair', 'procedure', 'recovery', 'completed'] as $stageCode)
+                <form method="POST" action="{{ route('care.specialty.dentistry.stage', $workspaceVisit) }}">
+                    @csrf
+                    <input type="hidden" name="stage" value="{{ $stageCode }}">
+                    <button type="submit"
+                        @class([
+                            'rounded-lg px-2.5 py-1 text-xs font-semibold',
+                            'bg-indigo-600 text-white' => $currentStage === $stageCode,
+                            'border border-slate-200 bg-white text-slate-700 hover:bg-slate-50' => $currentStage !== $stageCode,
+                        ])>
+                        {{ ucfirst($stageCode) }}
+                    </button>
+                </form>
+            @endforeach
+            @if ($currentStage && isset($stageFlow[$currentStage]))
+                <form method="POST" action="{{ route('care.specialty.dentistry.stage', $workspaceVisit) }}">
+                    @csrf
+                    <input type="hidden" name="stage" value="{{ $stageFlow[$currentStage]['next'] }}">
+                    <button type="submit" class="rounded-lg bg-emerald-600 px-2.5 py-1 text-xs font-semibold text-white hover:bg-emerald-700">
+                        {{ $stageFlow[$currentStage]['label'] }} →
+                    </button>
+                </form>
+            @endif
+        </div>
+    </div>
+
    <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
        <div>
            <dt class="text-slate-500">Visit status</dt>
@@ -0,0 +1,69 @@
+@php
+    $exam = $dentalPerioExam;
+    $siteMap = [];
+    foreach ($exam?->sites ?? [] as $site) {
+        $siteMap[$site->tooth_code][$site->surface] = $site;
+    }
+    $teeth = array_merge($dentalRows['upper'] ?? [], $dentalRows['lower'] ?? []);
+    $probeTeeth = array_slice($teeth, 0, 8);
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <h3 class="text-sm font-semibold text-slate-900">Periodontal exam</h3>
+    <p class="mt-0.5 text-xs text-slate-500">Record probing depths, bleeding, and plaque by tooth surface.</p>
+
+    @if ($exam)
+        <p class="mt-3 text-xs text-slate-500">Latest exam {{ $exam->exam_date?->format('d M Y') }} · {{ $exam->sites->count() }} sites</p>
+    @endif
+
+    <form method="POST" action="{{ route('care.specialty.dentistry.perio', $workspaceVisit) }}" class="mt-4 space-y-4">
+        @csrf
+        <div class="overflow-x-auto">
+            <table class="min-w-full text-left text-xs">
+                <thead>
+                    <tr class="border-b border-slate-200 text-slate-500">
+                        <th class="py-2 pr-2">Tooth</th>
+                        @foreach ($dentalPerioSurfaces ?? [] as $surface)
+                            <th class="px-1 py-2">{{ $surface }} mm</th>
+                            <th class="px-1 py-2">B</th>
+                            <th class="px-1 py-2">P</th>
+                        @endforeach
+                    </tr>
+                </thead>
+                <tbody>
+                    @foreach ($probeTeeth as $idx => $tooth)
+                        <tr class="border-b border-slate-100">
+                            <td class="py-2 pr-2 font-semibold tabular-nums">{{ $tooth }}</td>
+                            @foreach ($dentalPerioSurfaces ?? [] as $sIdx => $surface)
+                                @php
+                                    $existing = $siteMap[$tooth][$surface] ?? null;
+                                    $base = "sites.{$idx}_{$sIdx}";
+                                @endphp
+                                <input type="hidden" name="sites[{{ $idx }}_{{ $sIdx }}][tooth_code]" value="{{ $tooth }}">
+                                <input type="hidden" name="sites[{{ $idx }}_{{ $sIdx }}][surface]" value="{{ $surface }}">
+                                <td class="px-1 py-1">
+                                    <input type="number" min="0" max="15" name="sites[{{ $idx }}_{{ $sIdx }}][probing_mm]"
+                                           value="{{ $existing?->probing_mm }}"
+                                           class="w-12 rounded border border-slate-200 px-1 py-1 tabular-nums">
+                                </td>
+                                <td class="px-1 py-1">
+                                    <input type="checkbox" name="sites[{{ $idx }}_{{ $sIdx }}][bleeding]" value="1" class="rounded border-slate-300"
