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home."},"requirement":"routine"},{"purpose":"suture_removal","after":{"min":7,"max":10,"unit":"days","qualifier":"Removal of non-resorbable sutures if used, before flight home."},"requirement":"conditional"},{"purpose":"assessment","after":{"min":90,"max":120,"unit":"days","qualifier":"Imaging to assess graft integration."},"requirement":"routine"},{"purpose":"result_review","after":{"min":120,"max":270,"unit":"days","qualifier":"CBCT review before implant placement."},"requirement":"routine"}],"indications":["Bone defects or loss from trauma, tumor resection or infection","Fracture nonunion or delayed union","Alveolar ridge deficiency before dental implant placement","Periodontal bone defects or sinus floor augmentation","Spinal fusion","Joint reconstruction or arthrodesis requiring bone stock"],"main_risks":["Infection","Graft resorption, failure or non-integration","Bleeding or hematoma","Donor-site pain, numbness or morbidity when autograft is used","Nerve or adjacent structure injury","Wound dehiscence or delayed healing","Need for repeat surgery","Anesthesia-related risks"],"pain":"Usually moderate in the first days after surgery and controlled with standard analgesics; autograft donor sites such as the iliac crest can be more painful and for longer than the recipient site.","preparation":["Exam and imaging (X-ray, CT or CBCT) for graft planning","Medical history and fitness review","Stop smoking before and after surgery","Fasting if general or sedation anesthesia is planned","Discuss graft material choice (autograft, allograft, xenograft or synthetic)","Arrange transport home and aftercare"],"recovery_timeline":[{"phase":"Days 1-3","description":"Swelling, mild bruising and moderate pain controlled with standard analgesics.","restrictions":["Soft cold diet","No brushing at graft site","No smoking"]},{"phase":"Days 4-14","description":"Swelling subsides and gum begins to heal; sutures are removed or resorb.","restrictions":["Avoid pressure on graft","No strenuous exercise","Use prescribed mouth rinse"]},{"phase":"Weeks 3-6","description":"Soft tissue heals and normal diet gradually resumes.","restrictions":["Avoid chewing on graft area","Avoid temporary denture pressure"]},{"phase":"Months 4-9","description":"Graft integrates into living bone, then implant placement can be planned.","restrictions":["No smoking","Maintain oral hygiene"]}],"rehabilitation_days":{"min":21,"max":42,"unit":"days","qualifier":"Return to normal diet and activities; gradual over weeks; depends on graft extent and swelling."},"result_longevity":"Once integrated, the graft usually becomes living bone and can last long-term, but longevity depends on site, graft material, healing and later loading or oral hygiene.","revision_rate_pct":{"min":3,"max":10,"unit":"percent","qualifier":"Repeat grafting after graft failure or inadequate bone volume, usually within 12 months."},"scars":"Intraoral incisions leave no visible scar; sutures close the gum.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One grafting surgery for a single site."},"stages":[{"code":"graft_surgery","label":"Bone graft surgery","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of procedure."}},{"code":"integration_review","label":"Imaging review of graft integration","after":{"min":120,"max":270,"unit":"days","qualifier":"Depends on graft material and defect size."}}],"qualifier":"Single grafting surgery, followed by a healing period before implant placement."},"success":{"metric":"Graft integration allowing successful implant placement","value":90,"unit":"percent","horizon":"4-9 months after grafting","population":"Adults with dental ridge deficiency grafted before implant placement","evidence_status":"limited"},"techniques":[{"name":"Autograft (patient's own bone)","suits_whom":"Larger or critical defects, or nonunions, where the best biological healing is needed.","recovery":"Adds donor-site recovery and pain."},{"name":"Allograft (donor bone)","suits_whom":"Patients wanting to avoid a donor site, or moderate defects and ridge or sinus augmentation.","recovery":"No donor site, with graft incorporation over months."},{"name":"Xenograft or synthetic substitute","suits_whom":"Smaller contained defects, often in dental and periodontal use.","recovery":"Mostly slow graft integration, often with no donor-site pain."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":1,"max":2,"unit":"hours","qualifier":"Single-site dental graft; sinus lift or larger defect takes longer."},"initial_assessment_documents":["X-ray of the affected area","CT scan of the defect or graft site","MRI report (if available)","Previous surgery or implant reports","Panoramic dental X-ray (OPG) for dental grafts","List of blood thinners and bone-affecting drugs"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Single-site dental graft: one trip; second only if later review needs travel."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask whether follow-up care will be at the same facility as the procedure","scope":"treatment_abroad","source":{"url":"https://www.cdc.gov/yellow-book/hcp/health-care-abroad/medical-tourism.html","host":"cdc.gov","quote":"Medical tourists should also know whether follow-up care is scheduled to occur at the same facility as the procedure.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C2","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":"C3","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":"C4","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}},{"id":"C5","text":"Expect two consultations with the treating surgeon before any surgery, which also gives you time to reconsider","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"You should have 2 consultations with the surgeon treating you before any surgery.","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":"An advertisement that overstates benefits and understates risks","scope":"treatment_abroad","source":{"url":"https://www.orthoinfo.org/en/treatment/what-to-know-about-medical-tourism","host":"orthoinfo.org","quote":"Advertisements for these types of treatments often overestimate the benefits and underestimate the inherent risks or potential lack of effectiveness.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"Consultation offered only with sales staff, with no meeting with the surgeon","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"make sure you have a consultation with the surgeon (avoid meetings only with sales people)","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"A request for payment before the patient has met the surgeon","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery-abroad/","host":"nhs.uk","quote":"do not pay to see a surgeon you have not met","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Severe pain or swelling","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/16796-bone-grafting","host":"my.clevelandclinic.org","quote":"Severe pain or swelling","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W2","text":"Pus or drainage around the surgery site","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/16796-bone-grafting","host":"my.clevelandclinic.org","quote":"Infection signs like skin discoloration, pus, drainage or a feeling of warmth around your surgery site","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W3","text":"Fever","urgency":"contact_clinic","general":true,"source":{"url":"https://my.clevelandclinic.org/health/procedures/21727-dental-bone-graft","host":"my.clevelandclinic.org","quote":"Fever of 101 degrees Fahrenheit (38.3 degrees Celsius) or higher.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Tells the home doctor how pain and complication risk are being managed","document":"pain and complication instructions","source":{"url":"https://my.clevelandclinic.org/health/articles/bone-grafting","host":"my.clevelandclinic.org","quote":"They'll give you specific instructions and guidelines to manage pain and reduce your risk of complications.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"T2","text":"Tells the home doctor which medicines to keep taking after discharge","document":"discharge medicine list","source":{"url":"https://www.orthoinfo.org/en/treatment/patient-guide-to-safe-surgery","host":"orthoinfo.org","quote":"The nurse will give you the highlights in writing, including a list of the medications you will need to take.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"T3","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure 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