INFORMATION
PROCEDURE involves local anaesthetic, creating suitable sized space for insertion of implant in the bone. If the procedure involves bone graft it will be discussed separately. Leaflets regarding details of the procedure are available. Surgery will cause some discomfort, swelling and bleeding. The symptoms are generally well controlled with analgesics. Success rate with implants is about 95%. It is slightly lower in smokers. If an implant fails, it needs to be removed. Implant restorations need good hygiene maintenance for their long term success. The crowns and bridge or restorative work may need repair and maintenance on the long term and this may incur significant costs.
Treatment duration varies depending on healing. We will give you the best possible intermediate prosthesis during the process of treatment. It may be inevitable in some circumstances that you may not be able to wear temporary dentures for a short space of time.
There is no method to accurately predict the gum and bone healing abilities in each patient following implant surgery. To this end no guarantees or assurances as to the outcome of results can be made. As the implant does not replace missing soft tissue, often it may be necessary to compromise the gum margin appearance or replace it with pink prosthetic material.
Medical knowledge changes continuously and new information becomes available all the time regarding various aspects. New information and knowledge may change treatment philosophies in future.
CONSENT
I have read and understood the above information and discussed in detail the procedure, risks, benefits, options and long term needs related to implant based dental restorations. I have considered all alternatives carefully. All my questions related to implant treatment have been answered to satisfaction.
I give consent to carry out
- Examination and investigations
- Surgical placement of dental implants
- Additional procedures as soft tissue surgery and grafts
- Restoration using dental implants
- Photography, filming and radiographs to be recorded and used for educational purposes.
I agree to follow all home care instructions given to me by the dentist. To the best of my knowledge I have given an accurate history about my health, medications and allergies. I understand the importance of regular maintenance visits following implant treatment to ensure long and healthy life of implants. I will seek regular implant check up appointments with my dental practitioner or dentist providing the restorative treatment.
- I have asked all relevant questions related to my treatment.
- I have received a definitive treatment plan and all other alternate options available in writing and have considered the options carefully.
- I have received in writing, the cost of my treatment, both for surgical and restorative stages. I agree to pay the fees as per schedule.
- I have understood the approximate time needed to complete this treatment process.
Patient Name
Date and Signature. Mr K Shanbhag Dental Surgeon