Bone Graft Consent Form

Bone Graft Consent Form - This bone grafting procedure may involve more than one 1 stage Including procedures to signing this form Patient s or Legal Guardian s Signature Date Doctor s Signature Date Witness Signature Date Title Bone Grafting Consent Author Jason Lyman Created Date 6 10 2010 3 35 23 PM

Informed Consent For Bone Grafting Procedures Page 2 of 3 ALLOGRAFT Which transplants bone from one individual to a genetically non identical individual of the same species cadaver bone All allografts have been collected processed and distributed for use in accordance with the Standards of the American Association of Tissue Banks

Bone Graft Consent Form

Bone Graft Consent Form

The bone grafting procedure involves opening the gums in the area to expose the existing bone. This is then followed by placing bone material in such a manner so as to augment the existing bone both horizontally and vertically. A protective barrier or membrane is then placed over the grafted bone for protection.

Some bone graft and membrane material commonly used are approval derived fr means for m the human or to doctor be free to other from use mammal such contaminants materials sources according Signing These grafts judgment for your situation this to his consent are knowledge thoroughly form gives and purified clinical your by

Span Class Result Type

The goal of bone grafting and or regenerative surgery is to assist or help grow bone back repair bone that has been lost due to periodontal gum disease or to possibly allow for dental implant placement either at the same time as this surgery or a later date

Consent For Grafting

Loss of All or Part of the Graft success with bone and membrane grafting is high however it is possible the graft may not adhere or may become infected despite meticulous surgery particulate bone graft material can migrate out of the surgical site and be lost or membranes can become dislodged your compliance is essential to ensure success

Span Class Result Type

Particulate bone graft material can migrate out of the surgery site and be lost A membrane graft could start to dislodge If so the doctor should he notified Your compliance is essential to assure success 4 Types of graft material Some bone graft and membrane material commonly used are derived from human or other mammal sources

CONSENT FOR IMPLANT SURGERY BONE GRAFTING

Particulate bone graft materials can migrate out of the surgical site and be lost A membrane graft could start to dislodge If so the doctor should be notified Patient compliance is essential for success 5 Types of graft material Some bone graft and membrane materials commonly used are derived from human or other mammalian sources

These conditions include: 1) A block bone graft taken from somewhere else in your mouth may not adhere or could become infected; 2) Despite meticulous surgery, particulate bone graft material could migrate out of the surgery site and be lost; 3) A membrane graft could begin to dislodge. If so, the doctor should be notified.

Span Class Result Type

CONSENT FOR BONE GRAFTING Patient Name Doctor Name Mihran Asinmaz DMD In order for me to make an informed decision about undergoing a procedure I should have certain information about the F Excess bone graft particles floating in mouth or swallowed and risks described on this form to the patient or representative

Bone Graft Consent Form

Particulate bone graft materials can migrate out of the surgical site and be lost A membrane graft could start to dislodge If so the doctor should be notified Patient compliance is essential for success 5 Types of graft material Some bone graft and membrane materials commonly used are derived from human or other mammalian sources

Informed Consent For Bone Grafting Procedures Page 2 of 3 ALLOGRAFT Which transplants bone from one individual to a genetically non identical individual of the same species cadaver bone All allografts have been collected processed and distributed for use in accordance with the Standards of the American Association of Tissue Banks

Consent For Bone Grafting