Hi, I was born with a missing #24 and #25 teeth, (two bottom front teeth). I think it's 24 and 25? Anyway, I got braces to open up that gap so I can put dental implants in. I had braces for over 3-1/2yrs and finally, the time had come...Last yr, I went to a Dentist who does implants to get my two dental implants done. She said she covers everything from A-Z and charged me about almost $8000 for both implants. I then was told I had no bone there so got bone grafting done. I think its called an Allograft since she used a dead person's bone? Well, I think everything went well. Months later, she put in the dental implants and I thought I was done. So a couple weeks after the dental implants, I noticed something white on my gums of the tooth of the implant area. Turns out it was the bone piercing through the gums?? I went back to the dentist and she filed it down and told me the gums should close in a week or so. Turns out it didn't and so she did gum grafting on me where she took a piece of the gum from my palette and put it on the open gum area, hoping this will work. Well, it stil didn't close the gums and on top of that, since the gums were open, I was told that my bone grafting area was being rejected?? Ughhhhh So then she tried to do a guided tissue restoration, where she scraped out all the tissues and bone that was bad and inputed some new bone, then put some membrane in there and stitched me back up. Well, I'm not going on 3 weeks and the gum area is all healing well, except for that same gum area that was exposed in the first place. She said she's very disappointed in my body because it's healing so slowly. I don't get it. I'm 32 yrs old, don't smoke, don't drink, exercise and keep a pretty healthy life style. I dont' have any diseases or anything, yet my gum isn't healing. I've been through so much with this whole thing and have given her all my money for this implant. She says she's not sure what else to do and that I might just have to deal with a hole in my gums. She says its healing but just not healing at the the way to the line of the the implant is? I didn't pay all that money for it to look this defective. I'm so upset and I know I need to get a second opinion on this but everywhere I go, they want to charge for a consultation. Ughhh Now I'm regretting on ever getting dental implants done and I feel like there's just no one that can help me Can someone tell me what they think is the reason why my gums don't want to close?? Is there any way on getting this fixed?? Or is it just me? Help please

Hi cyn,

First of all just to help you become better informed, the bone in that area of the mouth is "naturally" thinner and narrower than anyplace else in the mouth. The fact that you were congenitally missing those two teeth means that the bone was going to be compromised in that area, even more so after having orthodontics because there is always some degree of bone loss or resorption once the ortho is complete. So to place two implants in that site was going to be a huge challenge. Did she inform you of any of that prior to consenting to this treatment?

Bryanna

Hello- I'm sorry you are going through all of this. Did you see a dentist or an Oral Surgeon? Dentist can preform implant surgery but an oral surgeon is better eduactated to do so. The previous person is correct that braces and the natually missing teeth cause the area to be less hospitable to implants. Talk to a specialist and spend the money if you can. The last thing you want is an open fissure in your mouth where bacteria has an open door to your tissue and bone. Good Luck!

Bryanna,

No she told me that my case is the easiest to do and has a high success rate. Now If I knew this was going to be a huger challege, I wouldn't have gotten this done in the first place. Also, I've seen other drs for a second opinion and they said this is a hard case to even fix. They questioned why did the Dr used such a big implant for such a tiny mouth, why didn't she just use 1 implant instead of 2, etc... This has been a total nightmare. Now the gumson the other implant is loose where its just a flap hanging. I don't even know what to do anymore.

My regret was to go to that Dentist who does cosmetic works too. She was referred to me by my regular dentist so I figured she was good. I mean she's nice but I should of gone to see an oral surgeon. After 2 more surgeries that this Dr did to try to fix the issue, I couldn't let her work on me anymore. I went to seek like 7 consultations and have gotten back different feedbacks on what I should do. Some say to leave it alone and wait until it gets infected because I have to worry about the two natural teeth next to the implants that could be damaged, on top of the artery below one of the implant and now that this happen, the success rate isn't too high because of all the scar tissues. Other people have told me to remove the implant , get bone grafting again, and then re-do the implants. Also I had a few telling me to just make a longer crown with a porceling gum to cover up the area?? I just want this fixed and corrected to where I should of been. Is this even possible? I've attached a pic of my implants

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Hi Cyn,

Oh boy, you have been through hell and I can see why other dentists are leery to touch this. The bone and gum tissue has been manipulated, traumatized and surgerized all to a severe extent. Anything that is attempted here to fix the situation will be risky. However, I cannot imagine leaving this like this not just for esthetic reasons but for your overall well being.

Thanks for posting the photo. Any chance you have a recent xray of that area that you could post? What have you been told about the current health of the jawbone around all of this?