+                                           @checked($existing?->bleeding)>
+                                </td>
+                                <td class="px-1 py-1">
+                                    <input type="checkbox" name="sites[{{ $idx }}_{{ $sIdx }}][plaque]" value="1" class="rounded border-slate-300"
+                                           @checked($existing?->plaque)>
+                                </td>
+                            @endforeach
+                        </tr>
+                    @endforeach
+                </tbody>
+            </table>
+        </div>
+        <div>
+            <label class="block text-xs font-medium text-slate-600">Notes</label>
+            <textarea name="notes" rows="2" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $exam?->notes }}</textarea>
+        </div>
+        <button type="submit" class="btn-primary">Save perio exam</button>
+    </form>
+</section>
@@ -1,5 +1,6 @@
@php
    $plan = $dentalPlan;
+    $history = ($dentalPlanHistory ?? collect())->filter(fn ($p) => ! $plan || $p->id !== $plan->id);
@endphp

 <section class="rounded-2xl border border-slate-200 bg-white p-5">
@@ -15,78 +16,132 @@
                @endif
            </p>
        </div>
-        @if ($plan && $plan->status === 'draft')
-            <form method="POST" action="{{ route('care.specialty.dentistry.plan.accept', $workspaceVisit) }}">
-                @csrf
-                <button type="submit" class="rounded-lg border border-emerald-200 bg-emerald-50 px-3 py-1.5 text-sm font-medium text-emerald-800 hover:bg-emerald-100">Accept plan</button>
-            </form>
+        @if ($plan)
+            <div class="flex flex-wrap gap-2">
+                @if ($plan->status === 'draft')
+                    <form method="POST" action="{{ route('care.specialty.dentistry.plan.accept', $workspaceVisit) }}">
+                        @csrf
+                        <button type="submit" class="rounded-lg border border-emerald-200 bg-emerald-50 px-3 py-1.5 text-sm font-medium text-emerald-800 hover:bg-emerald-100">Accept</button>
+                    </form>
+                @endif
+                @if (in_array($plan->status, ['draft', 'accepted'], true))
+                    <form method="POST" action="{{ route('care.specialty.dentistry.plan.reject', $workspaceVisit) }}" class="flex gap-1">
+                        @csrf
+                        <input type="text" name="rejection_reason" placeholder="Reject reason" class="rounded-lg border border-slate-200 px-2 py-1 text-sm">
+                        <button type="submit" class="rounded-lg border border-amber-200 bg-amber-50 px-3 py-1.5 text-sm font-medium text-amber-900">Reject</button>
+                    </form>
+                @endif
+                @if ($plan->status !== 'completed')
+                    <form method="POST" action="{{ route('care.specialty.dentistry.plan.cancel', $workspaceVisit) }}" onsubmit="return confirm('Cancel this plan?')">
+                        @csrf
+                        <button type="submit" class="rounded-lg border border-slate-200 px-3 py-1.5 text-sm font-medium text-slate-700">Cancel plan</button>
+                    </form>
+                @endif
+            </div>
        @endif
    </div>

-    <ul class="mt-4 space-y-2 text-sm">
+    <ul class="mt-4 space-y-3 text-sm">
        @forelse ($plan?->items ?? [] as $item)
-            <li class="flex flex-wrap items-center justify-between gap-2 rounded-xl border border-slate-100 bg-slate-50 px-3 py-2">
-                <div>
-                    <p class="font-medium text-slate-800">
-                        {{ $item->label }}
-                        @if ($item->tooth_code)
-                            <span class="text-slate-500">· {{ $item->tooth_code }}</span>
-                        @endif
-                        @if (! empty($item->surfaces))
-                            <span class="text-slate-400">({{ implode('', $item->surfaces) }})</span>
-                        @endif
-                    </p>
-                    <p class="text-xs text-slate-500">Priority {{ $item->priority }} · {{ ucfirst($item->status) }}</p>
+            <li class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+                <div class="flex flex-wrap items-start justify-between gap-2">
+                    <div>
