Diagnosis: After a comprehensive oral and diagnostic evaluation, my surgeon has informed me that surgically I am a suitable candidate to replace my teeth with an implant supported dental prosthesis. The treatment plan has been determined by my surgeon's professional recommendation for treatment after evaluation of my medical history, clinical findings and personal concerns. My surgeon will liaise with my restoring Dentist / Prosthodontist regarding all restorative aspects of the treatment.
Expected benefits: The purpose of immediate loading dental implant surgery is to allow the replacement of teeth for improved function and/or to improve aesthetics. The implants will provide support, anchorage and retention for a fixed prosthesis. In some cases my surgeon will work closely with other professionals or specialists to achieve the desired outcome.
Recommended treatment: Immediate loaded dental prosthesis is an advanced technique that provides a more functional and stable option, as opposed to the traditional removable dentures. This concept allows a whole dental arch to be supported on 4 or 6 implants, case dependent, and can provide fixed replacement teeth that function and look similar to natural teeth. They are not removable and can only be removed by a trained dental professional. The temporary interim prosthesis will be fitted within 24hrs from the surgery.
Surgery options: The procedure can be completed under the following treatment options;
Local anaesthetic: Performed at the Perio Centre in the dental chair, under routine dental local anaesthesia.
Oral Sedation: Used in conjunction with local anesthetic. A prescription for a relaxation medication will be provided, to take one hour prior to the procedure. It is important to note that the patient is awake and conscious during the procedure, but can expect to feel more calm and relaxed.
General anaesthetic: This is performed at a day procedure facility or hospital where the treatment is done under general anaesthesia, provided by an Anaesthetist.
Surgical procedure: The surgeon will remove any remaining teeth which may also include bone augmentation and in some cases bone reduction (re-shaping of the bone). The implants are strategically placed after careful and intricate planning.
Once the implants have been placed the soft tissue will be sutured around the implants. We would usually wait a minimum of 3 months before confirming integration of the implants. In some cases it can be longer due to case specific situations (for example where additional bone grafting has been performed).
I understand that during surgery, if in the unlikely situation that clinical conditions are unfavourable for the placement of implants, my surgeon will make a professional judgement to change the treatment directive. This procedure may require bone grafting to build up the ridge to allow for implant placement at a later date.
I understand that when there is insufficient bone, a bone graft will be placed using either my own bone harvested from my jaw and/or certified bone mineral of bovine origin or human donor tissue. In this event, I understand that I may have to wear a complete denture that is removable for a minimum of 3 months.
The surgery itself can range from 4 - 6 hrs case dependent. If being treated under sedation / anaesthesia, a family member or support person is required to escort one to and from the appointment. They will need to be present for discharging and for the explanation of all post operative instructions.
One should expect to be numb following the procedure for anywhere between 4-6hrs.
Common experiences post surgery are swelling, bruising, pain/discomfort, difficulty opening one’s mouth to full range. This generally is most evident in the first 3-5 days post surgery but is not uncommon up to 10 days.
Pre and postoperative medications and management plans will be provided to ensure you are as comfortable as possible during the recovery period. One week off work is typically advised for recovery but each individual case differs. A medical certificate can be provided during this time. It is important to be realistic in one’s expectations and that following surgery, only
soft foods can be eaten for the next
10-12 weeks, whilst the implants integrate and tissues heal. Eating of hard chewing foods may be detrimental to the outcome of the implants and can result in failure.
Interim Prosthesis: As mentioned above, the surgeon will liaise with the restoring Dentist / Prosthodontist regarding the restorative aspects of the treatment. Perio Centre
DOES NOT manage the restorative aspects of this treatment.
The interim prosthesis will be inserted on the day of surgery however if adjustments are required then it may be completed overnight and inserted the following morning. In the unlikely event that the surgeon is not satisfied with the bone quality and feels that the implants cannot be immediately loaded, one may have to wear a complete denture ,that is removable, for a minimum of 3 months. The implants will be buried and gums closed over. This is to allow time for the implants to integrate without any loading forces on them.
Post procedure: A post operative check appointment at the Perio Centre will take place two weeks following the surgery. This is completed by one of the specially trained periodontal hygienists and is an essential part to ensure success during the healing phase. The Periodontal Hygienist will assess a healing of the wounds and will remove any remaining sutures. Thorough instructions will be provided for the new oral hygiene routine which needs to be implemented into one’s daily habits to maintain a healthy mouth.
Restorative aspects: Three months post surgery the integration of the implants will be tested and confirmed at the Perio Centre. From this point the restorative Dentist / Prosthodontist and Prosthetist will commence fabricating and upgrading the interim prosthesis to the final prosthesis. Perio Centre
DOES NOT manage the upgrade of prosthesis and it is recommended to discuss with your restoring Dentist / Prosthodontist as to which final material is best suited to your mouth.
