Dental Implant Surgery Consent Form
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This dental implant surgery consent form provides detailed documentation for patients undergoing single or multiple implant placements, including immediate load protocols and staged approaches. The form covers pre-surgical requirements, bone quality assessments, sinus lift procedures, guided surgery techniques, and potential complications such as implant failure, nerve damage, or sinus perforation. It includes specific consent for sedation options and antibiotic protocols.
Designed for oral surgeons, periodontists, and prosthodontists, this template ensures patients fully understand the surgical process, healing expectations (osseointegration timeline), temporary restoration options, and final prosthetic delivery. The form captures medical contraindications, smoking history, bisphosphonate use, and diabetes management that may affect implant success rates. It includes financial consent for the surgical phase, abutment placement, and crown fabrication with clear treatment cost breakdown.
What's included
- Implant site location and number of implants
- Bone grafting and sinus lift consent
- Sedation and anesthesia options
- Surgical risks and complications disclosure
- Osseointegration timeline expectations
- Temporary restoration options
- Smoking cessation requirements
- Medical contraindications screening
- Financial responsibility agreement
- Post-operative care instructions acknowledgment
Who uses this template
- Oral Surgery Practices
- Periodontal Specialty Offices
- Prosthodontic Clinics
- Implant Dentistry Centers
- Full-Service Dental Practices
All form fields
10 fields across 3 pages. Customize any field after signing up.
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