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The acrylic provisional and definitive prosthesis may need repair or replacement after 5-10 years.","revision_rate_pct":{"min":3,"max":8,"unit":"percent","qualifier":"Implant loss needing removal or replacement within 5 years; prosthesis repairs not counted."},"scars":"No visible external scars; small intraoral healing marks only, usually not noticeable.","sessions_or_stages":{"sessions":{"min":2,"max":2,"unit":"visits","qualifier":"Surgery with immediate provisional prosthesis, then fitting of the definitive prosthesis; planning and follow-up checks are not counted."},"stages":[{"code":"surgery_provisional","label":"Extractions if needed, placement of four implants and immediate fixed provisional prosthesis","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of surgery."}},{"code":"definitive_prosthesis","label":"Fitting of the definitive fixed prosthesis after osseointegration","after":{"min":90,"max":180,"unit":"days","qualifier":"From the day of surgery."}}],"qualifier":"Typical one-arch protocol; the definitive prosthesis fabrication includes try-in visits not counted separately."},"success":{"metric":"Implant survival rate","value":95,"unit":"percent","horizon":"5 years","population":"Adults with one edentulous or hopeless-dentition arch, non-heavy smokers","evidence_status":"proven"},"techniques":[{"name":"All-on-4 with two straight anterior and two tilted posterior implants and immediate provisional bridge","suits_whom":"Edentulous or hopeless-dentition patients with sufficient anterior bone and good primary stability.","recovery":"Fixed provisional teeth the same day; soft diet for about 3-6 months until the definitive prosthesis."},{"name":"Guided (computer-planned) surgery","suits_whom":"Patients where precise planning with CBCT helps placement and prosthesis pre-fabrication.","recovery":"Similar to conventional; may involve less swelling due to minimally invasive approach."}],"treatment_conditions":["day_case"],"treatment_duration_hours":{"min":3,"max":5,"unit":"hours","qualifier":"One arch: any extractions, placement of four implants and fitting of the immediate provisional prosthesis on the same day."},"initial_assessment_documents":["Panoramic dental X-ray (OPG)","CBCT 3D scan of the jaws","Photos of smile and current teeth","List of blood thinners and bisphosphonates","Medical history: diabetes and smoking status"],"travel_trips":{"min":2,"max":2,"one_trip_possible":false,"qualifier":"Trip 1: surgery with same-day provisional teeth, 5-7 days. Trip 2: definitive prosthesis after 3-6 months, 5-7 days."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that you signed off on the treatment plan and that any changes from it were discussed and approved","scope":"treatment_type","source":{"url":"https://www.ada.org/resources/practice/practice-management/documentation-patient-records","host":"ada.org","quote":"Audits allow you to confirm that patients have signed off on treatment plans and confirm that any changes in care from the original plan were discussed and approved.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check that the proposed treatment plan, benefits, risks, alternatives, and no-treatment option are explained and documented","scope":"treatment_type","source":{"url":"https://www.ada.org/resources/practice/practice-management/documentation-patient-records","host":"ada.org","quote":"Progress and treatment notes; recaps of conversations about the nature of any proposed treatment, the potential benefits and risks associated with that treatment, any alternatives to the treatment proposed, and the potential risks and benefits of alternative treatment, including no treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that postoperative or home instructions are provided","scope":"treatment_type","source":{"url":"https://www.ada.org/resources/practice/practice-management/documentation-patient-records","host":"ada.org","quote":"Postoperative or home instructions, or a notation about any pamphlets or reference materials provided.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","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":"C5","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}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"The consultation does not explain treatment risks, benefits, alternatives, or the option of no treatment","scope":"treatment_type","source":{"url":"https://www.ada.org/resources/practice/practice-management/documentation-patient-records","host":"ada.org","quote":"Recaps of conversations about the nature of any proposed treatment, the potential benefits and risks associated with that treatment, any alternatives to the treatment proposed, and the potential risks and benefits of alternative treatment, including no treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","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}},{"id":"F3","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Pain that does not 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":"2026-11-13","http_status":200}},{"id":"W2","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":"2026-11-13","http_status":200}},{"id":"W3","text":"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":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Tells the continuing dentist which medicines, doses, directions, and refills were prescribed","document":"medication prescriptions","source":{"url":"https://www.ada.org/resources/practice/practice-management/documentation-patient-records","host":"ada.org","quote":"Medication prescriptions, including types, dose, amount, directions for use and number of refills.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T2","text":"Provides the postoperative or home instructions needed for continuing care","document":"aftercare instructions","source":{"url":"https://www.ada.org/resources/practice/practice-management/documentation-patient-records","host":"ada.org","quote":"Postoperative or home instructions, or a notation about any pamphlets or reference materials provided.","tier":"tier1_medical","fetched_at":"2026-11-13","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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of teeth","name":"Full dentures","source":{"url":"https://my.clevelandclinic.org/health/diseases/tooth-loss","host":"my.clevelandclinic.org","quote":"Full dentures replace an entire arch of missing teeth.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null},{"id":"A2","text":"You are missing several teeth in your upper or lower jaw","name":"Partial dentures","source":{"url":"https://my.clevelandclinic.org/health/diseases/tooth-loss","host":"my.clevelandclinic.org","quote":"Partial dentures replace several missing teeth in your upper or lower jaw.","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":"all-on-4","name":"All-on-4 with two straight anterior and two tilted posterior implants and immediate provisional bridge","how_it_works":{"text":"A full arch of teeth is supported by a few 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