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Oral Surgery/brittle bones & teeth


I have Osteogenesis Imperfecta (O.I), a rare genetic brittle-bone condition that not only affects My bones, but My teeth as well.

Largely due to this, I've had extensive problems with broken teeth and accelerated decay and have lost a number of teeth as a result.

I'm a young woman, so I often get treated like a irresponsible heathen when general dentists see the condition of My teeth. They just aren't familiar with My rare bone condition and its effects.
I wish I could make them understand. Ideas?

My question actually concerns the use of implants to replace the teeth that I'm missing.
Would I be disqualified as a candidate because of the weak bone condition?
I'm a little frightened to inform them of it because they might refuse to consider Me on that basis alone.
Should I avoid telling the implant specialist about My condition and let them judge by x-rays/scan for themselves whether I'm a good candidate for the procedure or not?

(additional info: My bottom jaw is very strong according to a dentists analysis of panoramic x-ray. not at all porous like My other bones. Also, no dentist has ever commented about My bones appearing weak or porous. I think this may be a good sign?)

Amanda, Thank you for your question. O.I as you know is a genetic bone disease. Some people also have Dentogenesis Imperfecta also (D.I.). There is no contraindication to having implants placed. In fact there was a case series of literature that came out of the NIH in the late eighties and early nineties that supported implant placement in patients with O.I. I have treated patients at NIH also with this issue. There still are risks involved with implant placement. It is best to inform your surgeon of your condition. If you are seeing a Board Certified Oral and Maxillofacial Surgeon but ABOMS, they will not be afraid of you and will understand your condition. This topic is fair game for the oral board exam. Ask your surgeon to recommend a restorative dentist to see you for the crowns or prosthesis. They will know all the dentists in the area and the ones who are qualified to handle your specific issue. I am truly sorry to hear that dental professions treat you like a heathen. Just remember that it is a lack of education and training and a sign that you do not want to see them anyway. Its actually a good gauge to see what they know. Best of Luck! Let me know if you have any other questions.  

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James M. Ryan. DDS, MS; Board Certified Oral and Maxillofacial Surgeon


Dr. Ryan's expertise is in the field of Oral and Maxillofacial Surgery. Specifically, Dr. Ryan is an expert in Orthognathic Surgery. He holds uniques experience as the former Assistant Program Director of the Oral and Maxillofacial Surgery Residency Training Program at Washington Hospital Center where he trained residents to perform these complicated surgical procedures. Additionally, Dr. Ryan also has a tremendous amount of experience in reconstruction of the maxillofacial skeleton related to trauma and tooth loss. Dr. Ryan is an expert in 3 dimensional treatment planning for Orthognathic Surgery, Dental Implant Surgery and Wisdom Teeth removal. To learn more about Dr. Ryan, his full profile can be seen at


Diplomate of the American Board of Oral and Maxillofacial Surgery with current hospital affiliations at: Washington Hospital Center Holy Cross Germantown Hospital National Institute of Health/NIDCR

American Dental Association. American Association of Oral and Maxillofacial Surgeons. District of Columbia Society of Oral and Maxillofacial Surgeons. District of Columbia Dental Society. American Board of Oral and Maxillofacial Surgeons. Health Volunteers Overseas.

Journal of Oral and Maxillofacial Surgery Journal of The American Dental Association

S.U.N.Y @ Stony Brook- B.S. in Biochemistry, Stony Brook, NY. Northeastern University- M.S. in Perfusion Technology, Boston, MA. D.D.S.- New York University College of Dentistry, New York, NY. Certificate and Chief Resident- Washington Hospital Center, Washington, DC. Clinical Fellow- The Johns Hopkins Hospital, Baltimore, MD.

Awards and Honors
Dr. Ryan has received numerous awards including: 2006 American Association of Oral and Maxillofacial Surgeons Dental Student Award, Washington Hospital Center 2008 Nurses' Choice Physician Collaboration Award, 2009 Resident Research Summit Scholarship Award, and the 2011 Outstanding Surgical Attending in the Department of Oral & Maxillofacial Surgery at Washington Hospital Center. He has also authored/coauthored and published several journal articles and held several teaching positions,including assistant professor, while at NYUCD.

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