Aa
Failed implant experience, deciding next step
This is going to be a long post and I thank anyone who has any advice and thoughts on my situation. I really appreciate any help you can give me.
Background health information:
Age: Early 30s
Not a smoker, no known health problems.
Oral Health: Really good. I’ve never had a cavity in my life. I brush 2-3 times a day. I use mouthwash 3 times a day. I get my teeth cleaned every 6 months on the dot. I’ll admit that I am not the most consistent flosser in the world. Prior to the events that I will speak of, the dental-related things I’ve had done are (A) all four wisdom teeth were removed with no problem and (B) I had invisalign braces.
Okay, here we go. In 2012 I was in an accident that ultimately knocked out 3 of my upper front teeth (both maxillary central incisors and my left maxillary lateral incisor). I had bone grafts to repair the damage done to my jaw and the 3 lost teeth. Next was the decision on what to do for the missing teeth.
My dentist and periodontist agreed that I should have implants put in. Implants would:
· Last the rest of my life
· They would look more natural
· The screws of the implants would hold my bone together, slowing the loss of bone from missing teeth.
My dentist and periodontist advised me NOT to get a conventional dental bridge/crown instead of implants because:
· I would have to shave down 4 of my healthy teeth in order to make abutments. On my left side, my canine and nearest premolar. On my right side, my right lateral incisor and canine.
· The lifespan of bridges are not long (5 years on average?).
I decided to go for implants because I wanted something that was going to last for the rest of my life, given my age. I also really didn’t want to ruin 4 of my healthy teeth for the bridge, and potentially have problems later in life as those 4 teeth develop problems of their own.
I underwent the implant process. I had one post placed where the left lateral incisor had been. The other post was placed where my right central incisor had been. I also had to go through a gum graft, because my gums had receded quite a bit from all the surgeries. During the healing time, I wore my invisalign brace, which had 3 fake teeth placed into it to hide the gap. The periodontist wanted me to wear that instead of a regular denture because the invisalign wouldn’t put any pressure on the healing gum or bone.
During this entire process, I never had any problems.
Once the posts were done, I was given a temporary implant-supported bridge (one bridge for all 3 missing teeth). I wore that for 8 months. I had no problems and it felt like my real teeth. Then I was given the permanent bridge.
That is when the problems started. First, the dentist couldn’t remove the temporary bridge. That was an ordeal. Then the permanent bridge didn’t fit well and the dentist had to work on it. During the 10 months that I wore the permanent bridge, it fell out twice.
After 10 months, I had visible abscesses forming on my gum in the areas around the posts. The periodontists tried to treat the abscesses without surgery. They took several x-rays and the bone looked fine around the implant.
Eventually, it became evident that surgery was necessary to detoxify the area. During the surgery, they found out that I had bone loss around both implants. The periodontist believed that the permanent bridge had put stress on my bone and over the 10 months, caused the bone loss. I had some bone loss around the left lateral incisor. I had a lot of bone loss around the right cental incisor. Basically, the bone loss was on the front of the implants. I still had bone up to the top thread on the back side of the implants, but bone loss on the front side. This is why they didn't see the bone loss on the x-ray, since that is a 2 dimensional image. Both implants were still integrated with the bone that was there and the implants were not mobile. The periodontist tried to graft bone to the implants, but he informed me that it was not likely to take.
It’s been 4 months since that surgery and the left lateral incisor seems okay, but the right central incisor doesn’t look great. The bone graft didn’t take and my gum has pulled away from the top of the post. I can see several of the post threads now when I look at my mouth. I had a CT-scan of my jaw and it confirmed that I didn’t get much bone growth from the graft. On the plus side, I have not had any infections or abscesses since the surgery. There was no sign of an infection on the CT-scan.
My current problem is what do I do going forward?
The periodontist suggested that we bury the implants/put them to sleep. Basically, we give up on implants and I get the conventional dental bridge.
The periodontist said that there is not enough bone on the implants currently to do an implant-supported bridge. If I want implants, I would have to have the current implants removed and start all over. However, part of the problem is that my implants are integrated into the bone (what is left there). He’s afraid that removing the implants would cause more damage to the bone, requiring multiple rounds of bone grafting and gum grafting. He’s not sure how much bone he’d get back if he did a bone graft. He mentioned that he could try INFUSE Bone Graft material, but that would be expensive and I would have to deal with a lot of facial swelling after the surgery.
I’m honestly just stuck and not sure what to do. My doctors keep saying that they have never encountered a case like mine before. I had originally chosen implants because I didn’t want to lose 4 more healthy teeth to make a conventional dental bridge. I wanted something that would last my life and wouldn’t have to be replaced every 5-10 years.
I’m looking for any advice that people may have.
· Has anyone ever been through a similar situation? Has anyone ever treated someone with a similar situation?
· Has anyone had an implant that was NOT mobile removed?
· Has anyone used the INFUSE Bone Graft material before? What is the swelling like?
· Does anyone have a conventional dental bridge on their upper front teeth? If so, what has your experience been with it? How long have they lasted? I don’t know anyone that has a bridge, or at least, no one has ever told me that they have one. What does it mean when a bridge fails? What does getting a bridge involve besides shaving the abutment teeth?
