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Bone Loss Question

L

LittleLynnie

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I'm even panicking while writing this and fear that a dental issue might tip me back into needing to take anti-depressants again (took them for anxiety only, not depression, for about 1 year, 6 years ago).

I had 6 dental implants in my lower jaw. All placed at different times and not to originally hold an implant-supported denture, which they do now. My implant supported denture only extends back as far as the implant with crown that remained intact on one side and a natural tooth with crown on top on the other side. My denture includes about 7 teeth that span that gap and clip onto the few implants at the front. I have lost two of my six implants to peri-implantitis, and am currently treating one more with antibiotics that aren't yet working (have had two different drugs over the last 10 days and will be calling my dentist for yet another, later today). Hopefully, a new antibiotic will do the trick soon and remove the infection which is causing me pain. Bizarrely enough, the pain is exactly like that from a real tooth, primarily triggered by biting down on it, or food banging up against it.

When looking at an x-ray from 11 days ago, there is a LOT of bone loss around the implant, and while the dentist thought that we could remove it and place something new either behind or in front of it (with or without augmentation), I am TERRIFIED that the loss will continue, even after the infection is resolved and there will then be a gap between my good bone on either side. Is that even possible? Can one have a jaw bone at the back, then a short gap and then more jaw ahead of it? This is really freaking me out and I'm trying to come up with a long-term plan for going forward. If my remaining implants aren't lost to infection, I could then just leave this space alone and remove my last natural tooth (with crown) on the other side, so that I could get a full bottom denture fitted that could clip onto those front implant posts.

My bone loss question really is this. If I get a full bottom denture, and am using that to bite with all day, every day, will that enable the bone loss to stop? I'd read that biting action is needed for bone not to dissolve, so will a denture provide enough "action"? Also, would augmenting that area as the implant is removed help, even if I don't plan to place another implant? Could a bone graft repair the area even if it doesn't receive another implant to adhere to?

I'm way more upset about this than I should be, or that is good for my health, so I hope that a dentist can put my mind at ease until I see my dentist on March 2nd. I will be calling his office today to leave a message about the anti-biotic not working, but can't really explain everything above on his message machine.
 
krlovesherkids777

krlovesherkids777

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LIttleLynnie,

I hope a dentist answers soon, just want to say sorry you are going through this! sounds really anxiety producing. I really hope they can find some answers to help. You've done so much work and come so far! I know for me the "what ifs' are dreadful to think of.. I also worry of bone loss and have alot of work.. anyways. I hope a dentist answers you soon! :grouphug:
 
L

LittleLynnie

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Thank you for your concern. I just wish that I could stop my brain from going off in horrible directions! I know that I'm my worst enemy sometimes, but can't help it.

I'm sorry that you're dealing with so much too.
 
krlovesherkids777

krlovesherkids777

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You are not alone, the what if scenarios have ways of just replaying , it’s scary. I hope your dentist will get back to you and put your mind to ease a bit. I know for me the more communication I get from them and more information at least makes me feel a little more in control which makes me feel better. Hope for word for you soon!
 
L

LittleLynnie

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I agree, but until I see him on March 2nd, I will have to live with my terrifying "what ifs". Thanks again for the support. It's much appreciated.
 
M

MountainMama

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I also hope a dentist answers you soon. I can’t speak to any of your issues, but I can relate to the fear. I know they can do amazing things with bone grafting now.
 
Gordon

Gordon

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Sorry, not my area, PM Lincoln on here, he's much more up to speed with implants than I am.
 
letsconnect

letsconnect

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Or we can try and mention @drhirst in this thread and see if he spots it ?
 
L

LittleLynnie

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Sorry, not my area, PM Lincoln on here, he's much more up to speed with implants than I am.
I tried to do that, but couldn't find a member under that name?
 
drhirst

drhirst

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Hi LittleLynnie,
I am far from being an expert regarding dental implants but have placed a fair few over the years.
It is difficult to comment on just a description alone but here goes...
It is unusal to get pain with peri-implantitis and antibiotics alone very rarely control it. Unfortunately, it does sound like this implant will need to be removed soon.
Once the implant is removed, the infection will resolve and no further bone loss will occur.
If you just have one natural tooth left, there may be some value in removing as mouths with no natural teeth at all may be less prone to peri-implantitis in some cases due to a change in the type of bacteria present.
Whilst loading implants with biting forces stimulates the bone around them for the good, it does not, as far as I am aware, prevent peri- implantitis developing. However, a well fitting denture can prevent incorrect loading of implants and help with hygiene which can help prevent further bone loss.
As to whether, to have augmentation or grafting, that is something only your dentist could advise you on. Probably, not needed if there are no plans to place a replacement implant.

