Re: Implant questions - Can this restoration be salvaged? Should we move on?



pdurant wrote: 
By way of background - I contacted this group two years ago about my
son who was about to have surgery for an upper right maxillary
ameloblastoma (which was discovered incidently during preparation for a
bone graft to reconstruct his upper front jaw which had been destroyed
in a bike accident 7 years earlier).

Following the surgery to reconstruct his upper front jaw we planned to
have implants placed to replace his four upper front teeth.  We also
needed to figure out how to deal with the gap left by the subsequent
ameloblastoma surgery which removed most of the upper right jaw,
palette and teeth from the eye tooth back.  (Search "ameloblastoma" and
see threads entitled "18 y/o son with ameloblastoma" for more details.)

So far, here's how it has gone since then....

Christmas break 2003 - Surgery to implant posts in my son's upper front
jaw. It was not possible to place 4 posts for individual implants
because part of the reconstructed jaw bone was not thick enough to
support the 4th post.  Thus we knew from that point that the proposed 4
implanted teeth would have to be connected.

Summer, 2004 - Implant posts are exposed and healing caps are placed.
Six weeks later, impressions are taken during which one of the
implanted posts pulled loose (painfully) from the jaw.  Two weeks
later, another surgery to implant a larger post to replace the failed
post.  Another 6 months of healing required.

Christmas, 2004 - New post exposed and healing cap placed.

March, 2005 - impressions taken again

June, 2005 - first try-in of implants - the initial fixed (4 teeth)
bridge seemed to be OK after a few adjustments and was sent back to the
lab for finishing.  The lab then added a partial plate (made of bright,
shiny metal and having 4 clasps - ugh!) which was affixed to the 4
implant teeth "bridge".  This metal partial had several cosmetic teeth
in the back to fill in the gap left by the ameloblastoma surgery.

July 12, 2005 - Final try-in and hopefully walk out with implants. The
finished appliance could not be made to fit. Our dentist, then told us
we had to start back at square one.  He did all new impressions that
week and sent the whole thing back to the same lab to have the entire
appliance redone.

August 19, 2005 - The appliance had been redone from scratch and did
not come close to fitting correctly this time either. Two of the three
implant posts could be made to seat well but the 3rd would not seat
correctly.  Then the attached metal partial plate would not fit right
either.  Then the 4 implant teeth and metal partial with clasps and
back teeth were separated and could not be made to fit separately
either.

Now....our dentist says we are back at square one again.....and has my
son scheduled to have new impressions taken the next time he is home
from college - which is the day before Thanksgiving.  The dentist says
he will not use the same lab....that he will "ask around" and find a
new lab.  BUT that's how he found this lab that supposedly had some
hotshot technician from Germany and was highly recommended.  The cost
of this was to be right around $6,000.  I know our dentist has hours in
it.  Presumably the lab has many hours and a lot of material in the
project.  BUT we still don't have anything for my son's mouth except
the "temporary" obturator with teeth made for him over two years ago
after his jaw reconstruction and tumor surgeries.

In addition, now our dentist is talking about doing the 4 front teeth
....then sometime later figuring out a way to fill the gap in the back
upper right area left from the ameloblastoma surgery. Perhaps by making
a separate partial plate that is never attached to the 4 front implant
(bridge) teeth.   My son is very concerned about that gap - right now
he has just one (non-functional) tooth (on his partial obturator/plate)
filling the space and he is satisfied with that but adament that he
does not want to spend days, weeks or even months with nothing filling
that area.

Initially,  the plan was to make the implant/partial plate device
removable - now the dentist is talking about making the implants
permanently attached, cemented in place - only to be removed when
having his teeth cleaned.  If my son has implants and also a partial
plate, we are all beginning to think the whole jaw reconstruction,
implant saga has been a waste.  After all, he had a partial plate with
teeth on it since he was 11 years old and lost his front teeth in the
bike accident. What is better about this scenario??? - to say nothing
about all the pain, trauma of bone graft, reconstruction, implant post
surgery and re-surgeries?

My son now wants me to find someone in the Chicago area and try to get
the implants done there (we live in PA - 10 hours from his college).
My question is - Is this drawn out process normal for this type of
complex dental restoration involving implants?   Or are we justified in
seeking someone else to do the job?  Would it be foolish not to change
providers at this point?

So far our insurance is covering everything and will continue to do so
until my son is 22 years old.  But I don't know if they will cover any
expenses incurred from these two failures (will the lab and dentist
bill for this?  I don't know.) or how they might view a change of
provider at this point.  Any advice or perspective (or alternate
approach) you would be willing to share would be greatly appreciated.


I remember you. I want to give your questions some consideration, and right now my eyes are crossing. I'll post tomorrow when I get a chance.

Steve

--
Cut the nonsense to reply

.

Relevant Pages

  • Implant questions - Can this restoration be salvaged? Should we move on?
    ... bone graft to reconstruct his upper front jaw which had been destroyed ... Following the surgery to reconstruct his upper front jaw we planned to ... have implants placed to replace his four upper front teeth. ... 2004 - Implant posts are exposed and healing caps are placed. ...
    (sci.med.dentistry)
  • Re: Can This Tooth Be Saved?
    ... sound to good as far as the fate of the abutment teeth and gum. ... I think I'll get the graft. ... leave the option open for an implant. ... do the extraction because I don't want the graft today? ...
    (sci.med.dentistry)
  • Re: Which is better option for single tooth: implant or bridge?
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  • Re: Rebuilding Crowned Lateral Incisor with 4 unit bridge
    ... Implant surgery in not very painful at all. ... your teeth and more chance of something needing a root canal. ... Also by avoiding the bridge you will be able to floss like you do with ... a bridge needs an extra tool called a floss threader to ...
    (sci.med.dentistry)
  • Re: OTP Need prayers for dental surgery UPDATE
    ... Surgery was an hour late because of the previous one, ... they delivered the new TV and plugged it in for Mom. ... Take out the FISH to email me. ... He will also do a bone graft and try to put in an implant. ...
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