What information is required in a patient's application form for dental implant placement and smile design?

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Last updated: February 28, 2025View editorial policy

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From the Guidelines

A comprehensive dental implant and smile design application form should include the patient's complete medical history, current medications, allergies, and previous adverse reactions, as well as dental history, aesthetic goals, and functional issues, to ensure informed decision-making and personalized treatment planning. When creating such a form, it is essential to consider the principles outlined in guidelines for obtaining valid consent for medical procedures, such as those discussed by Everett SM, et al. 1, which emphasize the importance of clear, accurate, and balanced information to help patients make informed decisions. Key elements to include in the application form are:

  • Complete medical history, including chronic conditions like diabetes, heart disease, or autoimmune disorders that might affect healing
  • Current medications, allergies, and previous adverse reactions to anesthetics or dental procedures
  • Dental history questions covering previous extractions, periodontal disease, bruxism (teeth grinding), and any failed dental work
  • Aesthetic goals, preferred tooth shape, size, and shade for smile design
  • Patient's timeline expectations, budget constraints, and whether they have dental insurance coverage
  • Radiographic examination consent for X-rays and possibly CT scans necessary for implant placement planning
  • A section for the patient to describe any functional issues they're experiencing, such as difficulty chewing or speaking. By incorporating these elements, the dental team can assess candidacy for implants, identify potential complications, and create a personalized treatment plan that addresses both functional needs and aesthetic desires, ultimately prioritizing the patient's morbidity, mortality, and quality of life.

From the Research

Patient Information Required for Dental Implant Placement and Smile Design

The following information is required in a patient's application form for dental implant placement and smile design:

  • Personal information
  • Chief complaint
  • Medical history
  • Dental history 2
  • Extra-oral and intra-oral clinical examinations
  • Radiographic examination 2
  • Smile line
  • Esthetic demands
  • Hard and soft tissue thickness and width
  • Gingival biotype 3
  • Tooth shape and shade principles 4
  • Mechanical, biological, and psychological factors 4

Contraindications and Precautions for Dental Implant Placement

When considering dental implant placement, the following contraindications and precautions should be taken into account:

  • Cognitive decline
  • American Society of Anesthesiology patient status IV or higher categories
  • Medical conditions that may jeopardize the life or lifespan of the patient 5
  • Past history of periodontal disease
  • Bruxism
  • Smoking
  • Radiation therapy 5

Digital Smile Design (DSD) Protocol

The DSD protocol can be used to assist in creating and planning a course of treatment, especially in a multidisciplinary approach, and provides a virtual simulation of the final result 6. This protocol can help to:

  • Create a personalized treatment plan
  • Communicate and discuss the treatment plan with the patient and the dental team
  • Simulate the final result and provide additional relevant information 6

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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