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Existing denture is adjusted or a temporary prosthesis is used.","restrictions":["Soft diet","Avoid pressure on surgical sites from the denture unless adjusted","No strenuous exercise"]},{"phase":"Weeks 2-4","description":"Soft tissue healing, return to normal daily routine; wound check.","restrictions":["Avoid hard or sticky foods","Avoid heavy loading of implants in the delayed protocol"]},{"phase":"Months 3-8","description":"Osseointegration, then impressions, CAD/CAM titanium bar fabrication, try-in and delivery of bar and overdenture.","restrictions":["Follow the clinician's loading instructions"]},{"phase":"After delivery","description":"Adaptation to the overdenture, adjustments, and regular hygiene and maintenance visits.","restrictions":["Remove and clean denture and bar daily"]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"Functional recovery after one-arch implant surgery, back to soft diet; adapting to the final overdenture takes more weeks."},"result_longevity":"Implants and the titanium bar can last many years with good hygiene and regular maintenance, but the overdenture's attachments and denture teeth typically need periodic servicing or replacement; longevity varies by patient.","revision_rate_pct":{"min":3,"max":10,"unit":"percent","qualifier":"Implant loss or bar/framework remake requiring surgical or major prosthetic revision within 5 years."},"scars":"No visible external scars; small intraoral incisions heal without visible marks.","sessions_or_stages":{"sessions":{"min":4,"max":6,"unit":"visits","qualifier":"Treatment visits for one arch, delayed loading: surgery, impressions, try-in, delivery; routine follow-up checks counted separately."},"stages":[{"code":"implant_placement","label":"Placement of four implants","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of first treatment session."}},{"code":"impressions_bar_design","label":"Impressions and CAD/CAM bar design after osseointegration","after":{"min":90,"max":150,"unit":"days","qualifier":"From implant placement."}},{"code":"bar_tryin","label":"Bar and denture try-in","after":{"min":110,"max":190,"unit":"days","qualifier":"From implant placement."}},{"code":"final_delivery","label":"Delivery of final bar and overdenture","after":{"min":130,"max":240,"unit":"days","qualifier":"From implant placement."}}],"qualifier":"Delayed-loading protocol for one arch; immediate-loading variants differ."},"success":{"metric":"Implant survival in bar-retained mandibular overdenture","value":95,"unit":"percent","horizon":"5 years","population":"Healthy edentulous adults with four implants and a splinted bar overdenture","evidence_status":"proven"},"techniques":[{"name":"Delayed-loading four-implant CAD/CAM milled titanium bar overdenture","suits_whom":"Edentulous adults with sufficient bone for four implants who want a stable removable prosthesis.","recovery":"Osseointegration of about 3 months before bar fabrication; final delivery roughly 4-8 months after surgery."},{"name":"Immediate or early-loading variant with a provisional prosthesis","suits_whom":"Selected patients with good primary implant stability.","recovery":"Provisional prosthesis used during healing; final bar later, following a different schedule than the delayed protocol."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":1.5,"max":3,"unit":"hours","qualifier":"Implant placement surgery of four implants in one arch only; prosthetic visits are shorter and not included."},"initial_assessment_documents":["Panoramic dental X-ray (OPG)","CBCT scan of the jaw (if available)","Photos of the mouth and current dentures","Front and side photos of the face","List of bisphosphonates and blood thinners"],"travel_trips":{"min":2,"max":3,"one_trip_possible":false,"qualifier":"Osseointegration takes about 3 months. Trip 1: surgery, 5-7 days. Prosthetic trip: 5-10 days, or split in two."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ensure the assessment includes a detailed mouth examination and X-rays","scope":"procedure","source":{"url":"https://www.leedsth.nhs.uk/patients/resources/dental-implants/","host":"leedsth.nhs.uk","quote":"Assessment begins with a detailed examination of your mouth and x-rays.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check that a three-dimensional X-ray is used when appropriate to assess relevant jaw structures","scope":"procedure","source":{"url":"https://www.leedsth.nhs.uk/patients/resources/dental-implants/","host":"leedsth.nhs.uk","quote":"A special 3D x-ray, (Cone Beam CT scan) is usually requested.This scan can provide important information about the position of structures, such as the roots of neighbouring teeth, nerves, the nose cavity and the sinuses (air spaces linked to the nose).","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check whether the clinic’s facilities and standards satisfy 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":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Understand possible complications and side effects before 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":"C5","text":"Confirm how aftercare will be coordinated","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":"2026-11-12","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 proposed treatment is offered without a detailed mouth examination and X-rays","scope":"procedure","source":{"url":"https://www.leedsth.nhs.uk/patients/resources/dental-implants/","host":"leedsth.nhs.uk","quote":"Assessment begins with a detailed examination of your mouth and x-rays.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"The clinic cannot explain possible complications and side 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implants","urgency":"contact_clinic","general":false,"source":{"url":"https://pubmed.ncbi.nlm.nih.gov/10220658/","host":"pubmed.ncbi.nlm.nih.gov","quote":"Peri-implant soft tissue complications included dehiscence, fistulas, and gingival inflammation/proliferation.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":203}},{"id":"W2","text":"New numbness after implant placement","urgency":"contact_clinic","general":false,"source":{"url":"https://pubmed.ncbi.nlm.nih.gov/10220658/","host":"pubmed.ncbi.nlm.nih.gov","quote":"Surgical complications included neurosensory disturbance, hematoma, mandibular fracture, hemorrhage, and tooth devitalization.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":203}},{"id":"W3","text":"Bleeding that does not stop","urgency":"emergency","general":false,"source":{"url":"https://pubmed.ncbi.nlm.nih.gov/10220658/","host":"pubmed.ncbi.nlm.nih.gov","quote":"Surgical complications included neurosensory disturbance, hematoma, mandibular fracture, hemorrhage, and tooth devitalization.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":203}},{"id":"W4","text":"Loose or fractured bar screws","urgency":"contact_clinic","general":false,"source":{"url":"https://pubmed.ncbi.nlm.nih.gov/10220658/","host":"pubmed.ncbi.nlm.nih.gov","quote":"Mechanical complications were screw loosening/fracture, implant fractures, framework, resin base and veneering material fractures, opposing prosthesis fractures, and overdenture mechanical retention problems.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":203}},{"id":"W5","text":"Loose abutment or bite changes","urgency":"contact_clinic","general":false,"source":{"url":"https://pubmed.ncbi.nlm.nih.gov/28653433/","host":"pubmed.ncbi.nlm.nih.gov","quote":"There were comparable incidences of postoperative complaints like swelling, hematoma, or wound dehiscence, as well as need for prosthetic treatment due to abutment loosening or occlusal 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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}},{"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}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You want removable appliances to replace missing teeth","name":"Dentures","source":{"url":"https://www.mouthhealthy.org/all-topics-a-z/dentures","host":"mouthhealthy.org","quote":"Dentures are removable appliances that can replace missing teeth and help restore your 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