Implant Information & Consent Form

Implant placement

Implant placement – Implants are titanium screws placed in the jaw and left to fuse to bone for 4-9 months before crowns, bridges or dentures are attached. All of the necessary implants can be placed together or some can be placed initially followed by others later.

Additional procedures – It may be necessary to carry out additional procedures which become apparent at the time of implant placement. Occasionally there may be insufficient bone present to support the implants. Bone from a bone bank may be added to allow implants to placed at the same time or at a later stage. There would be an additional fee for any extra procedures. The bone that we usually use are from bovine (cow) or synthetic bone plus a cover membrane (porcine) (pigs) that we apply on top of the bone for stability of the bone graft.

Immediate implant placement – In cases where the bone structure and anatomy are favourable, dental implant can be placed immediately at the same time of the tooth extraction. This will reduce the number of surgical intervention. This can only be done if the bone quality and quantity were sufficient. The surgeon will be able to know once the tooth is extracted and the bone is assessed directly.

Denture wearers – After implants are placed the existing denture may require modification to adapt to the changes to the soft tissues in your mouth. This may weaken the denture and cause breakages. If this occurs, repair may be necessary. Use of denture fixative may help keep dentures in place during the healing period, although this will not always be advised by your dentist.

Final restorative procedures – Implants are usually left undisturbed beneath the gum for around 4-9 months to allow them to firmly attach to the bone before any crowns, bridges or dentures are fitted.

Home care – Implants are susceptible to gum disease in the same way as natural teeth. Gum disease around the implants may result in loss of bone. It is imperative that you adopt a thorough home care routine to remove plaque from around the implants and prevent gum disease and bone loss from occurring.

Post-operative Information

Immediate post-operative effects – Some patients have little or no problems at all. Some patients may experience bruising, swelling and discomfort. These effects are different for each patient and it is not possible to predict who will experience what effects.

Later complications – The possibility of infection is low. If an implant does not heal into place satisfactorily, it will require removal and replacement at a later date.

Lower implants – Occasionally when implants are placed in the lower jaw numbness of the lip can occur. This can last for a few weeks and occasionally several months. It is very rarely permanent.

Both smoking and alcohol reduces the success rate of Implants

Success rates of modern implants are very acceptable. Implants, like natural teeth can be affected by gum disease and may require treatment. There would be no fee for the time spent on the treatment or replacement of an implant in the 1st Year. However there would be a fee for materials used and the cost of the implant.

Alternative forms of treatment – Missing teeth can be replaced with dentures without the use of implants. If there are sufficient natural, healthy teeth in the jaw it is possible to replace missing teeth using bridgework.

Timing – Avoid special business or social functions for approximately 10 days. You may not want to work for up to 10 days.

Alternatives to dental implant treatment

The alternative options to dental implant treatment are: 1) no treatment 2) denture (removable) cobalt chrome vs acrylic (this is a removable option that is quick and easy to make however it may be uncomfortable and could cause problems for the soft tissue/periodontal health in the future) 3) fixed or cantilever bridge that involves the shaving down of the adjacent teeth (This is a fixed option however it involves the preparation and shaving down of the adjacent teeth, and long term issues may arise from the adjacent teeth).

Questions – Please do not hesitate to contact us if you have any questions.

Bisphosphonates

Patients having been treated previously or currently with Bisphosphonate drugs should know that there is a significant risk of future complications associated with dental treatment. Bisphosphonate drugs appear to adversely affect the ability of bone to break down or remodel itself thereby reducing or eliminating its ordinary excellent healing capacity.

This risk is increased after surgery, especially from extraction, implant placement or other “invasive” surgical procedures that might cause even mild trauma to bone.

Osteonecrosis (death of bone) may result. This is a smoldering, long-term, destructive process in the jawbone that is often very difficult or impossible to eliminate. The decision to discontinue oral Bisphosphonate drug therapy before dental treatment should be made by you in consultation with your medical doctor.

Therefore:

1. Antibiotic therapy may be used to help control possible post-operative infections.
2. Despite all precautions, there may be delayed healing, Osteonecrosis, loss of bony and soft tissues, pathologic fracture of the jaw, oral-cutaneous fistula, or other significant complications.
3. If Osteonecrosis should occur, treatment may be include referral to the Oral Surgery and Maxofacial unit at the your local hospital.
4. Extreme care should be taken in the few days of surgery. Even minimal trauma from a toothbrush, chewing hard food, or denture sores may trigger a complication.
5. I realize that despite all precautions that may be taken to avoid complications; there can be no guarantee as to the result of the proposed treatment.

Consent for implant treatment

This consent form is to make sure that you are fully informed about what is involved in implant treatment.

1. I have been informed and I understand the purpose and nature of the implant surgery procedure. I understand what is required to place an implant under the gum and in the bone.
2. My dental surgeon has carefully examined my mouth. Alternatives to this treatment have been explained. I have considered these methods and I have elected to use implants to secure the replacement of missing teeth.
3. I have been informed of the possible risks and complications.
4. I understand that if I have lower implants placed there is a risk of lip numbness. I am aware that this is a risk in extreme cases and should this apply to me my dentist will specifically discuss this with me.
5. My dentist has explained that there is no method of accurately predicting the bone and gum healing capability in each patient following implant placement.
6. I understand that sometimes implants fail and must be removed.
7. I understand that excessive smoking, alcohol intake and/or sugar intake may affect gum healing and may limit the success of my implants. I agree to follow my dentist’s home care instructions and I agree to report to my dentist for regular examinations as instructed.
8. I consent to photography of procedures for my records and the advancement of implant dentistry and I understand that these photographs will be stored in accordance with data protection legislation and will not be used in any publications without my prior consent.
9. I fully understand that during or following implant treatment conditions may become apparent that, in the professional judgment of my dentist, warrant additional or alternative treatment pertinent to the success of comprehensive treatment. I approve the modifications in design, materials or care that my dentist feels are necessary.
10. If circumstances arise at the time of treatment which renders the placement of implants impossible, I understand that the procedure will be discontinued and there will be a charge for the time spent and any materials used. I understand that I will be fully informed of the circumstances that have arisen.
11. I understand that implants, like natural teeth, require maintenance and occasional treatment such as gum treatment. I understand that there would be a charge for the time spent and any materials used.
12. I understand that should my implant(s) fail in the 1st Year there would be no fee for the replacement except for the cost of the new implant and any materials used.

Consent

I have had the opportunity to ask questions regarding the placement of implants.

I consent to the placement of dental implants.