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years","population":"Adults with severely atrophic maxilla receiving two zygomatic implants with immediate fixed bridge","evidence_status":"limited"},"techniques":[{"name":"Zygomatic implants with extra-sinus path","suits_whom":"Marked lateral maxillary concavity, preference to avoid sinus passage","recovery":"Similar recovery; less sinus irritation risk."},{"name":"Quad zygoma (four zygomatic implants)","suits_whom":"Very severe maxillary atrophy with no anterior bone","recovery":"Slightly longer swelling and surgery time."},{"name":"Zygomatic with two anterior conventional implants","suits_whom":"Sufficient anterior bone","recovery":"Similar recovery to All-on-2."}],"treatment_conditions":["day_case","inpatient"],"treatment_duration_hours":{"min":2,"max":4,"unit":"hours","qualifier":"Surgery plus immediate provisional bridge fitting."},"initial_assessment_documents":["Panoramic dental X-ray (OPG)","CBCT scan of upper jaw (if available)","Front and side facial photos","Smile and intraoral photos","Records of sinus problems or prior sinus surgery","List of blood thinners"],"travel_trips":{"min":2,"max":2,"one_trip_possible":false,"qualifier":"Surgery trip with immediate bridge, stay 5-7 days; second trip months later for final prosthesis."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Get a doctor's second opinion on whether the treatment is necessary and which options exist","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 doctor can give you a valuable second opinion as well as advice about treatment options and whether it's necessary.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","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":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that you can ask the treating team questions about your 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":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Check that you are satisfied with the facilities and standards where you will be treated","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":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Check that you understand the possible complications and side effects of the 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":"2026-11-13","http_status":200}},{"id":"C6","text":"Check how your aftercare will be coordinated after 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":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C7","text":"Check whether the surgeon is experienced in zygomatic implants because the surgery is more complicated and not all surgeons provide it","scope":"procedure","source":{"url":"https://www.cuh.nhs.uk/patient-information/sinus-lift-procedures/","host":"cuh.nhs.uk","quote":"The surgery is more complicated compared with conventional dental implant placement and not all surgeons can provide it.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"A hard sell offered when considering 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":"2026-11-13","http_status":200}},{"id":"F2","text":"Pressure to make a quick decision about 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":"2026-11-13","http_status":200}},{"id":"F3","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":"2026-11-13","http_status":200}},{"id":"F4","text":"The surgeon says the procedure is no more complicated than conventional dental implant placement","scope":"procedure","source":{"url":"https://www.cuh.nhs.uk/patient-information/sinus-lift-procedures/","host":"cuh.nhs.uk","quote":"The surgery is more complicated compared with conventional dental implant placement and not all surgeons can provide it.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F5","text":"The offer does not provide an opportunity to discuss treatment with a dentist or clinician before booking","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 spoken to a GP, dentist or clinician?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-13","next_check_at":"2027-02-11"},"take_home":{"status":"ok","items":[{"id":"T1","text":"It gives the home doctor details needed to understand the treatment performed","document":"treatment report","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"As the doctor could be involved in your aftercare, discuss with them how to transfer medical notes to the overseas team.","tier":"tier1_medical","fetched_at":"2026-11-13","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":"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":"T4","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":"2026-11-13","next_check_at":"2027-11-13","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your posterior jaw bone height and width allow short implants","name":"Short dental implants","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC7788139/","host":"pmc.ncbi.nlm.nih.gov","quote":"Although in the posterior atrophic maxilla where the height of residual bone is at least 6–7 mm, and where the width of any residual ridge permits placement of at least 5-mm-diameter implants, short implants can be a safe choice [ 9 ].","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null},{"id":"A2","text":"You are willing to accept additional treatment time for grafting","name":"Upper jaw bone grafting","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC7788139/","host":"pmc.ncbi.nlm.nih.gov","quote":"Conventional grafting with autogenous bone has been considered the “gold standard” in the treatment of the extremely atrophic maxillae, but due to high failure rates of 10–30%, additional time and higher costs, the development and introduction of a new standard with superior clinical outcomes is warranted [ 11 ].","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"technique_details":{"status":"ok","items":[{"id":"zygomatic-implants","name":"Zygomatic implants with extra-sinus path","how_it_works":{"status":"missing","reason":"no_official_source"},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"quad-zygoma","name":"Quad zygoma (four zygomatic implants)","how_it_works":{"text":"Zygomatic implants are inserted on each side of the jaw","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10497463/","host":"pmc.ncbi.nlm.nih.gov","quote":"For cases without adequate anterior maxillary bone, the quad zygomatic implant concept was introduced, where two zygomatic implants are inserted on each side, providing acceptable antero-posterior implant positioning for force distribution.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"zygomatic","name":"Zygomatic with two anterior conventional implants","how_it_works":{"text":"One implant in each zygoma is combined with anterior conventional implants","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10497463/","host":"pmc.ncbi.nlm.nih.gov","quote":"The original Brånemark protocol included one implant in each zygoma, traversing the sinus, combined with two to four anterior conventional 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