Dental problems again

[Henners]

Sounds nasty, and I cant really help

But... what’s the thing in the tooth on the left, looks to have 2 tails, quite interesting.

[PostHeads123]

Henners said:

Sounds nasty, and I cant really help

But... what’s the thing in the tooth on the left, looks to have 2 tails, quite interesting.

That one has had a root canal and then a very large filling that has been topped up a number of times over the years, this is another thing to be aware of with implants, the reason that tooth decayed in the way it did (from the side) and not the top, is as a result of how the implant was placed making it very difficult to clean that part of the tooth. Implant technology come on along way now so new systems don't have such an issue. All the dentists I have seen have said its not that tooth ... but who knows.

I've had an MRI, CT, OPG xray and blood tests to check for dental infections now, seeing consultant early next week so either way I pray to god they can find what the issue is, otherwise its time to start pulling the teeth / removing the implant. Thank god Im lucky enough to have private health care they agreed to cover the investigation work even if turns out to be dental issue, they just wont cover the dental work itself if needed.

[PostHeads123]

This is the OPG scan implant on the right on image, too me it looks like the post is butting up to the sinus or perferated it abit ? I'm no expert seeing consultant on Tues but images given to me before probably shouldn't of looked at them tbh.

[DocJock]

Your OPG is a 2D image of a 3D structure, so there is not necessarily any perforation even if it did appear so

[Armitage.Shanks]

Why is there a recommendation to crown a tooth after a root filling? I've had several root fillings and not needed an implant. After the root work they've been filled like normal.

I'm lucky my dentist who I've been going to for near 30yrs is still NHS although recently I've explored a 'make-over' replacing crowns and metal fillings etc. I thought my teeth were in reasonable shape until I saw this private outfit. "There's a lot of work here so I'll have to worok it all out and the costs" :rollleyes: The X-rays were good quality although I can predict a 5-figure quote.

[PostHeads123]

Update, finally found out (after a lot of expense and some dental work) the pain is not dental but after a second MRI scan I was diagnosed with ' atypical trigeminal neuralgia' , which means the nerve in the left side of my face is dodgy due to pressure on it. Been given some tablets to ease the symptoms which seems to have helped to some degree but they are suggesting long term I need a op where they drill into the skull behind the ear and put something in between the nerve and face. Somedays the pain has been unreal I don't know how I managed to keep going I can understand why 'trigeminal neuralgia' is also called the suicide disease as some days I was really low and agony.

Edited by PostHeads123 on Wednesday 13th February 14:34

Edited by PostHeads123 on Wednesday 13th February 15:09

[dandarez]

Wow! Only just seen this, was off to bed but I'll bang a few words out if only in sympathy.

In the 80s I suffered what I called my aching face pain. It would come on gradually and worsen as the day went on. Sleep remedied it (like if you say, you could sleep!). I'm fairly sure mine was nothing like as severe as you have/are getting.
Nobody knew what it was. Docs always referred me to my dentist who pointed to my wisdom teeth (always had problems with them).
Had a painful wisdom removed. The face pain remained. I used to just put up with it.
Then one day the pain was not there. It was like heaven, it just disappeared as if by magic. I worried it would return. But it didn't.

When I had another wisdom 'drilled' out a good number of years on, I was asked how far the pain spread and my old face pain problem came up in discussion. The dentist suggested it would not have been the teeth that were the problem, but the trigeminal nerve.

I never thought anymore about it but just so glad it ceased. Then one day talking to a relative of mine we were discussing my family history and my gramp's name came up. He was decorated a fair bit in the war (WW2) and had shrapnel wounding. I said I remembered as a young child he would drop to his knees in pain holding his face. The relative said that was nothing to do with his wounds, it was because he suffered from Tic Douloureux.
I remembered those strange two words. She said 'it's better known as Trigeminal Neuralgia.'
I thought fk me at that point and wondered if it was hereditary, thinking back to my face pain, but apparently it's not. Not that I suffered any thing remotely like that. But it illustrates perfectly why it's also called the 'suicide pain'.
The good news is like mine, his did disappear. Obviously that nerve is like the sciatic nerve, a bit of God's handiwork that utterly failed!

