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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 which bone grafting material or barrier membrane is planned, since the procedure can use different options","scope":"procedure","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10720259/","host":"pmc.ncbi.nlm.nih.gov","quote":"The procedure could be performed using different bone grafting materials, barrier membranes, or a combination of these.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C2","text":"Ask how quickly the planned material resorbs, since socket preservation materials are grouped by resorption rate","scope":"procedure","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10720259/","host":"pmc.ncbi.nlm.nih.gov","quote":"Three categories of SP have been proposed regarding the resorption rate of the material used.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C3","text":"Check when implant placement is planned, since it can follow the primary healing stage","scope":"procedure","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10720259/","host":"pmc.ncbi.nlm.nih.gov","quote":"Implant placement could be performed after the stage of primary healing even in the presence of residual graft particles.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C4","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C5","text":"Check that possible complications and side effects are explained to you before treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C6","text":"Check the clinic's infection-control standards, since standards differ between countries","scope":"treatment_abroad","source":{"url":"https://www.mouthhealthy.org/en/all-topics-a-z/travel","host":"mouthhealthy.org","quote":"Countries differ in their standards for infection control and safety.","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":"Pressure to make a quick decision before booking treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"F2","text":"No discussion of possible complications before booking treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"F3","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}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-14","next_check_at":"2027-02-12"},"take_home":{"status":"ok","items":[{"id":"T1","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":"T2","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":"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}},{"id":"T4","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}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"alternatives":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-14","next_check_at":"2027-02-12"},"technique_details":{"status":"ok","items":[{"id":"bone-graft-particles","name":"Bone graft particles with collagen membrane","how_it_works":{"text":"Bone graft material fills the extraction socket","source":{"url":"https://ebooks.ada.org/18qn1on/27","host":"ebooks.ada.org","quote":"This kind of surgery is called a bone graft.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"collagen-plug","name":"Collagen plug or sponge only","how_it_works":{"status":"missing","reason":"no_official_source"},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"graft","name":"Graft with soft-tissue seal (punch graft or collagen cap)","how_it_works":{"status":"missing","reason":"no_official_source"},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"prf-membrane","name":"PRF membrane with 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