I really appreciate any help/advice that I can get. Thank you.
Background health information:
Age: Early 30s
Not a smoker, no known health problems.
Oral Health: Really good. I’ve never had a cavity in my life. I brush 2-3 times a day. I use mouthwash 3 times a day. I get my teeth cleaned every 6 months on the dot. I’ll admit that I am not the most consistent flosser in the world. Prior to the events that I will speak of, the dental-related things I’ve had done are (A) all four wisdom teeth were removed with no problem and (B) I had invisalign braces.
Okay, here we go. In 2012 I was in an accident that ultimately knocked out 3 of my upper front teeth (both maxillary central incisors and my left maxillary lateral incisor). I had bone grafts to repair the damage done to my jaw and the 3 lost teeth. Next was the decision on what to do for the missing teeth.
My dentist and periodontist agreed that I should have implants put in. Implants would:
· Last the rest of my life
· They would look more natural
· The screws of the implants would hold my bone together, slowing the loss of bone from missing teeth.
My dentist and periodontist advised me NOT to get a conventional dental bridge/crown instead of implants because:
· I would have to shave down 4 of my healthy teeth in order to make abutments. On my left side, my canine and nearest premolar. On my right side, my right lateral incisor and canine.
· The lifespan of bridges are not long (5 years on average?).
I decided to go for implants because I wanted something that was going to last for the rest of my life, given my age. I also really didn’t want to ruin 4 of my healthy teeth for the bridge, and potentially have problems later in life as those 4 teeth develop problems of their own.
I underwent the implant process. I had one post placed where the left lateral incisor had been. The other post was placed where my right central incisor had been. I also had to go through a gum graft, because my gums had receded quite a bit from all the surgeries. During the healing time, I wore my invisalign brace, which had 3 fake teeth placed into it to hide the gap. The periodontist wanted me to wear that instead of a regular denture because the invisalign wouldn’t put any pressure on the healing gum or bone.
During this entire process, I never had any problems.
Once the posts were done, I was given a temporary implant-supported bridge (one bridge for all 3 missing teeth). I wore that for 8 months. I had no problems and it felt like my real teeth. Then I was given the permanent bridge.
That is when the problems started. First, the dentist couldn’t remove the temporary bridge. That was an ordeal. Then the permanent bridge didn’t fit well and the dentist had to work on it. During the 10 months that I wore the permanent bridge, it fell out twice.
After 10 months, I had visible abscesses forming on my gum in the areas around the posts. The periodontists tried to treat the abscesses without surgery. They took several x-rays and the bone looked fine around the implant.
Eventually, it became evident that surgery was necessary to detoxify the area. During the surgery, they found out that I had bone loss around both implants. The periodontist believed that the permanent bridge had put stress on my bone and over the 10 months, caused the bone loss. I had some bone loss around the left lateral incisor. I had a lot of bone loss around the right cental incisor. Basically, the bone loss was on the front of the implants. I still had bone up to the top thread on the back side of the implants, but bone loss on the front side. This is why they didn't see the bone loss on the x-ray, since that is a 2 dimensional image. Both implants were still integrated with the bone that was there and the implants were not mobile. The periodontist tried to graft bone to the implants, but he informed me that it was not likely to take.
It’s been 4 months since that surgery and the left lateral incisor seems okay, but the right central incisor doesn’t look great. The bone graft didn’t take and my gum has pulled away from the top of the post. I can see several of the post threads now when I look at my mouth. I had a CT-scan of my jaw and it confirmed that I didn’t get much bone growth from the graft. On the plus side, I have not had any infections or abscesses since the surgery. There was no sign of an infection on the CT-scan.
My current problem is what do I do going forward?
The periodontist suggested that we bury the implants/put them to sleep. Basically, we give up on implants and I get the conventional dental bridge.
The periodontist said that there is not enough bone on the implants currently to do an implant-supported bridge. If I want implants, I would have to have the current implants removed and start all over. However, part of the problem is that my implants are integrated into the bone (what is left there). He’s afraid that removing the implants would cause more damage to the bone, requiring multiple rounds of bone grafting and gum grafting. He’s not sure how much bone he’d get back if he did a bone graft. He mentioned that he could try INFUSE Bone Graft material, but that would be expensive and I would have to deal with a lot of facial swelling after the surgery.
I’m honestly just stuck and not sure what to do. My doctors keep saying that they have never encountered a case like mine before. I had originally chosen implants because I didn’t want to lose 4 more healthy teeth to make a conventional dental bridge. I wanted something that would last my life and wouldn’t have to be replaced every 5-10 years.
I’m looking for any advice that people may have.
· Has anyone ever been through a similar situation? Has anyone ever treated someone with a similar situation?
· Has anyone had an implant that was NOT mobile removed?
· Has anyone used the INFUSE Bone Graft material before? What is the swelling like?
· Does anyone have a conventional dental bridge on their upper front teeth? If so, what has your experience been with it? How long have they lasted? I don’t know anyone that has a bridge, or at least, no one has ever told me that they have one. What does it mean when a bridge fails? What does getting a bridge involve besides shaving the abutment teeth?
