Re: Dental Implant failed after 2 years...

Alexander Vasserman DDS wrote:
Dear George

This is a terrible situation you are in. I can tell you it is not
supposed to turn out like this and for some reason something is not
compatable with you.
Bio-Oss is a matrix of cortical bone taken from a cow. It is possible
that within this bone mineral is hormones that were given to this cow
during its lifetime. Your body may not be compatible with this type of
bone graft although if you talk to the manufacturer of Bio-Oss they
will swear it is safe and can not be the problem. We really do not know
how much truth there is to this.
I've work with bio-oss all the time and I have to say it takes much
longer for this graft material to fuse with your own bone and having
good bleeding during placement helps. Some clinicians mix tetracycline
with the bio-oss to help with bacterial contamination which you can not
avoid in the mouth unlike heart or brain surgery. Others say adding
tetracycline make the site more acidic and it is not favourable to the
graft.
What I can tell you is this Biooss by itself in 6months still is
destinguishable from your own bone but is hard. Bio-oss with
tetracycline looks yellow with white particles both during placement
and at 6 months. Generally Bio-oss seems to stick around the site
longer than your own bone which would be the ideal choice of material
but will require a donor site surgery such as the chin area or back jaw
bone(ramus area).
If the implant is solid I do not recommend its removal. The surface of
it needs to be treated and a bone graft done again. Maybe the second
time around you should insist on using your own bone(autograft) vs from
a cow(bio-oss=xenograft) or from your dead neighbour(allograft). Freeze
dried bone no matter how well it is cleaned is not vascularized and
hence it is dependent on getting your own blood from surrounding bone
and sometimes taken from your vein centrifuged (PRP=Plasma Rich
Protiens) which helps in the grafts success. Having given you bone
grafting 102 course, you should also consider that either cement got
under the gums which caused this infection, or more likely the
infection is coming from a neighbouring tooth which abscessed sine it
was preppared for a bridge once and then once again for a single crown.
Best bet is to check the lateral incisor since it is a smaller tooth
and could be the culprit.
Do not get discouraged with implants it is still the best long term
alternative you just had a lot of bad luck. And going back to a bridge
does not mean you can not encounter abscess of the adjacent teeth since
this would be the third time they would have to be preppared getting
smaller each time and the risk of them fracturing at the gum line
increases as well. Also do you happen to know the implant
manufacturer???



What a very knowledgeable and helpful post. Good man. (I'm lurking because I'm considering implants).
.

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