+                        <p class="font-medium text-slate-800">
+                            {{ $item->label }}
+                            @if ($item->tooth_code)<span class="text-slate-500">· {{ $item->tooth_code }}</span>@endif
+                            @if (! empty($item->surfaces))<span class="text-slate-400">({{ implode('', $item->surfaces) }})</span>@endif
+                        </p>
+                        <p class="text-xs text-slate-500">Priority {{ $item->priority }} · {{ ucfirst($item->status) }} · {{ number_format($item->estimate_minor / 100, 2) }}</p>
+                    </div>
+                    @if (! in_array($item->status, ['done', 'cancelled'], true))
+                        <form method="POST" action="{{ route('care.specialty.dentistry.plan-items.cancel', [$workspaceVisit, $item]) }}" onsubmit="return confirm('Cancel this item?')">
+                            @csrf
+                            <button type="submit" class="text-xs font-medium text-rose-600">Cancel item</button>
+                        </form>
+                    @endif
                </div>
-                <span class="tabular-nums text-slate-600">{{ number_format($item->estimate_minor / 100, 2) }}</span>
+                @if (! in_array($item->status, ['done', 'cancelled'], true))
+                    <form method="POST" action="{{ route('care.specialty.dentistry.plan-items.update', [$workspaceVisit, $item]) }}" class="mt-3 grid gap-2 border-t border-slate-200/70 pt-3 sm:grid-cols-4">
+                        @csrf
+                        <select name="procedure_code" class="rounded-lg border border-slate-200 px-2 py-1.5 text-xs">
+                            @foreach ($dentalCatalog as $service)
+                                <option value="{{ $service['code'] }}" @selected($item->procedure_code === $service['code'])>{{ $service['label'] }}</option>
+                            @endforeach
+                        </select>
+                        <select name="tooth_code" class="rounded-lg border border-slate-200 px-2 py-1.5 text-xs">
+                            <option value="">Tooth</option>
+                            @foreach (array_merge($dentalRows['upper'] ?? [], $dentalRows['lower'] ?? []) as $code)
+                                <option value="{{ $code }}" @selected($item->tooth_code === $code)>{{ $code }}</option>
+                            @endforeach
+                        </select>
+                        <input type="number" name="priority" value="{{ $item->priority }}" min="1" max="100" class="rounded-lg border border-slate-200 px-2 py-1.5 text-xs">
+                        <button type="submit" class="rounded-lg bg-white px-2 py-1.5 text-xs font-semibold text-indigo-700 ring-1 ring-indigo-200">Save</button>
+                    </form>
+                @endif
            </li>
        @empty
            <li class="text-slate-500">No plan items yet.</li>
        @endforelse
    </ul>

-    <form method="POST" action="{{ route('care.specialty.dentistry.plan-items', $workspaceVisit) }}" class="mt-6 space-y-3 border-t border-slate-100 pt-4">
-        @csrf
-        <h4 class="text-sm font-semibold text-slate-900">Add item</h4>
-        <div class="grid gap-3 sm:grid-cols-2">
-            <div>
-                <label class="block text-xs font-medium text-slate-600">Procedure</label>
-                <select name="procedure_code" required class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
-                    <option value="">Select…</option>
-                    @foreach ($dentalCatalog as $service)
-                        <option value="{{ $service['code'] }}">{{ $service['label'] }} — {{ number_format(((int) $service['amount_minor']) / 100, 2) }}</option>
-                    @endforeach
-                </select>
-            </div>
-            <div>
-                <label class="block text-xs font-medium text-slate-600">Tooth (FDI)</label>
-                <select name="tooth_code" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
-                    <option value="">—</option>
-                    @foreach (array_merge($dentalRows['upper'] ?? [], $dentalRows['lower'] ?? []) as $code)
-                        <option value="{{ $code }}">{{ $code }}</option>
-                    @endforeach
-                </select>
-            </div>
-            <div>
-                <label class="block text-xs font-medium text-slate-600">Priority (1 = highest)</label>
