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Longer with same-day extractions, grafting or physically demanding work."},"complication_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Any complication needing extra care in year one, e.g. infection, mucositis, screw loosening, transient numbness."},"contraindications":["Uncontrolled diabetes or other uncontrolled systemic disease","Active oral infection or untreated periodontal disease (until treated)","Insufficient anterior mandibular bone without grafting or revised plan (relative)","IV bisphosphonate, denosumab or jaw radiotherapy (risk-dependent)","Heavy smoking or poor oral hygiene (relative)","Severe bruxism (relative)","Pregnancy (elective surgery usually deferred)","Anticoagulants or bleeding disorder without physician coordination (relative)"],"days_in_clinic":{"min":0,"max":0,"unit":"nights","qualifier":"Adult two-implant fixed hybrid under local anesthesia, outpatient. No overnight stay in uncomplicated cases."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":1,"max":2,"unit":"weeks","qualifier":"Counted from surgery day, for strenuous exercise once swelling settles. Light activity is fine early; contact sports may wait."},"final_result_months":{"min":3,"max":6,"unit":"months","qualifier":"From surgery day to osseointegration and definitive fixed prosthesis. Longer if grafting is needed."},"fly_home_after_days":{"min":2,"max":7,"unit":"days","qualifier":"From surgery day, once bleeding and swelling are controlled and the dentist clears you. Later after grafting, extractions or complications."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Reference event: surgery day. Check of healing and suture removal if non-resorbable sutures were used."}},{"purpose":"assessment","requirement":"routine","after":{"min":14,"max":30,"unit":"days","qualifier":"Reference event: surgery day. Bite and prosthesis check, with adjustments as needed."}},{"purpose":"result_review","requirement":"routine","after":{"min":90,"max":180,"unit":"days","qualifier":"Reference event: surgery day. Planned review of osseointegration before the definitive fixed prosthesis is fitted."}}],"indications":["Edentulous arch, usually mandible, with loose complete denture","Resorbed mandibular ridge where conventional denture stability is poor","Poor chewing or restricted diet from an unstable denture","Edentulous arch needing a fixed implant-supported restoration"],"main_risks":["Infection or peri-implantitis","Implant failure or lack of osseointegration","Bleeding, swelling and bruising","Temporary or rare persistent lip or chin numbness (mandible)","Prosthesis fracture or chipping","Screw loosening or fracture","Marginal bone loss around implants"],"pain":"Under local anesthesia the procedure is usually painless apart from pressure. Mild to moderate soreness and swelling for several days is typical and usually managed with ordinary analgesics as advised by the dentist.","preparation":["Clinical examination with panoramic X-ray or CBCT","Impressions and treatment planning, including implant positions and prosthesis design","Treatment of infection, decayed teeth or periodontal disease before surgery","Medical and medication review; coordinate with physician if needed","Assessment of ridge height, width and grafting need","Planning of immediate loading and provisional fixed prosthesis","Fasting usually unnecessary under local anesthesia; follow clinic instructions","Stop smoking before and after surgery where possible"],"recovery_timeline":[{"phase":"First days (days 0-3)","description":"Outpatient recovery at home. Swelling, mild to moderate soreness, bruising and minor oozing settle gradually. Light daily activity is usually fine.","restrictions":["Soft or liquid diet","Gentle oral hygiene and any rinses as advised","Avoid pressure on the surgical site","Follow the dentist's instructions on wearing the temporary prosthesis","Avoid smoking","Avoid strenuous exercise"]},{"phase":"Weeks 1-2","description":"Soft tissue heals and you adapt to the provisional prosthesis. Light work usually resumes earlier; strenuous exercise may resume late in this period.","restrictions":["Avoid hard or sticky foods","Avoid heavy lifting and intense exercise until cleared","Keep the implant area clean"]},{"phase":"Weeks 2-12","description":"Diet gradually progresses while implants integrate, with prosthesis adjustments as needed.","restrictions":["Stay on a softer diet as advised","Avoid biting hard foods on the implant-supported prosthesis"]},{"phase":"Months 3-6","description":"Osseointegration is confirmed, then the definitive fixed prosthesis is fitted. Longer with grafting or delayed loading.","restrictions":["Gradual return to a normal diet as advised","Keep up hygiene and maintenance visits"]},{"phase":"At any time","description":"Seek prompt dental or medical assessment for warning symptoms, without waiting for a scheduled visit.","restrictions":["Heavy or persistent bleeding","Increasing swelling, fever, pus or bad taste","Severe pain not eased by the advised analgesics","Numbness of the lip or chin that persists or worsens","Loose implant, loose screw or broken prosthesis","Breathing or swallowing difficulty, or spreading facial swelling (emergency)"]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"From surgery day: functional recovery on a soft diet with prosthesis adaptation; full osseointegration takes months."},"result_longevity":"Implants often last 10 years or more with good hygiene, no smoking and regular maintenance; no lifespan is guaranteed. Prosthesis screws, acrylic and parts need periodic checks and repair.","revision_rate_pct":{"min":3,"max":10,"unit":"percent","qualifier":"Unplanned reoperation, implant removal or replacement, or prosthesis remake within about 5 years; routine maintenance excluded."},"scars":"No visible external scars. Small intraoral gum healing marks at the implant sites are possible.","sessions_or_stages":{"sessions":{"min":3,"max":5,"unit":"visits","qualifier":"Treatment appointments for one arch (planning, surgery, prosthetic stages), excluding routine follow-up checks."},"stages":[{"code":"planning","label":"Examination, imaging and planning","after":{"min":0,"max":0,"unit":"days","qualifier":"Reference event: initial visit."}},{"code":"implant_placement","label":"Placement of two implants with same-day provisional fixed hybrid","after":{"min":7,"max":30,"unit":"days","qualifier":"After planning and any preparatory treatment, such as treating infection."}},{"code":"definitive_prosthesis","label":"Impressions and fitting of definitive fixed hybrid prosthesis","after":{"min":90,"max":180,"unit":"days","qualifier":"After implant placement, once osseointegration is adequate; counted from the surgery day."}}],"qualifier":"One mandibular arch, two implants, screw-retained fixed hybrid prosthesis, outpatient. Grafting extends the timeline."