Periodontics/bone loss around upper implants
hi Dr. Hormia
i wrote you a couple of weeks ago about using allerderm for an upper eye tooth implant..i decided to wait until spring to have it done.went to my other periodontist that has helped me while my other doctor is traveling and lecturing.
one wants to use allerderm and the other said i have enough tissue for one tooth..
in the meantime my upper left implants have not been doing well..i noticed alot of soreness above two of them..this week felt very ill and knew something was wrong. i decided to call my periodontist that did not place the implants to get an objective opinion..the other one cannot handle failures at all and tends to put it off a bit until it gets worse.
so i went in yesterday,he did a flap and sure enough on both implants the bone loss is 50 percent on one and maybe 40 percent on the other! he cleaned the infection and gunk out and sewed it up..told me after it heals he would like to do a gum graft from my own gum tissue and to wait on the eye tooth implant..he does not like allerderm and did a study in school proving it does not work as well as your own..he also mention pcp treatment which i had used before during surgical treatments..
im on zpak and a antibacterial rinse...im concerned because last year i did lose all three implants on my upper right..im chewing only on the left side now and now i cannot chew at all..he said wait a couple of days after it heals...
my doctor called last night and asked how i was doing and discussed options for treatment to save these implants..
im concerned..can they really be saved? my husband wrote my original periodontist a long letter telling him i already lost three implants and now its looks like another two..thats 50 percent failure rate! this is a world renounced periodontist and really an incredible doctor..he blames it always on me..i wont wear my mouth guard is one reason. im not even blaming him!
what do you think? if i was your patient what would you suggest?
I cannot really guess where all these problems stem from since I am not familiar with your case. I also have not seen any X-rays or photos that I could use for understanding.
My guess is that something has been wrong from the very beginning. Possibly too strong loads for small or too few implants (mouth guard!). Or periodontal problems that have not been fully solved before placing the implants? Too little or too weak bone? Difficulties in cleaning the implant crowns or remaining own teeth? Smoking? Problems with general health? Reasons can be many.
If you were my patient, I would re-plan your treatment from the very beginning. I would discuss the treatment options with you very carefully to make sure that you accept the treatment in terms of time, money and co-operation. I would be very strict about treating all periodontal problems and infections before reconstructing the teeth. I would very carefully examine the amount and quality of your bone. My plan would also take into consideration the effect of biting forces so as to avoid bone loss due to overload. If everything else would seem uncertain, one option might be a full-arch implant supported bridge.
However, all this is speculation since I do not know your case.
You might benefit from finding a skilled prosthodontist to work on your case together with your periodontist.