-                <input type="number" name="priority" value="50" min="1" max="100" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
-            </div>
-            <div class="sm:col-span-2">
-                <p class="text-xs font-medium text-slate-600">Surfaces</p>
-                <div class="mt-2 flex flex-wrap gap-3">
-                    @foreach ($dentalSurfaces as $surface)
-                        <label class="inline-flex items-center gap-1.5 text-sm">
-                            <input type="checkbox" name="surfaces[]" value="{{ $surface }}" class="rounded border-slate-300 text-indigo-600">
-                            {{ $surface }}
-                        </label>
-                    @endforeach
+    @if (! $plan || ! in_array($plan->status, ['completed', 'rejected', 'cancelled'], true))
+        <form method="POST" action="{{ route('care.specialty.dentistry.plan-items', $workspaceVisit) }}" class="mt-6 space-y-3 border-t border-slate-100 pt-4">
+            @csrf
+            <h4 class="text-sm font-semibold text-slate-900">Add item</h4>
+            <div class="grid gap-3 sm:grid-cols-2">
+                <div>
+                    <label class="block text-xs font-medium text-slate-600">Procedure</label>
+                    <select name="procedure_code" required class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                        <option value="">Select…</option>
+                        @foreach ($dentalCatalog as $service)
+                            <option value="{{ $service['code'] }}">{{ $service['label'] }} — {{ number_format(((int) $service['amount_minor']) / 100, 2) }}</option>
+                        @endforeach
+                    </select>
+                </div>
+                <div>
+                    <label class="block text-xs font-medium text-slate-600">Tooth (FDI)</label>
+                    <select name="tooth_code" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                        <option value="">—</option>
+                        @foreach (array_merge($dentalRows['upper'] ?? [], $dentalRows['lower'] ?? []) as $code)
+                            <option value="{{ $code }}">{{ $code }}</option>
+                        @endforeach
+                    </select>
+                </div>
+                <div>
+                    <label class="block text-xs font-medium text-slate-600">Priority (1 = highest)</label>
+                    <input type="number" name="priority" value="50" min="1" max="100" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                </div>
+                <div class="sm:col-span-2">
+                    <p class="text-xs font-medium text-slate-600">Surfaces</p>
+                    <div class="mt-2 flex flex-wrap gap-3">
+                        @foreach ($dentalSurfaces as $surface)
+                            <label class="inline-flex items-center gap-1.5 text-sm">
+                                <input type="checkbox" name="surfaces[]" value="{{ $surface }}" class="rounded border-slate-300 text-indigo-600">
+                                {{ $surface }}
+                            </label>
+                        @endforeach
+                    </div>
+                </div>
+                <div class="sm:col-span-2">
+                    <label class="block text-xs font-medium text-slate-600">Notes</label>
+                    <input type="text" name="notes" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
                </div>
            </div>
-            <div class="sm:col-span-2">
-                <label class="block text-xs font-medium text-slate-600">Notes</label>
-                <input type="text" name="notes" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
-            </div>
-        </div>
-        <button type="submit" class="btn-primary">Add to plan</button>
-    </form>
+            <button type="submit" class="btn-primary">Add to plan</button>
+        </form>
+    @endif
 </section>
+
+@if ($history->isNotEmpty())
+    <section class="mt-4 rounded-2xl border border-slate-200 bg-white p-5">
+        <h3 class="text-sm font-semibold text-slate-900">Plan history</h3>
+        <ul class="mt-3 space-y-2 text-sm">
+            @foreach ($history as $past)
+                <li class="flex flex-wrap items-center justify-between gap-2 rounded-xl border border-slate-100 px-3 py-2">