Bryanna

Here are the x-rays taken. They say they can't tell if anything is infected without cutting the area open to clean and see if there's any infection. This whole thing is a mess. I just wished I came to someone that was really knowledgeable with dental implants in the first place where they were honest with me to tell me this isn't an easy case to do . Had I known, I wouldn't have gotten it done. Also, I'm bothered by how this Dr treated the problem. She blamed that it's just my body not healing right. Then tried fixing it by doing gum grafting then guided tissue regeneration. After it not working, she tells me her colleague told her to try something else but I said, no thanks. I'm done. I can't just have her try something that someone else is telling her to do if she hasn't done it before. I'm not a guinea pig. This is so depressing. Sorry I'm just very frustrated and sad about this whole deal. I need to go find someone else that really knows what they're doing. Is there anyone out there that can tell me what's best?

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Hi cyn,
I am so sorry to hear what you are going through. I am under the care of a great oral surgeon whom I trust and I know they do implants. I am not sure where you are located. If you are located by me I can shoot you his name and practice. I really hope this works out for you, I am extremely sensitive now to teeth issues due to the fact that I am dealing with stuff now. God will be with you just have faith and believe and he will do wonders..
Nicole

Hi cyn,

Thanks for posting the xrays. The bone surrounding the actual implants looks ok on these films, but it does not give any clue as to the buccal portion of the bone which is the front of the bone facing the lip. This area is crucial for the retention of the implants. Is either implant loose? There is quite a bit of generalized bone loss interproximally, in between, the adjacent teeth on both sides of the implants. Did you or do you have periodontal disease? Did you have bone loss or deep pocketing on your lower teeth prior to or after the ortho... or the implants?

There are a number of reasons why this problem has occurred and most likely, it is a combination of things. As I originally said, placing implants in this lower portion of your jaw after congenitally missing 24 and 25 was a risky option and you should have been fully informed of that at the onset. if you had any perio disease, previously diagnosed or not, you should have been informed about it as well as the risks during the treatment plan phase and prior to doing the ortho. Has the dentist measured the pocket depths in your lower gums since all of this happened?

The only way to cover up the portion of the metal implant that is showing would be to redo that implant crown which would make that tooth quite a bit larger than any of the others. However, if the gum tissue is receding because of a disease process, perio or other, then making a bigger crown will not solve the problem because it will just continue to recede.

From my experience, the most significant issue here is the bacteria that is getting in that open gum tissue and down inside the bone along the implant. This area has got to be really difficult to clean and the gum tissue looks so friable, meaning irritated/inflamed/fragile.

Even if your body is to blame for the rejection of the grafting... that issue should not be ignored by your dentist and she should be offering you every thing possible to remedy this situation, including a referral to someone else, and a reimbursement of at least a portion of the fee for the grafting.

Generally, oral grafting is rejected by the immune system because there are certain factors that caused this to happen. It could be an <undiagnosed> autoimmune disease... periodontal disease...certain medications that inhibit wound healing...lifestyle habits such as smoking, excessive alcohol consumption, poor oral hygiene or even the use of mouthwash containing alcohol.....and the list goes on. Other reasons the graft would fail are due to the actual dental procedure and/or graft material itself. If during the procedure the surgical area or the graft material was not sterile....if there was contamination with your own saliva....if it was not placed properly... if it was disturbed before the clot was able to protect it and nourish it.... and this list of reasons goes on too.

It will be hard to find a dentist who is willing to redo this because the area has been surgerized alot which makes additional surgery risky. Also, because of all the previous circumstances, esthetics to your liking may be difficult to achieve.

I may have asked you this already. Have you consulted with a periodontist?

Bryanna

Bryanna,

I had a bunch of different xrays done, CT Scan, etc and everything seemed OK I was told. They say they can't tell more about the area until they open it up, clean it and see if it's infected or not. I have gone to see about 7 Drs. 3 periodontist, 1 oral surgeon, and like 4 dentist. They all had their own opinions so it was hard to decide on which is what I think is best. I've never had any periodontist disease at all. I am very good with taking care of my teeth. I floss all day long, always love to go to the dentist to get my teeth cleaned and live a healthy life style. Never had any problems with my gums what so ever. What I think happened was the bone grafting that the Dr did was rejecting so there was no blood supply for the gums to close. I've gone through 2 surgeries after my implants were done, trying to fix the open gum area. She did gum grafting on me then guided tissue regeneration. One of the periodontist told me that theres nothing that could be done and I should just leave it alone and keep it clean. Eventually it will get infected and I could go from there? Ughhh It's a nightmare. I feel like it's hopeless and I'm pretty much screwed. The other oral surgeon told me the I have an artery right below one of the implants so I have to be very careful with whoever removes the implants. Also there will be more bone loss if I get the implants removed.
Yeah, I totally regret getting them done. Had the Dentist told me that this is the most complicated case to do, I would of NEVER done it. She just made it should so simple and easy. I'm now traumatized from this and it's been a real pain trying to keep this clean. Also horrible looking. Talk about stress