Anne,

I read your posting about the results from your bone grafts with interest. As you know dental implants were my area of expertise for years, and I have a couple of observations to pass on to you. First, the success rate in all brands and designs of osteointegrated dental implants is very high, in the upper 90 percentile

Brian, I had back teeth, upper and lower, pulled prior to radiation. I had supposed that the only replacements I could get would be of the denture variety. I have been reading quite a bit about hyperbaric treatment and wonder if you know if that would allow placement of implants in irratiated bone. I will cross my fingers while waiting for your reply (grin).
Joanna

Saturation of tissues with O2 has proven to assist healing, which of course is what is necessary for a titanium implant to osteointegrated into bone. There are published studies that show some value of this prior to placement and during healing of surgically placed dental implants. If you still have your anterior teeth, the logical thing would be to have an appliance that is partially tooth born and partially ridge borne. (A chromium cobalt metal framework with clasps and an acrylic posterior portion supporting denture teeth.) That is something that is common, routinely successful, affordable, and does not run the risk of poor healing or failure such as with implants. You may even end up with a design that incorporates all three modes of retention and load bearing. Implants are not contraindicated in radiated patients; they just have a significantly lower success rate. The issue for me is when they fail to integrate properly, due to the vascularization issues or the poor quality of the bone graft, the patient can actually loose bone as a by-product. Poor quality of the graft bone does not refer to anything more than the density of grafts vs. normal bone. Even in normal bone, particularly in the very posterior of the mandible, there are issues that make integration of implants difficult. Iin this location it is considered poor quality since it is too dense.

Thanks Brian,

I'm right there with Joanna and had been wondering if a second mortgage on my house for implants was worth it.

Think I'll stay with the partials, they do a good enough job and were painless (except for the bill) but compared to implants what a bargain.

Thanks again for explaining so well the pros and cons.

Take care,
Dinah

Hi, When my teeth were pulled before surgery I objected to how many they took. They said because of tumor and the radiation treatments I would be getting it was in my best intrest. My insurance company did not want to pay for extractions, my dentist related the same to them, tumor and radiation. They paid, ever since my dental has been marked 'medical'. I read my insurance forms and they say, will pay for implants, partials, etc. if cause of loss of teeth is tumor, etc. This will be a fight I am sure, but loss of teeth was for a medical reason, therefore replacement should be part of that medical process. right? They paid to get me a jaw bone removed for the same reason.Did you check your coverage to be sure they would not pay for some of it? I hope I do not get caught up in some fine print. gnelson,Stage lV, 2years3months,cancer free.PS; I never did have radiation!

Hope you do better with your insurance than I did with mine. Medical paid to pull them but it would not pay anything towards partials or implants. I'd get it all cleared and in writing before I started unless you can afford to pay for it yourself.

After Brian's explanation, I too think I'll stick with my partials. I have seen the hyperbaric chamber at Penn and no way do I want so spend any time in that. The sight of it was what convinced me to let them extract my back teeth in the first place. The dentist there kept saying I would have to spend 2 hours a day for 30 days in that thing if I ever needed to have a tooth extracted. No thanks.

Eileen

Thanks Brian.

First, I never had radiation; consequently, I'm a good candidate for implants. I will be making a copy of your information and take that with me to my next appointment. Secondly, my insurance company is paying for all prep and surgery for the implants. They will not pay for the implants themselves. Each implant is around $1,000.00. This cost is coming out of my pre-tax medical dollars that I elect every year. So my total cost is basically nothing. I wish partials had worked for me but they didn't. Oh, well.

Anne.

Anne, you are an ideal candidate for the implants, and FYI the national average cost per implant is about $1,000.00. This includes the cost of the fixture itself and the surgical procedure. It however does not cover the cost of the crown or other restoration on top of it.

I had an Iliac Crest bone graft and two implants placed in my upper jaw. My insurance (Federal Blue Cross) covered both procedures. I have had to make several calls to my insurance company to explain my circumstances, and they have always covered my expenses following my calls. It as been three months since the teeth (crowns) were installed and I couldn't be happier with them. I did initially lose some of the graft so the rear tooth is slightly cantalievered. (no supporting bone under it). I will be going back to the prosthodontist in February and will inquire as to what brand, and size of implants I had installed.