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Old 04-06-2007, 04:15 PM #1
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Default Bryanna -implants questionhusband's infec.

Bryanna,
I was very interested in your scenario of a dental implant. My husband had an implant about a year ago. A few months after the implant was totally complete he had tooth pain. They removed the cap and discovered an infection from an ulcer. Thus he had to to do the entire implant routine again.
Very interesting. Thanks for the description. He is still in the waiting phase for the dentist with this 2nd implant.
As always thank you so much for your very articulate explanation of dental and medical procedures. I appreciate your willingness to take time on this forum.
Sorry to make this a new thread. I just wanted to be sure you read it.
Thanks,
Sydney
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Old 04-06-2007, 04:56 PM #2
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Sydney,
What you are describing is an abcess and/or cyst that formed around the circumference of the dental implant. This condition can occur from any residual infection that was present in the bone prior to the implant surgery.

If a tooth is extracted and the periodontal ligament is not thoroughly removed from the tooth socket during the extraction, the remnants of the ligament can lead to residual infection. Any time the tooth socket is not thoroughly debrided of all necrotic material during an extraction, it can lead to residual infection.

Sometimes during the implant surgery in the upper jaw, the implant is placed too close or even into the sinus cavity. If the implant is left like that, it will lead to infection and ultimate failure of the implant.

Other times, the surgery was not done under adeqaute sterile conditions and bacteria entered the surgical site via an instrument, etc.

If the implant is placed in healthy bone and it fails due to infection, then the culprit could be that the implant crown was ill fitting. If the margins on the implant crown were open in any way, then bacteria will get in there and work it's way up into the bone causing an infection and ultimate implant failure.

I hope the second one is successful for him!

Bryanna
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Old 04-07-2007, 11:04 AM #3
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Default Thanks again Bryanna

Thank you for explaining about the problem with my husband's tooth. I now have at least some understanding of what is going on. The dentist and perio really don't give much info. They just say - oh well - have to do it again. Fortunately they are not charging him. It cost us a small fotune for the implant - about $4,000 I think. Anyway - my dental specialist who is highly respected in his field said that implants are the way to go - not root canals. That is what you said in your post. Unfortunately, because of my medical condition I would have to just have an extraction and nothiing else. My nervous system is so miswired the nerves go crazy after any dental procedure.
Thanks again - as always - for your very thorough explanation of the procedure and problems which could arise.
Sydney
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Old 04-07-2007, 08:37 PM #4
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Sydney,
I'm in total agreement with your specialist about implants instead of root canals. I see so much jawbone infection caused by root canaled teeth that I personally, would never have one done on any of my own teeth. Dental implants are a foreign matter (titanium in the US and zirconium in Germany)that can pose certain risks, but under healthy circumstances, they are quite remarkable!

Keep us posted on your husband's journey with this second implant! Hopefully it will work out ok!

Bryanna
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Old 04-07-2007, 09:04 PM #5
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Default Update on husband's implant

Bryanna- I was speaking with my husband in more depth about his implant. He did not have monthly x rays. He only had one at the beginning and end of the procedure from the periodontist. Then he had one at the beginning and end at the dentist(who did the cap). I guess that means(from your explanation about sources of infection) that he probably got the infection from the dentist not securing the cap properly. I am assuming that is the correct reason since the perio. did an xray and so did the dentist prior to the cap. Luckily he is very healthy and can handle another one.
Re: root canals. Many of the patients my dentist (facial pain specialist) sees are root canal patients. They have constant pain from root canals. For some people the root canal disturbs the nerves resulting in chronic pain. Patients return to the dentist and he usually denies the pain because the nerves are removed and also because he/she knows nothing about facial pain. I believe the condition is called - deafferentation neuralgia. My former dentist (a facial pain specialist also-now deceased) taught me a lot as he was the leading researcher in facial pain in the country and shared many of his research articles with me. His research showed 5% of patients will have pain following root canals. My new dentist said recent research said it is 10. Unfortunately, my local dentist (who is very reputable) never even heard of deafferentation neuralgia. That is typical unfortunately.
Just rambling - as I know you are into the dental field and are really very serious about your profession. You are such an asset to have on this forum. Thanks for starting it. Great idea. I have a question later on "biforcation" but my hands hurt now from typing. I have RSD and Fibro - full body - constant chronic severe pain.
Thanks
Sydney
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Old 04-08-2007, 12:49 PM #6
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Sydney,
The office I work in uses digital radiography. The radiation exposure is minimal to both the patient and the office staff. Any exposure is not good, but to monitor areas of the mouth that cannot be seen with the eye, radiographs are an absolute necessity.