+                    <span>{{ $past->title ?: 'Treatment plan' }} · {{ ucfirst(str_replace('_', ' ', $past->status)) }} · {{ $past->items->count() }} items</span>
+                    <span class="text-xs text-slate-500">{{ $past->created_at?->format('d M Y') }}</span>
+                </li>
+            @endforeach
+        </ul>
+    </section>
+@endif
@@ -0,0 +1,52 @@
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <h3 class="text-sm font-semibold text-slate-900">Recalls</h3>
+    <p class="mt-0.5 text-xs text-slate-500">Schedule follow-ups and mark them complete when the patient returns.</p>
+
+    <ul class="mt-4 space-y-2 text-sm">
+        @forelse ($dentalRecalls ?? [] as $recall)
+            <li class="flex flex-wrap items-center justify-between gap-2 rounded-xl border border-slate-100 bg-slate-50 px-3 py-2">
+                <div>
+                    <p class="font-medium text-slate-800">{{ $recall->reason ?: 'Recall' }}</p>
+                    <p class="text-xs text-slate-500">
+                        Due {{ $recall->due_on?->format('d M Y') }} · {{ ucfirst($recall->status) }}
+                    </p>
+                </div>
+                @if (in_array($recall->status, ['scheduled', 'due'], true))
+                    <div class="flex gap-2">
+                        <form method="POST" action="{{ route('care.specialty.dentistry.recalls.complete', [$workspaceVisit, $recall]) }}">
+                            @csrf
+                            <button type="submit" class="text-xs font-medium text-emerald-700">Complete</button>
+                        </form>
+                        <form method="POST" action="{{ route('care.specialty.dentistry.recalls.cancel', [$workspaceVisit, $recall]) }}">
+                            @csrf
+                            <button type="submit" class="text-xs font-medium text-rose-600">Cancel</button>
+                        </form>
+                    </div>
+                @endif
+            </li>
+        @empty
+            <li class="text-slate-500">No recalls scheduled.</li>
+        @endforelse
+    </ul>
+
+    <form method="POST" action="{{ route('care.specialty.dentistry.recalls', $workspaceVisit) }}" class="mt-6 space-y-3 border-t border-slate-100 pt-4">
+        @csrf
+        <h4 class="text-sm font-semibold text-slate-900">Schedule recall</h4>
+        <div class="grid gap-3 sm:grid-cols-2">
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Due date</label>
+                <input type="date" name="due_on" required class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm"
+                       value="{{ now()->addMonths(6)->toDateString() }}">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">Reason</label>
+                <input type="text" name="reason" placeholder="e.g. 6-month check" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div class="sm:col-span-2">
+                <label class="block text-xs font-medium text-slate-600">Notes</label>
+                <input type="text" name="notes" class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+        </div>
+        <button type="submit" class="btn-primary">Schedule recall</button>
+    </form>
+</section>
@@ -22,8 +22,15 @@
        && $openConsultation->status !== \App\Models\Consultation::STATUS_COMPLETED;
        $chartTab = collect($workspaceTabs ?? [])
            ->keys()
-            ->first(fn ($key) => ! in_array($key, ['overview', 'timeline', 'plan', 'treat', 'notes', 'imaging', 'orders', 'billing', 'documents'], true))
+            ->first(fn ($key) => ! in_array($key, ['overview', 'timeline', 'plan', 'treat', 'notes', 'imaging', 'orders', 'billing', 'documents', 'perio', 'lab', 'recalls'], true))
            ?: 'odontogram';
+    $stageFlow = [
+        'waiting' => ['next' => 'chair', 'label' => 'Seat at chair'],
+        'chair' => ['next' => 'procedure', 'label' => 'Start procedure'],
+        'procedure' => ['next' => 'recovery', 'label' => 'Move to recovery'],
+        'recovery' => ['next' => 'completed', 'label' => 'Complete visit'],
+    ];
+    $currentStage = $workspaceVisit?->specialty_stage;
@endphp

@if ($onWorkspace)
@@ -44,6 +51,20 @@
@endif

@if ($workspaceVisit)
+    @if ($moduleKey === 'dentistry' && $currentStage && isset($stageFlow[$currentStage]))
+        <form method="POST" action="{{ route('care.specialty.dentistry.stage', $workspaceVisit) }}" class="w-full" @click.stop>
