Informed Consent For Apical Surgery
Uploaded by
ScribdTranslationsInformed Consent For Apical Surgery
Uploaded by
ScribdTranslationsINFORMED CONSENT FOR SURGERY
Periapical and Apicoectomy
Yo,
AS A PATIENT, in full use of my faculties, freely and voluntarily,
I DECLARE that I have been duly INFORMED, by the surgeon below
signer, and consequently, I AUTHORIZE you along with your collaborators, to
that the procedure called.......................... be carried out on me.
................................................................................................................................
I acknowledge the following points relating to it.
procedure:
Oral surgery becomes necessary for the treatment of very diverse
problems and pathologies of the oral cavity.
Among these pathologies are periapical lesions and apex lesions.
(root) radicular of the various teeth, for whose correct treatment it
periapical surgery is necessary.
As a consequence of a cavity, dental pathology, or a dental trauma
it can produce pulp necrosis, followed by a chronic infection in the
apical region and periapical of its root, which over time develops a granuloma
periapical and sometimes dental cysts.
The initial step for the treatment of these lesions is usually endodontics.
(kill the nerve) of the affected tooth and, in case of failure of the same, not
full resolution of the lesion or large size of it is performed the
apicoectomy of all affected roots.
Apicoectomy is the removal of the final tip of a dental root, with
cleaning of the residual cavity and filling and sealing of the ducts
root when this is incomplete.
I have been informed and understand that the execution of this intervention does NOT
ENSURES the permanence of the dental piece in question in my mouth, being
at times the extraction of it is necessary.
In indicated cases, reconstruction of the surgical bed is necessary.
through bone grafts, platelet-rich plasma fraction rich in growth factors
from the patient himself or other synthetic materials, in order to ensure success
and viability of the treated teeth.
All these procedures aim to achieve an undeniable benefit,
however, they are not exempt from complications, some of which are unavoidable
in exceptional cases, being statistically the most frequent:
Allergy to anesthetics, or medications used before, during or after
surgery.
Hematoma, hemorrhage, and postoperative inflammation of the operated area
Postoperative infection of the surgical bed and/or materials used.
Opening of the suture points.
Gave to the neighboring teeth.
Partial or total sensitivity loss, temporary or permanent of the dental nerve
inferior
(sensitivity of the lower lip).
• Partial or total loss of sensitivity of the lingual nerve, temporary or definitive (of
the language and
of taste).
Partial or total lack of sensitivity of the infraorbital nerve (of the cheek),
temporal or
definitive.
Infection of the tissues or bone.
Sinusitis.
Communication between the mouth and the nose or the maxillary sinuses.
Bone fractures.
Breakage of instruments
Having received the previous information, I believe that I have understood the nature and
purposes of the procedure
Additionally, in a personal interview with the doctor ………………………………………
I have been informed, in terms that
I have understood the scope of said treatment. In the interview, I have had the
opportunity to propose and resolve my possible doubts, and to obtain how much
I have deemed it necessary to provide additional information. Therefore, I consider myself in
conditions for properly weighing both its possible risks and the
utility and benefits that I can obtain from it.
I am satisfied with the information that has been provided to me and, therefore,
I GIVE MY CONSENT for it to be performed on me..........................
...............................................................................................................................
This consent can be revoked by me without the need for justification.
anyone, at any time before carrying out the procedure.
Observations
...............................................................................................................................
................................................................................................ ...............................
And, for the record, I sign this original after reading it,
duplicate, of which a copy is provided to me.
In Lima, on ......................... of ............................................... of.........................
The Patient or The Dentist / Stomatologist
Legal Representative COP ...
