Sorry I have to create a new thread, but my newsreader is automatically
deleting recent posts, including the x-ray link.
Based on my recollection of the x-rays and your explanation of food
accumulation around the necks of the implants:
Today, implant placement is ideally supposed to be driven by the final
prosthodontic and aesthetic result desired. In your situation,
aesthetics of the final product is not a factor, but prosthetics and
comfort are factors.
On the left side, you have 3 implants. Ideally you would have at least 4
implants to replace all the missing teeth, at least one for one. However
you have 3 and they are placed with large spacing between the implants.
As I can remember from the x-rays, the middle implant has a rather large
un-naturally shaped pier abutment. This causes an un-natural emergence
profile and hence large embrasures. Perhaps this is the best result they
could get based upon bony ridge augmentation that may or may have not
been totally successful prior to implant placement. Based upon what I
see, the resultant prosthesis is the best that could be achieved with
the number of implants placed and the bone they were placed in. I do not
know why they placed the prosthesis as a single 3 unit replacement as
opposed to the use of individual single units with contact areas.
Personally, splinting like this impedes home care and the natural self
cleansing mechanisms of the mouth.
On the right side, it appears that the molars have drifted forward into
a two tooth edentulous space that was restored with a single implant and
single tooth. The replacement appears to be 1.5 times the size of a
natural molar. Ideally, you would have had adjunctive orthodontic molar
uprighting that would have allowed for the placement of 2 implants an 2
smaller crowns instead of 1 wicked big one.
So, from a financial point of view, i.e. doing as much as possible with
the minimum number of implants and minimum number of pre-prosthetic
surgeries, your result is probably the best that was expected. If $,
post-op discomfort, and time were not factors, then perhaps the
foundation for, and number of, implants could have been different.
The 2 implants on the UR appear to be adequate for 2 separate single
crowns. So hopefully, they won't be splinted together and the embrasures
at the necks of the implants will be more natural.
I don't think anything was done "wrong" or that a new prosthetic
treatment will be better for you. I think that this is the best result
you could expect, albeit a compromise from ideal.
Your friend's implants, I am sure, are different as his/her edentulous
areas present different opportunities for prosthetic satisfaction.
I hope that this info will help you better adjust to what you have as a
final result and that it is an adequate second opinion from a 3rd
disinterested person.
JimSocal - 03 Jul 2007 19:56 GMT
>Sorry I have to create a new thread, but my newsreader is automatically
>deleting recent posts, including the x-ray link.
[quoted text clipped - 49 lines]
>final result and that it is an adequate second opinion from a 3rd
>disinterested person.
Thank you very much for taking the time to look at the xray and give
me this opinion!
I guess I'll just have to live with using those little brushes that go
in the holes between the crowns, to get the impacted food that gets
stuck in there EVERY time I eat! It's better than not having teeth
there, at all.
I was not asked if I wanted a bridge of 3 crowns or 3 individual
implant crowns there. The surgeon apparently just decided that was
what was needed and that was that. I'd much rather have had 3 implant
crowns, and yes, I could have paid for them but was not consulted on
this.
I had these done at a dental school, and one problem I had was that I
often did not get to consult with the professors, the student just
told me what he thought should be done and even when I asked to
consult with the prof it was very difficult to get a meeting with him.
The prof was there when the surgery was done and I remember him doing
a good job of supervision during the surgery. But before and after the
surgery it was for all practical purposes, impossible to meet with
him. I suppose I could have been more aggressive about asking for an
appt. but I got the impression that they just didn't want to do it. I
have to assume that the prof approved everything before it was done.
This particularly became a problem when I went in for my upper
implants and they told me they had to do a bone graft, that they'd be
scraping bone from my jawbone or something. I was not at all prepared
for that, they had led me to believe that it was only a sinus lift I
needed. So I was quite surprised to hear I was going to have a bone
graft.
The bone graft was very painful, afterwards, and traumatic while it
was being done, even though it didn't "hurt" per se, at the time. Hurt
like hell afterwards.
What was worse though was the sinus lift. I had a headache for 2 weeks
after that. For the first few days it was so bad I had to wear dark
glasses even in the living room at night, to watch tv. I was afraid
they did permanent damage to some optical nerve or something because
my eyes became super sensitive to light and I had a constant headache
for a week or two. Finally it went away. But I'll never forget that
pounding on my sinus bone that must have gone on for like 20 minutes
or more. It seemed like an eternity!
As for the crown placement, the profs there were easier to consult
with, but by that time it was too late to change anything, it seemed.
The prof there did tell me that the implants and crowns were done well
and this was the best I could expect. But I was afraid he was just
saying that to avoid having to re-do anything.
I must say that they did a great job on the Bite of the crowns against
my natural teeth, at least on the bridge side. On the other side I
don't have any opposing teeth, yet. I get the other 2 crowns in Sept.
or October.
In case you want or need to take another look, or if another dentist
wants to give his or her opinion, here is the info from the other
thread:
Implants 18, 19, 20 and 29. I believe the name of them is
Nobelbiocare. #19 and #20 are "Branemark MkIII Groovy RP 4x10 #3,4,18
and 29 are Branemark Speedy Groovy 4x10
Here is a jpg of the xray and info the surgeon wrote on it:
http://img167.imageshack.us/img167/3784/implantxrayrevag4.jpg