Hope you get some respite. Pain is such a bd and hard to convey to others who don't suffer.

[PostHeads123]

Any dentist in the place ? I started this post a while ago thought we had the issue sorted but its back, this time I have managed to get hold of the 3D scan thing of my teeth so had a look myself and I spotted something, I'm no expert but it looks odd to me. Below is a picture the tooth in front of the implant is has root canal and large filling you can see a little black hole on the side of it, now I'm guessing it shouldn't be there ? This picture is from the inside of the mouth looking out.




This image was done as imaging centre and sent to my dentist so he has time to review it, the tooth with the black hole on he suggested a crown which he has prepped it for and currently has temp crown on. I assumed he was going to remove the filling and check and then redo it before he started the crown prep it was only at the end of the treatment he said he didn't do that just prepped with the existing filling in there.

[Driller]

I would be concerned about the bone loss around the implant (depending on how long it's been there). What sort of cleaning are you doing around it?

For the crown prep he would have other placed a little restoration in that hole before doing the prep or it could have been removed during the prep itself and will be replaced by the crown material. At any rate the tooth doesn't look to be in great shape and has already undergone quite a lot of treatment by the look of it.

Edited by Driller on Wednesday 20th March 12:01

[Driller]

I would be concerned about the bone loss around the implant (depending on how long it's been there). What sort of cleaning are you doing around it?

For the crown prep he would have other placed a little restoration in that hole before doing the prep or it could have been removed during the prep itself and will be replaced by the crown material. At any rate the tooth doesn't look to be in great shape and has already undergone quite a lot of treatment by the look of it.

Edited by Driller on Wednesday 20th March 18:22

[PostHeads123]

Driller said:

I would be concerned about the bone loss around the implant (depending on how long it's been there). What sort of cleaning are you doing around it?

For the crown prep he would have other placed a little restoration in that hole before doing the prep or it could have been removed during the prep itself and will be replaced by the crown material. At any rate the tooth doesn't look to be in great shape and has already undergone quite a lot of treatment by the look of it.

Edited by Driller on Wednesday 20th March 12:01

Thanks, the implant has been there 10 years now, I was told to expect a little bone lose but this is the first time I have seen it myself from the under side and it looks worse there to be honest then I see on the 2D. I also had the original OPG when I had the implant fitted and compared it to one I had done last year and the bone loss is there but marginal, When I had the implant fitted they had to do jaw expansion for it to be big enough. I had the 3D x-ray thing done at the Cavendish imaging in London then my own dentist looked at it but, not sure how well he kind of looked at it for 5mins when I was there I had a good look at home, I asked him today about the black mark and he did say he would of drilled through it as you said.

In terms of cleaning I use those small brushes daily and go hygienist every 6 months, though I admit I probably didn't look after it well enough in the early days.

My dilemma now is what are next steps, I could just have the tooth in front of the implant pulled and hope that sorts it, my worry is if it doesn't though it then means I've pulled a tooth I didn't need to and a visible one to. Other option is to try treating the bone lose around the implant first and hope that helps but I've had quotes of £1500 + for trying to treat that cover lazer cleaning or antibiotics injections, and the only people who I have found who would do it seem to be Harley Street practices who have prices to match, unless you know anyone on the implant side who is more reasonable price Im happy to travel in the UK ? I'm already 1.5k in from seeing dentists, ct scan, 3 scan having other work done to rule that out as the cause.

Its not a tooth ache pain buts its a fullness / tightness tingling in the cheek above the implant and tooth, I did notice when it first started and before the crown prep that tooth the bite seem to change it was like the tooth had dropped a bit and was hitting the bottom tooth more but that would come and go as well so not sure if it swelling somewhere, After the crown prep that went but not 100%. I've had a few courses of antib to rule out infections they did nothing to help.

My own dentist is suggesting extract the tooth first see if sorts it then tackle the implant if its still an issue.

