Re: Another question about Implants
From: Mark & Steven Bornfeld DDS (bornfeldmung_at_dentaltwins.com)
Date: 08/04/04
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Date: Wed, 04 Aug 2004 18:12:10 -0400
Sky wrote:
> I have recently been diagnosed by a periodontist with periodontal
> disease. I am facing the loss of many teeth, and both partial dentures
> and implants have been discussed.
>
> The periodonist gave me 2 options, 1st recommendation was to pull my
> whole upper, even tho my 6 teeth can be saved now(both my eye teeth
> and all 4 of my bi-cupids). He said that because he can't say how long
> these would last, it would be cheaper for me in the long run because
> if one failed I would have to replace them all.
>
> The 2nd option is pull my front incisors make an implant bridge, keep
> both eye teeth and bi-cupids. Replace the molars. This option would
> involve 4 implants, so it be more affordable to me. The peri then sent
> me to a prostadontist who said if I lost one of the remaining teeth
> down the line, he would have to remake the whole thing. So his most
> recommanded treatment would be to pull the whole top, because he can't
> say how long they will last. But I don't understand why the whole
> thing would have to be remade as the front and back molars would not
> be attached. I don't see why If I lost one or two down the line I
> couldn't just put in a single implant. Option1 would be over 20grand
> more then option2. I still don't have all the figures so could be more
> and I'm not sure I could afford to do this all at this time. Option 2
> my be the only way I could keep myself out of a denture, and save for
> any further treatment.
>
> As far as I can tell their great Dr's and I trust his opinion, but the
> problem with this team is they don't seem to be communicateing with
> one another and kept deferring me back and fourth to get my answers.
> There have also been differences of opinions which have left me with
> more questions and more confusion. I wrote this peri over a week ago
> as I wanted to get things cleared up and he hasn't returned my email
> as of yet. This kinda upsets me to. To be fair both these Dr's have
> spent a great deal of time with me, but being new to this, and in
> shock over it I didn't know what questions to even ask.
>
> So I decided to go for a 2nd opinion. I went to a guy who specializes
> in implants. He said the only way he would do them is to pull the
> whole top. If I couldn't afford it now, he would pull the front and
> put in a partcial and just keep cleaning the rest.
>
> I have a dental phobia to begin with, along with a terrible gag reflex
> so I am scared of what I am facing. I knew nothing about implants up
> until 2 months ago, I only knew one person who had them, and over the
> years one by one fell out. Had she had pulled them all she would have
> had to have a denture instead of partcials. So pulling them all scares
> me more incase they fail. The 1st prost. understood this. The 2nd guy
> said if I pull the whole top I have a 99% chance they will take, now I
> never heard those odds.
>
> To cut a long story short I'm confused, and scared as I feel pressured
> to decide soon as one of my front teeth is loose and it could go. I'm
> thinking a 3rd opinion might be a good idea and noticed you said you
> knew good Dr's on Long Island. I thought maybe you could recommend
> another, I'm in the Babylon/Deer park area.
> Thank you.
The most telling thing is that you are a gagger. Ordinarily I would
opt to take out the hopeless teeth, make an acrylic base partial
denture, and see the periodontal treatment through on the teeth with a
reasonably good prognosis. After a couple of years, if your periodontal
situation is stable, then you can consider involved implant dentistry.
Most folks do OK with full dentures on the top; most don't do so OK
with full lower dentures. So most of my implant restorative dentistry
has been on the bottom (except for single tooth replacements of upper
teeth, esp. in the front).
There are some types of partials that are ideal for questionable teeth
and may accomodate a cut out palate, which would minimize the gag
reflex, such as a CuSil partial.
In any case, I had an office in Lindenhurst, but I've been out of there
since 1986. I'm not in touch with the specialists like I used to be,
but Alex Corsair (in Rockville Center) and Lonnie Ratner (forget the
village) are excellent periodontists, and Elliot Siegel in Massapequa is
an excellent oral surgeon, and I'm sure could steer you to a good
restorative dentist in the area. The president of our dental school
class, Tony Fragola (an endodontist), is on Montauk Hwy in W. Islip, and
could also give you some good leads.
Good luck,
Steve
Good luck,
Steve
-- Mark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001
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