Following post moved from tail of another thread:


posted March 22, 2006 08:55 AM
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Hello,

Has anyone had implants for a full denture in a radiated jaw after HBOT?

Hal

Hal, I had lower implants and will be happy to answer any questions you have.

Joanna,
Thanks for getting back to me.
I finished 30 dives of HBO last Wednesday and am tentatively scheduled for implants in both upper and lower jaws on 4/12. Did you have HBOT before you had implants and how long has it been. Any issues I should be aware of. My oral surgeon and HBO doc say it's just another day at the office.
Thanks,
Hal

Yes, 20 dives before, then 10 after. The implants were placed under anesthetic and were not painful when I awoke. They are topped with screw on caps to keep food out. NO chewing. Usual healing time is 3 months, but for rad patients, it can be 6 or more. It has been about 2.5 years since I had the procedure. They work fine, just about like teeth, but need to be cleaned differently as you cannot floss. There are two kinds of dentures: fixed, removable only by dentist; and snap out, which are much easier to clean. I have the fixed variety because my dentist says they are better. His opinion. I wish I could pop them out. You will be given antibiotics after the surgery. Be sure to take them all. Your docs are correct -- other than the expense, it is not a big deal.

There is always the possibility that one of more of the implants will not integrate properly and will need to be replaced. This does not involve anesthesia, but does extend the time until the denture. My very nice dentist made some lower false teeth that fit over the healing caps, just for show, not for eating. You might be able to have those too. I had an immediate upper denture, no implants, but I am not sure how you would be able to hold "for show only" upper teeth in -- maybe with denture glue. Anyway, there are options.

Bottom line, implants are not just like real teeth, but they work very, very well. The teeth are aligned very carefully with the posts, because the pressure of eating stimulates the bone just as it does with real roots, thus keeping the bone healthy. I know you will be pleased.

My treatment plan for implants was finalized today..............finally!! Going with implants upper and lower, and will also need to do some additional HBO as my first 30 dives were 2 years ago. So, procedure will take place in approx. 6 weeks. Oral Surgeon said my bone looks great, even the new bone I now have in my lower jaw. He feels my implants will be very successful and will give me approx. 90% of what I had before. Natural teeth can withstand 540 pounds of biting pressure, implants can do 450. Dentures only about 50. That is how it was explained to me.
Good luck and let us know how it goes.
Minnie

Thanks guys, I appreciate the feedback.

I too will have 10 more dives after implants. It's great to hear how similar they are to "real teeth". My o.s. has recommended the snap-ins for the same reason as you did (cleaning).

I've had no bone grafts, however he says he can add some during surgery if needed. My lower gum is extremely flat due to the flap and there is no ridge for dentures to fit over. I've been through 3 dentists and 2 full sets of dentures with no luck.

I began to research HBO online and was disappointed by the lack of info related to our cases. So I contacted an HBO clinic that had treated others prior to dental implants and they referred me to an o.s. and collectively they gave me the short course on the process.

After the implants, the o.s. says I need to see a prosthodonist to have dentures made and installed. I'm hoping he can use the last set I had made since they look great and have good oclusion. Also the o.s. said that maybe they can be adapted so that I can wear them during healing.

It's interesting that your HBOT was 2 yrs. ago. This confirms what my HBO doc said about the effects being permenant and the body continues to improve even after the treatments end. Some side effects for me so far have been 20/20 vision (temporary?), the fold from my neck incision has all but disappeared, healthier tighter skin, and a better general feeling of well being.

Have a nice weekend,

Hal

Hi Hal,

Just putting my two cents in here as a dentist. It would be a good idea to see the prosthodontist BEFORE having the implants done. The reason for this is that he/she can have input with the surgeon as far as the final treatment plan goes, from their perspective. I know that if I am going to restore someone's mouth, it can be more difficult coming into the situation after the implants are done. Not that it is impossible to do, it just makes it easier.

Hope this is helpful.

Good luck with your treatment.

Jerry

I couldn't agree with Jerry more. I have seen implant placements that virtually make prosthetic reconstruction impossible. Surgeons like to put them where the optimum bone is, (for good reason), however that is not necessarily where the ideal location restoratively is for them. A few millimeters this way or that means a workable prosthetic solution or a nightmare for the restoring doctor and lab tech. I was the first dental prosthetic technician to be asked to speak at the American Academy of Oral and Maxillofacial Surgery annual meeting.... the topic was the impact of surgical placement on final function and esthetics. Lawsuits are born in implants that are non restorable, poorly angled, and more. Just as in cancer treatment, complete coordination of the surgical and prosthetic dental TEAM is the manner in which ideal outcomes are generated.

Thanks,

The advice is well taken, and fortunately the o.s. and the prostodontist are in the same organization and work as a team in these procedures. In a related issue, ever heard of releasing the left side of a tethered tongue from the floor of the mouth? The o.s. and I have discussed this possibility after the impants are done.

Hal

Hal,

I can't comment on the releasing of your tongue, but I'm sure someone else will.

Sounds like a great set-up with your dentists and it's just what we have. We have a prosthodontist in our office full time and an oral surgeon that comes in 2 times per week. The surgeon places implants for me, my partner and the prosthodontist. With the communication that this affords us, we have great success with out patients.

Good luck with your implants and keep me posted with your progress.

Jerry