The whole thing is driving insane, cant concentrate with it and has really got me depressed, I've got to get it sorted.

thanks

Edited by PostHeads123 on Wednesday 20th March 15:20

Edited by PostHeads123 on Wednesday 20th March 15:29

Edited by PostHeads123 on Wednesday 20th March 15:30

[Johnny]

My wife spent years with issues until Rach from PH recommended her old place:

http://www.chilterndental.co.uk/

[cringle]

The implant disease here is very established and due to the modern rough surfaces of dental implants, it is all but impossible to remove the bacteria successfully. These Harley Street charlatans and their fancy gizmos ain’t gona do anything for you except drain more of your hard earned. I would want that implant removed before it destroys even more bone. The site is pretty salveageable at the moment; explant, allow healing, graft then place again if you still want a tooth there. However, if it is left, the damage to the bone in the site can be catastrophic, making future treatment extremely difficult (and even more expensive!) trust me on this, as i do have a particular interest in regenerating large defects/complex cases.

The root canal treated tooth in front is hard to call from info you’ve given. It may be failing, and there is an infection which is not detectable, or a hairline fracture somewhere which again are largely undetectable. Pain affecting sleep is usually an indicator of an infection somewhere.

Good luck my friend.

[PostHeads123]

cringle said:

The implant disease here is very established and due to the modern rough surfaces of dental implants, it is all but impossible to remove the bacteria successfully. These Harley Street charlatans and their fancy gizmos ain’t gona do anything for you except drain more of your hard earned. I would want that implant removed before it destroys even more bone. The site is pretty salveageable at the moment; explant, allow healing, graft then place again if you still want a tooth there. However, if it is left, the damage to the bone in the site can be catastrophic, making future treatment extremely difficult (and even more expensive!) trust me on this, as i do have a particular interest in regenerating large defects/complex cases.

The root canal treated tooth in front is hard to call from info you’ve given. It may be failing, and there is an infection which is not detectable, or a hairline fracture somewhere which again are largely undetectable. Pain affecting sleep is usually an indicator of an infection somewhere.

Good luck my friend.

Ok .. not what I wanted to hear but kind of guessed this was the case, I did want it removed but can imagine that its going to cost plus its been in there 10 years so its well fused. If this is your area of expertise could you PM me and some details where you practice and I can get in contact. I'm happy to travel in UK ?

thanks

[Driller]

Cringle, what method do you use for explantation, knowing that this in itself can be very destructive to bone?

Not an easy situation to remedy at any rate.

[PostHeads123]

One question I have for you both and I know its hard to say and this is all in an unofficial context but do you think my symptoms are from the implant bone loss or the tooth in front ? I read that typically there is no pain or discomfort with peri implantitus ? In my case the gum around the implant looks fine, on probing its not bleeding (but did bleed once a year ago when I slipped with floss), on probing they can feel the pocket at the front, there is no movement in the implant. I was at the hygienist earlier in the week and she confirmed that redness in the gum was around the tooth with the temp crown on. When I wiggle that tooth I get the weird sensation, I don't get it if I wiggle the implant. My priority at the moment is to remove the weird feeling then I can address anything after.

thanks

Edited by PostHeads123 on Friday 22 March 11:54

Edited by PostHeads123 on Friday 22 March 11:59

[Driller]

Even with the bone loss you’ve had around the implant it will still be very solidly stuck in the jaw. That’s not to say that it doesn’t need to be looked at though.

Indeed typically boneless around implants is chronic and usually symptomless (painless). Scanning quickly over the thread though it seems you were experiencing some sort of atypical facial pain which normally would update be caused by the tooth next to the implant either.

[Alucidnation]

Just get them to take the fker out.

Not worth the pain, cost and aggro.

[PostHeads123]

Im going to have the root canal tooth extracted next Thurs and will pray it sorts the wierd feeling.

[cringle]

Driller said:

Cringle, what method do you use for explantation, knowing that this in itself can be very destructive to bone?

Not an easy situation to remedy at any rate.

Hi driller, long time no speak!

I’d use either the neobiotech or BTI explantation kits. Piece of cake. No trephines obviously so preserve maximum bone. I’d also recommend Prof Urban’s regenerator course in Hungary, awesome