Generic Printable Consent Form For Sinus Lift Description of the Procedure for Direct Sinus Lift After anesthetics have numbed the area to be operated the gum is reflected from the jaw surface so as to gain access to the side of the jaw which forms the side wall of the sinus Next a hole in this sinus wall is formed gaining access to the sinus
6 ANESTHESIA a Local Anesthesia Novocaine Local An esthesia with Cl Anesthesia with Nitrous Oxide Oxygen Analgesia and Oral Sedation Children Local Anesthesia with Nitrous Oxide Oxv2en Analzesia and IV Sedation ANESTHETIC RISKS include discomfort swelling bruising infection prolonged numbness and allergic reactions GRAFTING During this procedure gum tissue will be pulled back an opening will be created in the wall on the side of my maxillary sinus and the lining of sinuses will be lifted under which a bone graft will be placed This graft may include my own bone synthetic bone substitute human bone obtained from tissue banks or a combination of these
Generic Printable Consent Form For Sinus Lift
Generic Printable Consent Form For Sinus Lift
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Medical Treatment Consent Form Printable Pdf Download
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Alternatives to Suggested Treatment Alternatives to the sinus elevation procedure include 1 no treatment resulting in an inability to place implants of sufficient length in the area 2 grafting on top of the bony ridge in the area 3 anchorage of implants in anatomic areas behind the maxillary sinus pterygoid plate anchorage 4 f Injury to the nerve branches of the upper jaw resulting in the numbness or tingling of the lower eyelid side of the nose and upper lip cheek area along with the gums on the operated side This may persist for several weeks months or in rare instances permanently
1 I hereby authorize Dr Amir Guorgui to perform a sinus lift elevation procedure A procedure being done to allow for sufficient bone volume in the posterior maxilla in order to place root form implants that will provide support for the planned restoration 2 I am satisfied that I fully understand the nature and purpose of the treatment 3 Sinus lift procedure 4 I have been informed of possible alternative forms of treatment if any including I understand that other forms of treatment or no treatment at all are choices that I have and the risks and consequences associated with those choices have been explained to me 5
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sinus augmentation surgery Local anesthetic will be administered to me as part of the treatment Antibiotics and other medications may also be given During this procedure the gums may be opened to permit better access to the bone Bone irregularities may be reshaped Some bone may be removed to create a window to access the maxillary sinus I have been informed of possible alternative forms of treatment if any including doing nothing full sinus lift crestal sinus lift removable partial denture fixed partial denture if possible I understand that other forms of treatment or no treatment at all are choices that I have and the risks of those choices have been presented to me
CONSENT FOR SINUS LIFT PROCEDURE WITH BONE REPLACEMENT GRAFT I authorize and request my periodontist to perform surgery on my upper jaw maxilla I understand that the surgery will be performed to place a bone graft material below the floor of the sinus to build up adequate bone height for the placement of implants The bone graft will consist of Bone Graft Sinus Lift Consent Form The purpose of this document is to provide an opportunity for you to understand and give permission for a bone grafting procedure I have been informed and afforded the time to fully understand the purpose and the nature of the bone graft surgery procedure
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Description of the Procedure for Direct Sinus Lift After anesthetics have numbed the area to be operated the gum is reflected from the jaw surface so as to gain access to the side of the jaw which forms the side wall of the sinus Next a hole in this sinus wall is formed gaining access to the sinus
https://www.mworalsurgery.com/wp-content/uploads/2019/01/Consent-for-Sinus-Lift.pdf
6 ANESTHESIA a Local Anesthesia Novocaine Local An esthesia with Cl Anesthesia with Nitrous Oxide Oxygen Analgesia and Oral Sedation Children Local Anesthesia with Nitrous Oxide Oxv2en Analzesia and IV Sedation ANESTHETIC RISKS include discomfort swelling bruising infection prolonged numbness and allergic reactions
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Generic Printable Consent Form For Sinus Lift - A sinus graft procedure is performed when there is insufficient bone in the upper jaw to place an implant due to the presence of the sinus Microsoft Word Sinus Lift Consent Form doc Author Chella Levesque Created Date 4 11 2013 10 57 56 PM
