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non-resorbable sutures were used."},"requirement":"conditional"},{"purpose":"assessment","after":{"min":90,"max":180,"unit":"days","qualifier":"X-ray or CBCT before implant planning."},"requirement":"routine"}],"indications":["Tooth extraction with planned implant or bridge","Prevention of ridge collapse after extraction","Preserving aesthetics in the front teeth area","Extraction sockets with intact or partly damaged walls"],"main_risks":["Swelling, bruising and bleeding","Infection of the graft site","Graft particle loss or membrane exposure","Incomplete bone fill needing further grafting","Dry socket-like pain","Gum recession or soft-tissue changes"],"pain":"Mild to moderate for 2-4 days, controlled with standard painkillers; discomfort resembles tooth extraction.","preparation":["Dental exam with X-ray or CBCT","Treat active gum disease or infection first","Stop smoking before and after the procedure","Review blood thinners and diabetes control with the clinic"],"recovery_timeline":[{"phase":"Days 1-3","description":"Swelling and mild bleeding peak; soft cold diet.","restrictions":["No rinsing hard or spitting","No straws","Avoid touching the site"]},{"phase":"Days 4-14","description":"Gum heals over the graft; sutures removed if needed.","restrictions":["Chew on the opposite side","No smoking","Gentle brushing near site only"]},{"phase":"Months 1-4","description":"Graft integrates into new bone; implant planning follows.","restrictions":["Avoid pressure from temporary dentures on the site"]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"Normal eating and routine return; gum covers the site in about 2-4 weeks."},"result_longevity":"Preserved bone volume remains while the site is later restored with an implant or bridge; long-term stability depends on restoration and oral hygiene.","revision_rate_pct":{"min":2,"max":10,"unit":"percent","qualifier":"Need for repeat or additional grafting at implant placement due to insufficient bone fill or graft failure."},"scars":"No visible scars; small intraoral gum mark at the site that fades.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Grafting is done at the time of extraction in one appointment."},"stages":[{"code":"extraction_graft","label":"Tooth extraction with graft and membrane placement","after":{"min":0,"max":0,"unit":"days","qualifier":"Same visit."}},{"code":"healing_check","label":"Healing and bone maturation before implant","after":{"min":90,"max":180,"unit":"days","qualifier":"Implant or bridge planning after healing."}}],"qualifier":"One procedure visit, then a healing period of about 3-6 months."},"success":{"metric":"Ridge width preserved versus unassisted healing","value":2,"unit":"mm","horizon":"3-6 months after extraction","population":"Adults with extraction sockets and intact or mildly damaged walls planned for implant","evidence_status":"limited"},"techniques":[{"name":"Bone graft particles with collagen membrane","suits_whom":"Most sockets with intact walls, standard choice.","recovery":"Sutured or covered site; 1-2 weeks of gum healing."},{"name":"Collagen plug or sponge only","suits_whom":"Small sockets with intact walls and thick gum.","recovery":"Quick healing, mild discomfort."},{"name":"Graft with soft-tissue seal (punch graft or collagen cap)","suits_whom":"Front teeth, thin gum biotype or missing wall.","recovery":"1-2 weeks; sutures are usually removed."},{"name":"PRF membrane with graft","suits_whom":"Patients preferring autologous blood-derived material or with slow healing risk.","recovery":"Similar to standard; blood draw required."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":0.5,"max":1.5,"unit":"hours","qualifier":"Includes extraction, graft placement and suturing; longer for molars."},"initial_assessment_documents":["Panoramic dental X-ray (OPG)","CBCT scan of the area (if available)","Photos of the affected tooth and gums","List of medications including blood thinners","Previous dental treatment report (if available)"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"One trip covers extraction and graft; optional return for implant."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that the dentist conducts a comprehensive examination before discussing treatment options","scope":"procedure","source":{"url":"https://www.ada.org/about/press-releases/statement-on-dental-implant-practices-in-the-news","host":"ada.org","quote":"In all settings, patients should expect to first be comprehensively examined by a dentist and then have a conversation about the range of treatment options available based on the dentist’s diagnosis.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check that three-dimensional assessment is recommended when examination indicates bone grafting or reconstruction will be needed","scope":"procedure","source":{"url":"https://health.ri.gov/sites/g/files/xkgbur1006/files/2026-01/ADA-AAOMR-patient-selection.pdf","host":"health.ri.gov","quote":"When results of clinical examination indicate bone grafting or reconstruction will be needed, 3-dimensional assessment of the implant site is recommended.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C3","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C4","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Check that the surgeon who consults with you is the same person who will carry out the procedure","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"The offer proceeds without a comprehensive examination and diagnosis-based treatment discussion","scope":"procedure","source":{"url":"https://www.ada.org/about/press-releases/statement-on-dental-implant-practices-in-the-news","host":"ada.org","quote":"In all settings, patients should expect to first be comprehensively examined by a dentist and then have a conversation about the range of treatment options available based on the dentist’s diagnosis.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-12","next_check_at":"2027-02-10"},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Implant placement is planned before or during placement","name":"Guided bone regeneration","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10720259/","host":"pmc.ncbi.nlm.nih.gov","quote":"While socket preservation (SP) is performed at the stage of tooth extraction, guided bone regeneration (GBR) takes place before or simultaneous to implant placement.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"bone-graft-particles","name":"Bone graft particles with collagen 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