Patients taking bisphosphonates (ie: Aredia, Actonel, Zometa, Didronel, Fosamax, Skelid, Boniva, Reclast, etc.) may experience complications including, but not limited to, compromised wound healing, infection, osteonecrosis of the jaw, bone exposure, severe pain, etc.
I understand that the design and structure of the prosthetic appliance can be a substantial factor in the success or failure of any implants that are placed. I further understand that alterations made on artificial appliances or the implants can lead to the loss of the appliance and/or implant. This loss would be the sole responsibility of the person making such alterations, whether those alterations are made by me myself, a dentist or dental practitioner outside of the dental office or any other party. The dental office will not be held liable for any such alterations. I have been advised that the connection between the implant and the tissue may fail and that it may become necessary to remove the implant. This can happen during placement, the initial integration of the implant, or anytime thereafter.
Alternative treatments to replace missing teeth may include no treatment, removable and/or fixed appliances where applicable. I understand that these treatments may result in additional bone and soft tissue loss and damage and will make implant treatment in the future unlikely.
I understand that it is important for me to continue to see my restorative dentist. Implants, natural teeth, and appliances have to be maintained daily in a clean, hygienic manner. Implants and appliances must also be examined periodically and may need to be adjusted. I understand that it is important for me to abide by the specific prescriptions and instructions given to me by my doctor.
I hereby acknowledge that no guarantee, warranty or assurance has been given to me that the proposed treatment will be successful. Due to individual patient differences, a doctor cannot predict the certainty of success. There exists the risk or failure, relapse, additional treatment, or worsening of the present condition, including the possible loss of the implant or other teeth, despite the best of care.
I authorize photos, slides, x-ray films, or any other viewings of my care and treatment during or after its completion to be used for the advancement of dentistry and for educational purposes. My identity will not be revealed to the general public, however, without my express permission.