Andrea...I had to get upper dentures last February. Dentures were made prior to extractions and put in immediately after teeth were removed. I won't tell you it is an enjoyable experience nor that dentures are anywhere near like the real thing, but they are tolerable. I had to keep going back about every three or four weeks for ajustments as the gums continue to shrink. Nothing real painful but not real comfortable either. After radiation, everything is a walk in the park. I'm doing everything possible to save the bottom ones though....I've heard nothing good about that experience. Best of luck to you. Gary

Andrea...getting old and forgetful and almost forgot to tell you the most important part of what I wanted to tell you...I did 30 hyperbaric dives prior to the teeth removal and 10 afterwards. My oral surgeon wouldn't even consider any extraction without the dives since I had had radiation treatment....not sure if you had radiation or not. Gary

Brian, why would any dentist recommend to Andrea pulling the lower cuspids if your technique[which sounds wonderful, but I don't quite understand it] is a possibility?

Brian, I have been following this post very carefully. You state" Implants in radiated patients do not do well." I had my Mandible replaced with part of the bone from my left leg. Then I had radiation. This was all done at the Mayo Hosiptal in Phoenix, Arizona. Now, three years later the Drs. at Mayo tell me that they can do implants with me taking a few dives. What I really want to know is do I really want to physically go through the implant process with little chance of success. Also the cost is quite expensive. I would try it if it would work. At the moment I have no bottom teeth and am doing OK eating soft foods. Although a steak would sure taste good. Are there any successus with implants on radiated patients? I am anxious to hear from you.

Hacklene

I am sorry to have stated this in such general terms. In the normal population, implants have success rates of around 97% regardless of manufacturer. Variables are more dependent on operator than on product. There are some designs that are more desirable than others for various reasons, but that is another issue. In radiated patients, there have only been a few articles published and the success rates (using my own averaging method from several different published articles) is about 74% - which is a significant drop, but the studies do not indicate all the reasons besides radiation treatments that may have affected the outcome. For instance implant failures in general are greater in people that have co factor problems such as diabetes, who are tobacco users, etc., so the data is very rough as many bias factors have not been fully explained in the published data. None of this means that you shouldn't take a shot at having them, since they are a SIGNIFICANT improvement over not having them. What I should have said is that the success rate is lower in radiated patients, and that a factor that increases initial survival is O2 dives. Please note that long term survival of implants in all patient populations is heavily dependant on oral hygiene, something that is complicated to some degree in people with xerostomia. Implants can be lost due to the same reasons that natural dentition can be lost such as periodontal disease, or better stated in this case peri-implant disease. Go for them if it is an option for you. Please note that dental implants are influenced by loading factors that are different than in mandibular bar systems that are used as stabilizers in the initial surgical reconstructions, and they behave differently as a result than the other osteointegrated implant devices.

JAM - The lower cuspids may be periodontally involved and have to go. They will not serve much use as an anchoring point for the denture if periodontal disease has compromised their stability in the mandible.

Brian,

The reason for the delay in reading the x-ray is that they recently, as in the last week, moved to a newly renovated office. Hence, I had to have the x-ray taken at the local hospital. I'm going tomorrow to meet with my ENT to discuss all of this. Out of all of my doctors, I trust his opinion the most. I called last week to see if I could go in to discuss this situation. I have the consultation with the oral surgeon / dentist later this week. I'll let you guys know what happens. This site really provides a great service. It is nice to be able to communicate to people who have walked the same path.

John

Brian, Here's another question when you have time. Why are dental implants so expensive? I see the proceedure advertised in a bunch of different kinds of magazines[non dental related]When I got mine over 6 yrs. ago, I went to an oral surgeon for the surgery and then an Orthodontist for the rest of the implant preceedure. Now,dentists are advertising doing them. I am also disheartened by what I've read above, as John believes he will get lower implants at some point. Having lost part of his jaw bone, it sounds like this may be really "iffy" for him. Amy

They are worth the try. The worst-case scenario is that they will not integrate into the bone, fail and exfoliate themselves, and the very small defect that they leave (less than 6 mm across and 15mm deep will heal back in, leaving him with a conventional denture. Implants cost the doctors about 400+ apiece, then there is the surgical procedure to put them in, then there is the restorative process once they are in and integrated in the bone. If a lab is involved in making porcelain crowns on them, add another 500+ per implant for that. So it is not such a simple thing. Add to this for radiated patients that they have O2 dives to make before and after surgery which cost money and you can kind of get a feel for where this is going. The upper denture is usually little problem, as I said before it's pretty stable because of the suction formed there. The least expensive way of restoring a lower arch is just 2 implants and some overdenture attachments and a full denture on top. Where implants get really expensive is in the normal population and they are being used to support multiple tooth porcelain bridges.

Brian, Thank you so much for the clarification on implants with a radiated leg bone for a jaw bone. I think I will give it a try, but not until after the Christmas Holidays. I too feel very gratified for this forum. It is nice to hear opinions and experiences from people who have already had the experiences that are questioned. I don't post often, but I read the forum every evening. Thanks again.

Hacklene