I understand that it is my responsibility as the patient to ensure I follow through with the treatment by upgrading the interim prosthesis to the final prosthesis and by failing to do so may result in a failure of the interim prosthesis and or implants.
Primary risks and complications: I understand the success of surgical procedures can be affected by medical conditions, dietary and nutritional problems, smoking, alcohol consumption, clenching and grinding of teeth, oral hygiene, and medications that I may be taking. To my knowledge I have reported to my surgeon any prior drug reactions, allergies, diseases, symptoms, habits or conditions that in any way relate to this surgical procedure.
I understand that some patients do not respond successfully to dental implants, and in such cases, the implant may need to be removed. I understand that complications may result from the implant surgery, drugs, and anaesthetics. These complications include, but are not limited to:
Post surgical infection
Restricted ability to open mouth
Impact on speech
Allergic reactionsInjury to teeth
Accidental swallowing of foreign objects
Delayed healing
Jaw bone fracture
Pain, swelling and post-operative discoloration of the face, neck and mouth
Mal-union, delayed union, or non-union of the bone graft material to normal bone
Lack of adequate bone growth into the bone graft replacement material
Referred pain to the ear, neck or head.
Post-operative, unfavorable reactions to drugs, such as nausea, vomiting and allergies
Unfavourable conditions for the placement of the implant(s) which may require a bone graft, or a soft tissue graft.
This may delay the placement of the implant and the healing process.
Damage to sinuses requiring additional treatment or surgical repair at a later date.
Transient or permanent numbness of the lip, tongue, teeth, chin or gum
Bleeding which might require more advanced techniques to control
Failure of implant(s) integrating resulting in implant removal
Smoking: The risks for failure and other complications are significantly higher in smokers and patients are strongly encouraged to quit. Continuing to smoke may affect the healing time and compromise the success of the surgery. Patients that are not prepared to cease smoking altogether are recommended to avoid smoking during the crucial early healing period of at least 2 weeks. I understand that if I smoke I have an increased risk of the above complications. The exact duration of any complication(s) can not be determined, and they may be irreversible.
Alternatives to suggested treatment: I understand that alternatives to immediate loading surgery may include: 1) no treatment, 2) dental bridgework (if there are dentally suitable adjacent teeth for supporting a fixed bridge) 3) removable dentures with implant locators 4) removable dentures
Conditional warranty: It is understood that although good results are expected, they cannot be and are not implied, guaranteed, or warrantable. Just as teeth require healthy gums and bone, so do implants. They are not impervious to gum disease. The new teeth will be permanently fixed to the implants, they can not be removed, except by a dental professional. A detailed home care routine will be provided to me including how to care for the implants and prosthetic appliance. You understand that it is your responsibility to ensure you follow this routine diligently.
You will enter our periodontal hygiene program, returning to us every 4 - 6 months. This appointment includes: comprehensive examination of all dental implants, including routine dental radiographs, professional cleaning of the implants and prosthesis, monitoring and advising on home care procedures. Periodically, we will remove your fixed appliance and clean around your implants, this allows for better access and also allows the opportunity to polish the implant abutments as well as the prosthesis. This appointment will be an extended appointment to allow time to remove the prosthesis and place it back after the maintenance appointment. A treatment plan will be provided to you to reflect the costs associated with the extended implant maintenance appointment. These costs are subject to change with any company fee schedule updates, in which case you will be advised and provided with an updated plan. If you neglect to enter or fail to attend the maintenance program, after 18 months the warranty will be void and we cannot be liable for any complications or failures that occur with your implants. Should your implant fail within 5 years of placement, the dental implant and abutments will be replaced at no extra charge, provided that you have complied with the suggested maintenance schedule. There may be a fee to cover the costs for additional procedures for example if a bone graft and/or soft tissue grafting if now required. Providing that you have adhered to the suggested maintenance programme, should an implant fail within 5 - 10 years, the implant will be replaced at 50% of the fee at that point in time to place the implant. However there will be a fee to cover the costs of the surgery and materials (for example if bone and / or soft tissue grafting is required).
**Warranty on your restorative prosthesis will be provided by the Dental Lab technician / restoring party. This is for technical issues only. Any damage or failures due to lifestyle or nocturnal habits is not covered. Should you have any questions about what this entails or you are concerned please speak to your dental technician or restoring dentist / specialist to be advised on what technical issues can arise.
Publication of records: I authorise photos, slides, x-rays or any other viewings of my care and treatment during or after its completion to be used for the advancement of dentistry. However my identity will not be revealed to the general public without my permission.