Hope this answers some of your questions.

Lincoln
 
L

LittleLynnie

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Thank you for your reply.

When I lost my other implants due to peri-implantitis, the pain near the end was in the gums, and much like the periodontal disease I'd had in the past. This time, however, it is only when I bite down, or the crown on top on the implant is hit (with either my top denture, or a piece of food). This is a really "out there" question, but it occurred to me last night while I was stewing on this. Could this implant be low enough down, and so much of the bone gone that there is very little left between it and the trigeminal nerve below? Could each bite put enough downward force to cause that nerve to respond?

And one of biggest fears is of losing all of the bone there completely. Could I end up with a bit of jaw at the back, then a span of no jaw, and then the jaw resuming toward the front?

VERY much appreciate your reply and hope that you can help with those last two big fears. Thank you!
 
drhirst

drhirst

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It is not really possible for the implant to start pressing on the nerve if it was not always doing so.
No, you cannot totally lose the middle bit of your jaw if i understand you correctly!
 
L

LittleLynnie

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Thank you. You have relieved a LOT of my stress.

Also, I left a message about the second type of antibiotics not working on Sunday, and heard back from my dentist this morning (holiday Monday yesterday in Ontario, Canada). I was squeezed in to discuss my options, and ended up having the implant removed about an hour ago. He said that there was about 2 millimeters of bone beneath the implant, which didn't sound like much to me (!!!!!), but said that it was solid enough and it wouldn't just break accidentally.

I will now still have to figure out what to do about what's left going forward, but for today, I am extremely grateful knowing that the root of the infection is gone. I am also going to try to put this all out of my mind for at least the rest of today and recover from the traumatic extraction (not really traumatic, but I find all dental procedures difficult). My dentist today told me that he has an adult patient who always brings her teddy bear with her, lol. He thought that it was a cool and smart thing to do.


Thank you again for your replies. They really helped me a lot.
 
drhirst

drhirst

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Hey, your welcome pleased to have helped a little.
It is good that the failed implant has been removed. I would guess the two millimeters of bone he was referring to, was the amont of bone above the the nerve. There will be a whole lot more bone below the nerve as well.
 
L

LittleLynnie

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Aaaah. I didn't realize that. I had assumed that the nerve ran beneath the entire jaw, and not through it. And it explains what he said about a new xray done today, on another implant that is failing. He pointed to an area and called it "the nerve", and I couldn't understand why it looked like it was running through the bone. And you didn't just help a little, you helped a LOT! Thank you again.
 
L

LittleLynnie

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Dr. Hirst responded to my previous implant question, but I now can't find that thread. The implant that was removed is seen in the picture attached. Was there a reason that the crown was sitting to one side and not centered on the implant? I'm wondering if it failed because too much force would have been placed on the part of the crown that didn't have support from the implant? My dentist confirmed that my pain had been coming from the bone because "the implant was moving around down there". I can just picture it moving due to pressure coming unevenly.
 

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letsconnect

letsconnect

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Hi @LittleLynnie , I’ve merged your new thread with your previous one. Hopefully @drhirst will spot it!

By the way if you click on your avatar (the round “L”) in the blue bar near the top and then click on “Your content”, you should be able to see any posts you’ve made (and find your previous threads)!
 
L

LittleLynnie

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Thank you for doing that and thank you for helping me find my own posts in the future.
 
drhirst

drhirst

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@LittleLynnie . Ideally, one would want to have the implant in the centre of the crown but it is not uncommon for this not to happen. It your case it looks like it was done because the bone on the cheek side of the implant had shrunk away following extraction of the tooth or due to infection when the tooth was still present.
It is unlikely to be the cause of the implant failing.
 
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