Hi Barbara,

I'm sure that you will hear from members that have been through what you are facing right now. In addition, there is a prosthodontist who has recently joined the board and hopefully he will see your post.

It might be best if you heard some basic information. If we take the radiation out of the picture for a minute, dentures can be made either as immediate ones or after healing has taken place after extractions. If done as the immediate type, most likely they would need to be relined to fit the mouth after the bone reshapes itself. Everyone is different and the time frame for when relining of dentures would be necessary can vary greatly. Waiting for healing, about 6 weeks, will put off the need for relining them for a longer period of time, but most people will still need it done at some time in the future. The downside of waiting is obviously being without teeth during the healing phase as well as while the dentures are being made.

Now if you add in radiation to the mix, you have to deal with the possibility of osteoradionecrosis, which is caused by the radiation. The following is a response that I posted on this forum in December of 2005:

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Osteoradionecrosis...bone that has received doses of radiation may lack the ability to repair itself after trauma. Radiation destroys the blood vessels in the area causing a reduction of circulation to the area of oxygen and other nutrients. This then will prevent normal healing in that area if the bone is injured.

Hyperbaric oxygen to the area will stimulate new blood vessel growth and therefore stimulate bone healing.

Without hyperbaric oxygen, removal of a tooth will probably result in bone that won't heal.

This is a good article: http://www.virginiamason.org/dbHyperbaricOxygen/sec181033.htm

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It is certainly understandable that you are confused with the situation that you find yourself in as you are getting mixed messages. There is no doubt that the safest way to do anything in a mouth that has been radiated, is to use hyperbaric oxygen which has proven to help healing.

Now here is my opinion in general. Doing extractions without HBO is something I would not suggest. Waiting the 6 weeks before taking impressions would be the safest thing to do since then the healing could be checked, the bone would be reshaped and the dentures would fit better.

Now as far as the implants are concerned, there are many members that have successfully had implants placed and I'm sure you will hear from them. HBO was most probably used in all successful cases as placing implants in radiated bone is just as much of a problem as extracting teeth from radiated bone. Whether or not you would need implants at all is something you can decide after you try your new lower denture. Many people can function very well with just a denture and many find that it is difficult to keep them in place. (Lower dentures are not as stable as upper ones as the tongue can cause dislodging of them and the surface area that they sit on is horseshoe shaped rather than a large area, as in the upper jaw). You have to see which category you fall into. There is no doubt that the security of having a denture clip onto implants can be a great thing, however the cost of the implants, the cost of the HBO treatments and the extra cost of the denture will certainly enter into the picture.

I personally do not have any experience with making dentures for post radiation patients, but am just trying to give you some things to think about and hopefully to clear up some questions you might have.

Jerry