I really appreciate any help/advice that I can get. Thank you.
14 weeks for bone grafts to heal? I'd of thought 12 months as bones are SLOW based on studying this about 5 years ago (but on reading about it now, 4 months is possible at least for minor dental bone grafts, though it may run 6-7 months).
Yours sounds like larger than the usual bone graft was likely involved, which I think implies a longer healing period would have been prudent (heavily favouring the 6-7 months period instead of 4 months or as you say, 14 weeks) -- as a lot of dental bone grafts being discussed online are just for prudently beefing up a fair existing structure.
6-7 months ought to be sufficient time for the posts to integrate (considering what's at stake, longer wouldn't hurt I imagine)
Sounds like it is clearly time for a 2nd opinion from an independant implant specialist imo, even, if you have to travel out of town and lug a copy of the x-rays with you. To chat about: what and how it was done, along with your outlook now using a bridge. I'd personally have fair confidence in a bridge (while realizing that yes, it would likely need replacement after five years, but I'd expect the neighbouring teeth with the anchoring posts, would fare well and ought to last a lifetime -- something to ask about). Supposedly, well done implaints are the gold standard for quality results. I would NOT expect to be able to safely chew hard foods but would forego that pleasure.
My only experience is decades of dealing with dentists, a late adolescence wisdom teeth extraction (under a general anesthetic), a periodontist, several minor gum surgeries (due to deep gum pockets), one molar extraction (due to a gum pocket becoming too advanced and infection risks being seen as too worrisome) along with contemplating/researching dental implants earlier.
For implaints, good bone structure is essential (you'd certainly not want to be on bone meds and/or contending with osteopenia or osteoporosis, as that means a high risk of bone necrosis since the bones have their self-healing capability crippled by such meds). I do suspect the heart of the matter here, may have been not allowing sufficient time for the initial bone grafts to be fully integrated.
It's sad you've experienced pressure related bone loss (presumably, because the bone structure wasn't up to the forces it was put under). I suppose a question to ponder would be: would a longer wait have allowed the bone to have been more ready? Or was it a design flaw doomed to failure from day one? Or what? Just unlucky?
If it were gum pocket related bone loss, I'd not be shy about strongly recommending using a Water Pik with warm salt water (as I've found that to be an Excellent gum care gadget). I suppose sticking with soft foods for now would be a coping tactic while things are figured out.
Yours sounds like larger than the usual bone graft was likely involved, which I think implies a longer healing period would have been prudent (heavily favouring the 6-7 months period instead of 4 months or as you say, 14 weeks) -- as a lot of dental bone grafts being discussed online are just for prudently beefing up a fair existing structure.
6-7 months ought to be sufficient time for the posts to integrate (considering what's at stake, longer wouldn't hurt I imagine)
Sounds like it is clearly time for a 2nd opinion from an independant implant specialist imo, even, if you have to travel out of town and lug a copy of the x-rays with you. To chat about: what and how it was done, along with your outlook now using a bridge. I'd personally have fair confidence in a bridge (while realizing that yes, it would likely need replacement after five years, but I'd expect the neighbouring teeth with the anchoring posts, would fare well and ought to last a lifetime -- something to ask about). Supposedly, well done implaints are the gold standard for quality results. I would NOT expect to be able to safely chew hard foods but would forego that pleasure.
My only experience is decades of dealing with dentists, a late adolescence wisdom teeth extraction (under a general anesthetic), a periodontist, several minor gum surgeries (due to deep gum pockets), one molar extraction (due to a gum pocket becoming too advanced and infection risks being seen as too worrisome) along with contemplating/researching dental implants earlier.
For implaints, good bone structure is essential (you'd certainly not want to be on bone meds and/or contending with osteopenia or osteoporosis, as that means a high risk of bone necrosis since the bones have their self-healing capability crippled by such meds). I do suspect the heart of the matter here, may have been not allowing sufficient time for the initial bone grafts to be fully integrated.
It's sad you've experienced pressure related bone loss (presumably, because the bone structure wasn't up to the forces it was put under). I suppose a question to ponder would be: would a longer wait have allowed the bone to have been more ready? Or was it a design flaw doomed to failure from day one? Or what? Just unlucky?
If it were gum pocket related bone loss, I'd not be shy about strongly recommending using a Water Pik with warm salt water (as I've found that to be an Excellent gum care gadget). I suppose sticking with soft foods for now would be a coping tactic while things are figured out.
I had the bone grafts in March 2012.
Waited 14 weeks for the grafts to heal.
Implant surgery was May 2012.
Waited 6-7 months for posts to integrate before bridge was put on.
Waited 14 weeks for the grafts to heal.
Implant surgery was May 2012.
Waited 6-7 months for posts to integrate before bridge was put on.
Have an Answer?
You are reading content posted in the Dental Health Community
If you suffer from frequent headaches, jaw clicking and popping ear pain, you may have TMJ. Top dentist Hamidreza Nassery, DMD, has the best TMJ treatments for you.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.
Condoms are the most effective way to prevent HIV and STDs.
