Dental implants - how to quiz the dentist
Discussion
I had an implant 5 years ago now, had to have jaw augmentation for it as well (expand jaw bone with hammer and punch). Its front top tooth 3rd in from my left big front tooth. Same situation as you, had a crown there before, broke that, got a absese in there had rest of tooth out.
I've had no real problems with it and it feels very secure and it xrays it looks good
The jaw augmentation wasn't nice, no pain as lots of pain killers but I was awake for it and I regret that. Only issue I have had is self inflicted really, I didn't floss enough or keep the areas between the implant and healthy teeth clean enough though I did brush 2 x daily. End result was 4 years after the implant one of the teeth next to it decayed from the side down. So though implants are good you need to keep it clean.
I went to a cosmetic dentist in Islington, Angel Dental, the dentist who did had done hundreds, showed me his portfolio a bit of a nutter but had very good taste in dental nurses
Getting it done was one of the best things I have done, I spent 5 years with a gap in my smile and I hated it and wouldnt smile.
I've had no real problems with it and it feels very secure and it xrays it looks good
The jaw augmentation wasn't nice, no pain as lots of pain killers but I was awake for it and I regret that. Only issue I have had is self inflicted really, I didn't floss enough or keep the areas between the implant and healthy teeth clean enough though I did brush 2 x daily. End result was 4 years after the implant one of the teeth next to it decayed from the side down. So though implants are good you need to keep it clean. I went to a cosmetic dentist in Islington, Angel Dental, the dentist who did had done hundreds, showed me his portfolio a bit of a nutter but had very good taste in dental nurses
Getting it done was one of the best things I have done, I spent 5 years with a gap in my smile and I hated it and wouldnt smile.
Edited by BumFLuff on Tuesday 11th September 18:09
Edited by BumFLuff on Tuesday 11th September 18:10
Edited by BumFLuff on Tuesday 11th September 18:14
Dentists, please explain this to me:
In joint replacement surgery there is an absolute mania for sterility and laminar flow theatres - for good reason; I've seen the consequences of infected joint prostheses. Like you, one has to be very careful with people with any foreign body both at implantation or later for fear of seeding it with a transient bacteraemia - in dentistry mechanical heart valves are a good example.
However, my limited understanding of implants is that however gorgeous your receptionist, however hot your assistant, however fabulous your car (Maserati favoured by our local practitioner), however clean your operating room, instruments, gloves etc you (forgive the simplification) reflect a flap, screw in a post which then passes from a "dirty" oral cavity into mandible or maxilla and later, after one end of it becomes integrated in the bone (while the other marinades in an evil broth of saliva and bacteria), you attach a crown, repeating as required, perhaps for many teeth. Even if there isn't a radicular cyst needing curettage and grafting, just normal healthy bone, how do you avoid osteomyelitis, especially with a foreign body forming a potential bridge from the "dirty" mouth to the sterile cortex or medulla of the bone? Antibiotics don't work every time in the far, far more optimal setting of elective major joint replacement so I can't see them being a great deal of use in implantology. This isn't a dig or piss-take (comment about babes & motor excepted), but a genuine question.
D.O.I. I have a UR1 crown on a gold post, now some 30+ years old (trauma caused # of the original tooth not long after eruption); the crown is showing signs of cracking and years ago it developed a radicular/apical cyst which is still present and recurred after apicectomy (not surprisingly given the fact that the post and crown were, quite appropriately, preserved). The post is pretty rigid now, so the cyst may have partially re-ossified I've got to think about either having a bone graft (if required) + implant or a re-crown of the post, a bridge, or grinning gap-toothed at everyone in due course. My personal circumstances are an aside from my real, theoretical question - how often does one get osteomyelitis around a solitary implant post and how often when the number of implants increases?
In joint replacement surgery there is an absolute mania for sterility and laminar flow theatres - for good reason; I've seen the consequences of infected joint prostheses. Like you, one has to be very careful with people with any foreign body both at implantation or later for fear of seeding it with a transient bacteraemia - in dentistry mechanical heart valves are a good example.
However, my limited understanding of implants is that however gorgeous your receptionist, however hot your assistant, however fabulous your car (Maserati favoured by our local practitioner), however clean your operating room, instruments, gloves etc you (forgive the simplification) reflect a flap, screw in a post which then passes from a "dirty" oral cavity into mandible or maxilla and later, after one end of it becomes integrated in the bone (while the other marinades in an evil broth of saliva and bacteria), you attach a crown, repeating as required, perhaps for many teeth. Even if there isn't a radicular cyst needing curettage and grafting, just normal healthy bone, how do you avoid osteomyelitis, especially with a foreign body forming a potential bridge from the "dirty" mouth to the sterile cortex or medulla of the bone? Antibiotics don't work every time in the far, far more optimal setting of elective major joint replacement so I can't see them being a great deal of use in implantology. This isn't a dig or piss-take (comment about babes & motor excepted), but a genuine question.
D.O.I. I have a UR1 crown on a gold post, now some 30+ years old (trauma caused # of the original tooth not long after eruption); the crown is showing signs of cracking and years ago it developed a radicular/apical cyst which is still present and recurred after apicectomy (not surprisingly given the fact that the post and crown were, quite appropriately, preserved). The post is pretty rigid now, so the cyst may have partially re-ossified I've got to think about either having a bone graft (if required) + implant or a re-crown of the post, a bridge, or grinning gap-toothed at everyone in due course. My personal circumstances are an aside from my real, theoretical question - how often does one get osteomyelitis around a solitary implant post and how often when the number of implants increases?
Gingival tissues reorganise around the implant as part of the healing process. This then acts in a similar fashion to the gingiva surrounding a natural tooth in terms of preventing bacterial ingress. Poor oral hygiene around implants will lead to their loss in the same way as it does with teeth i.e gingival inflammation, pocket formation and progressive bone loss.
Oh and in answer to your question, I don't have figures but osteomyelitis around implants is very rare. An increase in the number of implants is usually accompanied by more complicated restorations attached to them (bridges,dentures). These can increase plaque retention and increase failures in less motivated patients.
Oh and in answer to your question, I don't have figures but osteomyelitis around implants is very rare. An increase in the number of implants is usually accompanied by more complicated restorations attached to them (bridges,dentures). These can increase plaque retention and increase failures in less motivated patients.
Edited by Rollin on Friday 11th April 23:22
I have one, lower left first molar. It's been fine - the implant osseointegrated in a few months (no bone graft) as expected then a crown was fitted to that. Eating feels similar to a normal tooth, though the actual sensation through the implant site is different to a live tooth. You can feel pressure through the jaw bone, but not through the implant itself. The crown looks much like a normal tooth too. Only slight problem I've had is I managed to chip the crown, it was repaired free of charge though so not a big deal overall.
I'm not an expert but the sensation would be different as a normal tooth is held in the socket by little hairy type ligaments thus creating a small space between tooth and bone. This a;;ows small movements in the socket which I'd guess give you the positional sensation of tooth contacts...we call it proprioception. This is the goal for all dentists. Thats why we try to avoid full mouth extractions so patient has better sense of jaw positions whilst eating.
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