+            @csrf
+            <input type="hidden" name="stage" value="{{ $stageFlow[$currentStage]['next'] }}">
+            <button type="submit" class="{{ $btnAccent }}">{{ $stageFlow[$currentStage]['label'] }}</button>
+        </form>
+    @elseif ($moduleKey === 'dentistry' && ! $currentStage)
+        <form method="POST" action="{{ route('care.specialty.dentistry.stage', $workspaceVisit) }}" class="w-full" @click.stop>
+            @csrf
+            <input type="hidden" name="stage" value="chair">
+            <button type="submit" class="{{ $btnAccent }}">Seat at chair</button>
+        </form>
+    @endif
+
    @if ($canCompleteConsultation)
        <button
            type="button"
@@ -36,7 +36,7 @@
    <div class="space-y-4">
        @if ($activeTab === 'timeline')
            @include('care.partials.patient-timeline', ['events' => $timeline ?? []])
-        @elseif ($moduleKey === 'dentistry' && in_array($activeTab, ['odontogram', 'plan', 'treat', 'notes', 'imaging', 'overview'], true))
+        @elseif ($moduleKey === 'dentistry' && in_array($activeTab, ['odontogram', 'plan', 'treat', 'notes', 'imaging', 'overview', 'perio', 'lab', 'recalls'], true))
            @include('care.specialty.dentistry.workspace-'.$activeTab)
        @elseif ($activeTab === 'billing')
            <section class="rounded-2xl border border-slate-200 bg-white p-5">
@@ -119,11 +119,24 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
            Route::post('/specialty/{module}/workspace/{visit}/services', [SpecialtyModuleController::class, 'addService'])->name('care.specialty.services.add');
            Route::post('/specialty/{module}/workspace/{visit}/start-consultation', [SpecialtyModuleController::class, 'startConsultation'])->name('care.specialty.consultation.start');
            Route::post('/specialty/dentistry/workspace/{visit}/tooth', [DentistryWorkspaceController::class, 'updateTooth'])->name('care.specialty.dentistry.tooth');
+            Route::post('/specialty/dentistry/workspace/{visit}/dentition', [DentistryWorkspaceController::class, 'setDentition'])->name('care.specialty.dentistry.dentition');
            Route::post('/specialty/dentistry/workspace/{visit}/plan-items', [DentistryWorkspaceController::class, 'addPlanItem'])->name('care.specialty.dentistry.plan-items');
+            Route::post('/specialty/dentistry/workspace/{visit}/plan-items/{item}', [DentistryWorkspaceController::class, 'updatePlanItem'])->name('care.specialty.dentistry.plan-items.update');
+            Route::post('/specialty/dentistry/workspace/{visit}/plan-items/{item}/cancel', [DentistryWorkspaceController::class, 'cancelPlanItem'])->name('care.specialty.dentistry.plan-items.cancel');
            Route::post('/specialty/dentistry/workspace/{visit}/plan/accept', [DentistryWorkspaceController::class, 'acceptPlan'])->name('care.specialty.dentistry.plan.accept');
+            Route::post('/specialty/dentistry/workspace/{visit}/plan/reject', [DentistryWorkspaceController::class, 'rejectPlan'])->name('care.specialty.dentistry.plan.reject');
+            Route::post('/specialty/dentistry/workspace/{visit}/plan/cancel', [DentistryWorkspaceController::class, 'cancelPlan'])->name('care.specialty.dentistry.plan.cancel');
            Route::post('/specialty/dentistry/workspace/{visit}/procedures', [DentistryWorkspaceController::class, 'completeProcedure'])->name('care.specialty.dentistry.procedures');
            Route::post('/specialty/dentistry/workspace/{visit}/notes', [DentistryWorkspaceController::class, 'saveNotes'])->name('care.specialty.dentistry.notes');
            Route::post('/specialty/dentistry/workspace/{visit}/images', [DentistryWorkspaceController::class, 'uploadImage'])->name('care.specialty.dentistry.images');
+            Route::post('/specialty/dentistry/workspace/{visit}/images/{image}/void', [DentistryWorkspaceController::class, 'voidImage'])->name('care.specialty.dentistry.images.void');
+            Route::post('/specialty/dentistry/workspace/{visit}/stage', [DentistryWorkspaceController::class, 'setStage'])->name('care.specialty.dentistry.stage');
+            Route::post('/specialty/dentistry/workspace/{visit}/perio', [DentistryWorkspaceController::class, 'savePerio'])->name('care.specialty.dentistry.perio');
+            Route::post('/specialty/dentistry/workspace/{visit}/lab-cases', [DentistryWorkspaceController::class, 'createLabCase'])->name('care.specialty.dentistry.lab-cases');
