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#78909 08-18-2008 11:40 AM
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Markus Offline OP
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Recently tooth #2 bit the dust and had to be extracted (#1 is still there). No problems, except for the fact that for a day I had an oral-antral communication. Needless to say that this puzzled me then! This healed very rapidly and I was eating "normally" after day 2.
The question is this I am thinking about longer term strategies. Implants are a possibility, but given the potential problems I wonder if this is worth it? I.e. am I asking for trouble.
Other than 2 wisdom teeth (left) I am missing 4 premolars (one in each quadrant), the latter were taken when I was a kid, together with 2 milk teeth for each premolar. Hence my aversion to certain professions... sorry guys. This came full circle and bit me you know where.

The radiation damage is not too bad, but but I still have to go back for several fillings.....
What are the non binding opinions of the dental folks on this. Leave well enough alone or aim to keep at least (1 premolar and 2 (or 1?) molars). In this case that would mean do nothing for the upper right quadrant which would be my preference.

Thanks for your input (Jerry, Mike?)

Markus


Partial glossectomy (25%) anterior tongue. 4/6/07/. IMRT start @5/24/07 (3x) Erbitux start/end@ 5/24/07. IMRT wider field (30x) start 6/5/07. Weekly cisplatin (2x30mg/m2), then weekly carbo- (5x180mg/m2). End of Tx 19 July 07.
Markus #78918 08-18-2008 04:45 PM
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Hi Markus,

Under ordinary circumstances, implants are are by far, always the best alternative, whenever they are possible.

I assume that the problems that you are referring to is the possibility of ORN. When you add in the need for HBO treatments, you are certainly going to lower the risk for this, but not entirely remove it.

Trying to picture your missing tooth situation over the internet is very difficult. Where you had the teeth extracted as a kid, have the spaces closed or are they still there? You also don't mention which teeth are below the missing #2. Do you have a lower second molar #31, which would occlude with the missing #2?

Doing a bridge to replace #2 using the wisdom tooth as an end abutment is usually not a good idea as upper wisdom are usually very short with cone shaped roots.

With a little more details, I may be able to zero in on more advice. Of course, you must have good periodontal health, in order for implants to even be considered.

Jerry



Jerry

Retired Dentist, 59 years old at diagnosis. SCC of the left lateral border of the tongue (Stage I). Partial glossectomy and 30 nodes removed, 4/6/05. Nodes all clear. No chemo no radiation 18 year survivor.

"Whatever doesn't kill me, makes me stronger"
wilckdds #79623 08-29-2008 09:19 PM
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Hello,
Has anyone heard of the body rejecting the screws that are used in jaw reconstruction after oral cancer? My mom is having fistulas open up around where the screws are. The doctors are saying they might have to go in and take the screws out (6-8 of 'em) which will leave her jaw unstable and not fit for teeth ever.
Just got the news today so we are both stunned.

wrightwood #79634 08-30-2008 03:39 AM
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Hi,
I've never heard of anyone having this sort of problem after Oral Surgery. I'll try and find some information for you.
In my opinion, whether or not the screws have to be removed the bone will heal across the surgical cut similar to a broken leg. It may take longer for this to occur without rigid fixation but, the process will still happen. She should be able to have teeth placed in the area either implants or dentures.
Cheers,
Mike


Dentist since 1995, 12 year Cancer Survivor, Father, Husband, Thankful to so many who supported me on my journey so far, and more than happy to comfort a friend.
Live, Laugh, Love & Learn.
Dr. Mike #79639 08-30-2008 06:51 AM
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Dr. Mike,

Looking at Wrightwood's other post, his Mom's surgery took place four years ago...????


Deb..caregiver to husband, age 63 at diagnosis, former smoker who quit in 1997.
DIAGNOSIS: 6/26/07 SCC right tonsil/BOT T4N0M0
TREATMENT START: 8/9/07 cisplatin/taxol X 7..IMRT twice daily X 31.5.
TREATMENT END: 10/1/07
PEG OUT: 1/08
PORT OUT: 4/09
FOLLOWUP: Now only annual exams. ALL CLEAR!

Passed away 1/7/17 RIP Bill
debandbill #79644 08-30-2008 11:50 AM
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I guess I missed that. That would make this even rarer than rare.
I'm still researching it though.
Mike


Dentist since 1995, 12 year Cancer Survivor, Father, Husband, Thankful to so many who supported me on my journey so far, and more than happy to comfort a friend.
Live, Laugh, Love & Learn.

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