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one arch: planning/preparation, surgery, impressions and try-in, final delivery; excludes routine check-ups."},"stages":[{"code":"surgery","label":"Implant placement (8 implants) with extractions if needed, often with provisional prosthesis","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of surgery."}},{"code":"impressions","label":"Final impressions or scans and try-in after osseointegration","after":{"min":90,"max":180,"unit":"days","qualifier":"From surgery."}},{"code":"final_delivery","label":"Delivery of monolithic zirconia prosthesis","after":{"min":120,"max":270,"unit":"days","qualifier":"From surgery."}}],"qualifier":"Typical staged protocol for one arch; immediate-load and delayed-load protocols differ."},"success":{"metric":"Implant survival rate","value":95,"unit":"percent","horizon":"5 years","population":"Adults with complete edentulism receiving full-arch fixed zirconia prostheses on multiple implants","evidence_status":"proven"},"techniques":[{"name":"Immediate-load protocol with provisional prosthesis, then final monolithic zirconia","suits_whom":"Patients with good primary implant stability and adequate bone.","recovery":"Fixed provisional teeth on day of surgery; final prosthesis after healing."},{"name":"Delayed-load protocol","suits_whom":"Patients with limited bone quality, grafting or low implant stability.","recovery":"Longer period with removable or no provisional before final prosthesis."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":2,"max":4,"unit":"hours","qualifier":"Surgical visit for one arch placing 8 implants, with or without extractions; prosthetic visits are shorter."},"initial_assessment_documents":["Panoramic dental X-ray (OPG)","CBCT scan of the jaw (if available)","Front and side photos of face and smile","Photos of current teeth or denture","List of blood thinners and bisphosphonates"],"travel_trips":{"min":2,"max":2,"one_trip_possible":false,"qualifier":"Two trips of 5-7 days each: surgery, then final delivery after 3-6 months osseointegration."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Confirm that the clinic provides a consultation to discuss your condition and treatment options","scope":"treatment_type","source":{"url":"https://www.guysandstthomas.nhs.uk/our-services/dental-implants-service/appointments","host":"guysandstthomas.nhs.uk","quote":"Your first appointment will be a consultation to discuss your condition and treatment options.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C2","text":"Confirm that the clinic evaluates whether remaining teeth and gums are healthy and need treatment","scope":"treatment_type","source":{"url":"https://www.guysandstthomas.nhs.uk/our-services/dental-implants-service/appointments","host":"guysandstthomas.nhs.uk","quote":"Your dentist will also need to confirm that your remaining teeth and gums are healthy and do not need treatment.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"C3","text":"Confirm the clinic discusses possible complications before booking, because implants require ongoing care and complications can affect 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":"2026-11-12","http_status":200}},{"id":"C4","text":"Ask a dentist or clinician for a second opinion about treatment options and whether treatment is necessary","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":"2026-11-12","http_status":200}},{"id":"C5","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}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"The clinic pressures you to make a quick decision","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":"pressure to make a quick decision","tier":"tier1_medical","fetched_at":"2026-11-12","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":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Pus around an implant","urgency":"contact_clinic","general":false,"source":{"url":"https://pubmed.ncbi.nlm.nih.gov/37083903/","host":"pubmed.ncbi.nlm.nih.gov","quote":"Observed complications included implant loss, peri-implantitis, mucositis, purulence, sinus tract formation, oroantral communication, implant fracture, titanium base debonding, ceramic chipping, prosthetic screw fracture or loosening, damage to opposing teeth, and clicking sounds.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":203}},{"id":"W2","text":"A loose prosthetic screw","urgency":"contact_clinic","general":false,"source":{"url":"https://pubmed.ncbi.nlm.nih.gov/37083903/","host":"pubmed.ncbi.nlm.nih.gov","quote":"Observed complications included implant loss, peri-implantitis, mucositis, purulence, sinus tract formation, oroantral communication, implant fracture, titanium base debonding, ceramic chipping, prosthetic screw fracture or loosening, damage to opposing teeth, and clicking sounds.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":203}},{"id":"W3","text":"Throbbing pain and swelling in one leg","urgency":"contact_clinic","general":true,"source":{"url":"https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/","host":"nhs.uk","quote":"throbbing pain in 1 leg (rarely both legs), usually in the calf or thigh","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"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":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You need replacement of an entire arch of missing teeth","name":"Removable 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":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"immediate-load-protocol","name":"Immediate-load protocol with provisional prosthesis, then final monolithic zirconia","how_it_works":{"text":"A provisional restoration is supported immediately by the implants","source":{"url":"https://pubmed.ncbi.nlm.nih.gov/28402357/","host":"pubmed.ncbi.nlm.nih.gov","quote":"A provisional restoration is supported immediately by the implants before the final restoration.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":203}},"recovery_daily":{"event":"back_to_daily_activities","min":2,"max":3,"unit":"days","label":"2–3 days","source":{"url":"https://my.clevelandclinic.org/health/treatments/24303-implant-supported-dentures","host":"my.clevelandclinic.org","quote":"In most instances, you can return to routine activities in two to three days.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}},{"id":"delayed-load-protocol","name":"Delayed-load protocol","how_it_works":{"text":"Replacement teeth are attached after the implants fully fuse with bone","source":{"url":"https://www.mouthhealthy.org/en/az-topics/i/implants","host":"mouthhealthy.org","quote":"Some patients might need to wait until the implant is completely integrated, up to several months, before replacement teeth can be attached to the 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