+            Route::post('/specialty/dentistry/workspace/{visit}/lab-cases/{labCase}/status', [DentistryWorkspaceController::class, 'transitionLabCase'])->name('care.specialty.dentistry.lab-cases.status');
+            Route::post('/specialty/dentistry/workspace/{visit}/recalls', [DentistryWorkspaceController::class, 'scheduleRecall'])->name('care.specialty.dentistry.recalls');
+            Route::post('/specialty/dentistry/workspace/{visit}/recalls/{recall}/complete', [DentistryWorkspaceController::class, 'completeRecall'])->name('care.specialty.dentistry.recalls.complete');
+            Route::post('/specialty/dentistry/workspace/{visit}/recalls/{recall}/cancel', [DentistryWorkspaceController::class, 'cancelRecall'])->name('care.specialty.dentistry.recalls.cancel');
            Route::get('/specialty/dentistry/workspace/{visit}/print', [DentistryWorkspaceController::class, 'printChart'])->name('care.specialty.dentistry.print');
            Route::get('/specialty/{module}', [SpecialtyModuleController::class, 'show'])->name('care.specialty.show');
            Route::post('/specialty/{module}/call-next', [SpecialtyModuleController::class, 'callNext'])->name('care.specialty.call-next');
@@ -266,4 +266,131 @@ class CareDentistrySuiteTest extends TestCase
            ->assertSee('Odontogram (FDI)')
            ->assertSee('Afia Darko');
    }
+
+    public function test_plan_item_cancel_and_reject(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.plan-items', $this->visit), [
+                'procedure_code' => 'den.fill',
+                'tooth_code' => '16',
+                'priority' => 10,
+            ])
+            ->assertRedirect();
+
+        $plan = DentalTreatmentPlan::query()->where('patient_id', $this->patient->id)->firstOrFail();
+        $item = $plan->items()->firstOrFail();
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.plan-items.cancel', [$this->visit, $item]))
+            ->assertRedirect();
+
+        $this->assertSame(DentalPlanItem::STATUS_CANCELLED, $item->fresh()->status);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.plan-items', $this->visit), [
+                'procedure_code' => 'den.cleaning',
+                'priority' => 20,
+            ])
+            ->assertRedirect();
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.plan.reject', $this->visit), [
+                'rejection_reason' => 'Patient declined',
+            ])
+            ->assertRedirect();
+
+        $this->assertSame(DentalTreatmentPlan::STATUS_REJECTED, $plan->fresh()->status);
+    }
+
+    public function test_visit_stage_advance_and_primary_dentition(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.stage', $this->visit), [
+                'stage' => 'chair',
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('chair', $this->visit->fresh()->specialty_stage);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.dentition', $this->visit), [
+                'dentition' => 'primary',
+            ])
+            ->assertRedirect();
+
+        $chart = DentalChart::query()->where('patient_id', $this->patient->id)->firstOrFail();
+        $this->assertSame('primary', $chart->dentition);
+        $this->assertTrue($chart->teeth()->where('tooth_code', '55')->exists());
+    }
+
+    public function test_imaging_void_perio_lab_and_recall(): void
+    {
+        Storage::fake('public');
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.images', $this->visit), [
+                'attachment' => UploadedFile::fake()->image('xray.jpg'),
+                'modality' => 'bw',
+                'tooth_codes' => ['16'],
+                'add_fee' => 0,
+            ])
+            ->assertRedirect();
+
+        $image = \App\Models\DentalImage::query()->where('visit_id', $this->visit->id)->firstOrFail();
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.images.void', [$this->visit, $image]))
+            ->assertRedirect();
+
+        $this->assertSoftDeleted('care_dental_images', ['id' => $image->id]);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.perio', $this->visit), [
+                'sites' => [
+                    ['tooth_code' => '16', 'surface' => 'B', 'probing_mm' => 4, 'bleeding' => 1],
+                ],
+                'notes' => 'Perio demo',
+            ])
+            ->assertRedirect();
+
+        $this->assertDatabaseHas('care_dental_perio_exams', [