},"success":{"metric":"Implant survival","value":92,"unit":"percent","horizon":"5 years after implant placement","population":"Adults with two-implant fixed hybrid, adequate bone, good hygiene.","evidence_status":"limited"},"techniques":[{"name":"Primary protocol: two-implant fixed hybrid with immediate loading","suits_whom":"Edentulous adults with enough anterior mandibular bone and adequate primary implant stability.","recovery":"Soft diet for several weeks, then normal diet after osseointegration. Prosthesis adjustments may be needed."},{"name":"Two-implant fixed hybrid with delayed loading","suits_whom":"Patients with lower primary stability or who need grafting or a longer healing period.","recovery":"Longer healing period of about 3-6 months before functional loading."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":1,"max":2.5,"unit":"hours","qualifier":"Surgical visit for two mandibular implants with provisional fixed connection; excludes planning, impressions and later visits."},"initial_assessment_documents":["Panoramic dental X-ray (OPG)","CBCT scan of the lower jaw (if available)","Photos of the mouth and gums","Photos of current dentures (if available)","List of blood thinners and bisphosphonates"],"travel_trips":{"min":2,"max":2,"one_trip_possible":false,"qualifier":"Surgery trip of about 3-7 days, then return after 3-6 months of healing for definitive fixed prosthesis."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Expect a comprehensive examination by a dentist before treatment options are discussed","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":"2026-11-14","http_status":200}},{"id":"C2","text":"Ask questions about the treatment options and alternatives that may be available","scope":"procedure","source":{"url":"https://www.ada.org/about/press-releases/statement-on-dental-implant-practices-in-the-news/","host":"ada.org","quote":"Patients are encouraged to ask questions about their treatment options and alternatives that may be available – if they are uncomfortable with what is being recommended, they should feel free to seek a second 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care.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C5","text":"Check that the dentist explains proposed treatment and reasonable alternatives so you can join decisions","scope":"treatment_type","source":{"url":"https://www.ada.org/about/principles/code-of-ethics/patient-autonomy","host":"ada.org","quote":"The dentist should inform the patient of the proposed treatment, and any reasonable alternatives, in a manner that allows the patient to become involved in treatment decisions.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C6","text":"Check that the dentist will provide records to you or another dentist on request","scope":"treatment_type","source":{"url":"https://www.ada.org/about/principles/code-of-ethics/patient-autonomy","host":"ada.org","quote":"Upon request of a patient or another dental practitioner, dentists shall provide any information in accordance with applicable law that will be beneficial for the future treatment of that patient.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Clinic proposes implants without first giving you a comprehensive dental examination","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":"2026-11-14","http_status":200}},{"id":"F2","text":"Clinic discourages questions or a second opinion about the recommended treatment","scope":"procedure","source":{"url":"https://www.ada.org/about/press-releases/statement-on-dental-implant-practices-in-the-news/","host":"ada.org","quote":"Patients are encouraged to ask questions about their treatment options and alternatives that may be available – if they are uncomfortable with what is being recommended, they should feel free to seek a second opinion.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"F3","text":"Financing is raised before the treatment options have been discussed with the dentist","scope":"procedure","source":{"url":"https://www.ada.org/about/press-releases/statement-on-dental-implant-practices-in-the-news/","host":"ada.org","quote":"Any discussion regarding the financing of complex dental procedures, such as implants or full arch implants, should take place only after patients have discussed the range of treatment options with their dentists.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"F4","text":"Treatment is proposed without the reasonable alternatives being explained","scope":"treatment_type","source":{"url":"https://www.ada.org/about/principles/code-of-ethics/patient-autonomy","host":"ada.org","quote":"The dentist should inform the patient of the proposed treatment, and any reasonable alternatives, in a manner that allows the patient to become involved in treatment decisions.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Severe bleeding","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/24303-implant-supported-dentures","host":"my.clevelandclinic.org","quote":"If you’ve had dental implants placed, call your dentist if you notice: Severe bleeding","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"W2","text":"Pain that doesn't improve with medication","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/24303-implant-supported-dentures","host":"my.clevelandclinic.org","quote":"Pain that doesn’t improve with medication.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"W3","text":"Pus or infection near your implants","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/24303-implant-supported-dentures","host":"my.clevelandclinic.org","quote":"Pus or infection near your implants.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"W4","text":"A fever of 101 degrees Fahrenheit or higher","urgency":"contact_clinic","general":true,"source":{"url":"https://my.clevelandclinic.org/health/treatments/24303-implant-supported-dentures","host":"my.clevelandclinic.org","quote":"A fever of 101 degrees Fahrenheit (38.22 degrees Celsius) or higher.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Home dentist needs X-ray copies to plan future treatment","document":"dental x-ray copies","source":{"url":"https://www.ada.org/about/principles/code-of-ethics/patient-autonomy","host":"ada.org","quote":"A dentist has the ethical obligation on request of either the patient or the patient's new dentist to furnish in accordance with applicable law, either gratuitously or for nominal cost, such dental records or copies or summaries of them, including dental X-rays or copies of them, as will be beneficial for the future treatment of that patient.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"T2","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":"T3","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":"T4","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T5","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":"2026-11-14","next_check_at":"2027-11-14","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You still have several healthy 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