+            'patient_id' => $this->patient->id,
+            'visit_id' => $this->visit->id,
+        ]);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.lab-cases', $this->visit), [
+                'case_type' => 'crown',
+                'lab_name' => 'City Lab',
+                'tooth_codes' => ['16'],
+                'status' => 'ordered',
+            ])
+            ->assertRedirect();
+
+        $case = \App\Models\DentalLabCase::query()->where('patient_id', $this->patient->id)->firstOrFail();
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.lab-cases.status', [$this->visit, $case]), [
+                'status' => 'received',
+            ])
+            ->assertRedirect();
+        $this->assertSame('received', $case->fresh()->status);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.recalls', $this->visit), [
+                'due_on' => now()->addMonths(3)->toDateString(),
+                'reason' => 'Check-up',
+            ])
+            ->assertRedirect();
+
+        $recall = \App\Models\DentalRecall::query()->where('patient_id', $this->patient->id)->firstOrFail();
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.dentistry.recalls.complete', [$this->visit, $recall]))
+            ->assertRedirect();
+        $this->assertSame('completed', $recall->fresh()->status);
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.dentistry.reports'))
+            ->assertOk()
+            ->assertSee('Revenue by procedure');
+    }
 }
@@ -165,7 +165,7 @@ class CareSpecialtyClinicalTest extends TestCase
            ->assertSee('ABC compromise');
    }

-    public function test_blood_bank_request_and_dentistry_odontogram_save(): void
+    public function test_blood_bank_request_save(): void
    {
        [$bbVisit] = $this->activateWithVisit('blood_bank', 'blood_bank');

@@ -188,68 +188,6 @@ class CareSpecialtyClinicalTest extends TestCase
            'module_key' => 'blood_bank',
            'record_type' => 'blood_request',
        ]);
-
-        app(SpecialtyModuleService::class)->activate(
-            $this->organization->fresh(),
-            $this->owner->public_id,
-            'dentistry',
-        );
-
-        $dentalDept = Department::query()
-            ->where('branch_id', $this->branch->id)
-            ->where('type', 'dental')
-            ->firstOrFail();
-
-        $patient = Patient::create([
-            'owner_ref' => $this->owner->public_id,
-            'organization_id' => $this->organization->id,
-            'branch_id' => $this->branch->id,
-            'patient_number' => 'P-CL-2',
-            'first_name' => 'Ama',
-            'last_name' => 'Boateng',
-            'gender' => 'female',
-            'date_of_birth' => '1990-01-01',
-        ]);
-
-        $denVisit = Visit::create([
-            'owner_ref' => $this->owner->public_id,
-            'organization_id' => $this->organization->id,
-            'branch_id' => $this->branch->id,
-            'patient_id' => $patient->id,
-            'status' => Visit::STATUS_OPEN,
-            'checked_in_at' => now(),
-        ]);
-
-        Appointment::create([
-            'owner_ref' => $this->owner->public_id,
-            'organization_id' => $this->organization->id,
-            'branch_id' => $this->branch->id,
-            'patient_id' => $patient->id,
-            'department_id' => $dentalDept->id,
-            'visit_id' => $denVisit->id,
-            'type' => Appointment::TYPE_WALK_IN,
-            'status' => Appointment::STATUS_WAITING,
-            'scheduled_at' => now(),
-            'waiting_at' => now(),
-        ]);
-
-        $this->actingAs($this->owner)
-            ->post(route('care.specialty.clinical.save', ['module' => 'dentistry', 'visit' => $denVisit]), [
-                'tab' => 'odontogram',
-                'payload' => [
-                    'teeth_affected' => '16, 26',
-                    'findings' => 'Caries on occlusal surfaces',
-                    'planned_procedures' => 'Fillings',
-                    'anesthesia' => 'Local',
-                ],
-            ])
-            ->assertRedirect();
-
-        $this->assertDatabaseHas('care_specialty_clinical_records', [
-            'visit_id' => $denVisit->id,
-            'module_key' => 'dentistry',
-            'record_type' => 'odontogram',
-        ]);
    }

    public function test_ophthalmology_uses_eye_exam_form_not_generic_notes(): void