To give an example of how we monitor the surgical healing phases..... After an extraction and the initial post op appointment, we see that patient in one month for their first post op xray. Then based on those findings, we see them once every 2 months for an xray of the area, for the next 4-6 months. When the bone has filled in properly, we place the implant. During the implant surgery we take 2-4 xrays to monitor the angle and length of the implant. Over the next 6 months, we see the patient every 2 months for an xray to monitor the integration of the bone and implant. An implant crown is placed once the integration is complete and the patient has been symptom free. We take a final xray to see that the margins on the abutment and implant crown are solid.

In your husband's case, based on what you have stated, if the restorative dentist took an xray prior to placing the implant crown and the area looked healthy, then either there was marginal leakage in the abutment or the implant crown, or something got contaminated during the placement and it was just enough to set off an infection. It is almost impossible to determine what actually occured.

I work in the field of Biological dentistry. Those who truly practice this form of dental care are more than just tooth carpenters, they are well informed doctors who treat their patients from an overall perspective and not just their teeth. The goal is to bring no harm to the patient by utilizing the least toxic and most biocompatible materials. We also are well read on the residual affects caused by root canaled or infected teeth. Where as the main stream practitioner is basically clueless about the detrimental side effects of keeping a dead tooth in ones head. I guarantee that 9.5 out of 10 mainstream dentists have no clue about deafferentation neuralgia. Especially as it is associated with the removal of nerve material from the inside of a tooth as well as from the cutting of the main nerve fibers that branch out of the tooth into the jawbone during a root canal procedure. I spent over 20 years in main stream dentistry and never once did I hear acknowledgment of that condition being associated with a dead tooth. Based on what I have learned over the last 10 years, compiled with what I have witnessed throughout my career............ I have no doubt whatsoever that there is a definite correlation between facial neuralgias and root canaled, infected teeth or infected jawbone. The tooth is a living organ and it needs a healthy blood supply in order to remain healthy. When it becomes infected or traumatized during a root canal procedure, the main blood supply is cut off as the nerves are severed and the surrounding area that was once highly vascular is now ischemic. The end result is disruption or death of the nerve fibers that once nourished that tooth. It is very common for people to complain of tooth pain/discomfort in a root canaled tooth........ and that's in part due to the neuralgia that has set in to those once vascular nerve bundles.

Our office does not perform root canals. It is always a patients option to have one done elsewhere if that is the treatment that they choose to have. We see people from all over the country who have gone from one dentist to another seeking help for their chronic pain. We get alot of referrrals from integrative physicians who have patients with all sorts of health problems and dental histories of root canals, infections, and various facial traumas. We are not a pain specialty practice, but we work with dentists who are.

A good friend of mine, Dr Robert Kulacz, had a surgical practice in NY State that he limited to treating patients with various oral infections. He wrote a book with a cardiologist entitled The Roots of Disease, Connecting Dentistry and Medicine.

I'm sorry that you are in such pain. My sister has RSD and fibro and a sleu of other unpleasant conditions. She is always hurting too :-(( When you are able to write some more, I'll try to help you with your question on bifurcation.

Take care,
Bryanna
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Old 04-08-2007, 10:56 PM #7
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Default Thank you Bryanna for your detailed explanation

Bryanna,
Once again thank you for your detailed and well writtenn explanation of what is done in your office for an implant. My husband is not receiving nearly the amount of care that your patients receive. I am going to check into this with his perio and dentist.
I am curious as to what is "biological dentistry". How does this practice that you have been in differ from the other. Also, I find it quite interesting that your office does not do root canals. As I said my pain dentist who is also a phd neuroscientist says they are not the way to go anymore.
I am glad you are aware of deaff. neuralgia. I see so many patients suffering from it and must get weekly painful facial injections for years. They go from dentist to dentist re: pain from root canal and they all deny it. Finally, they get to my dentist and he knows exactly the problem and how to treat it with injections and meds. It is my understanding that different dental schools have their own curriculum .It depends on the school you graduated from - if you learned about deaff neur. and other facial pain associated with dental work.
I am glad you refer patients to a dental pain specialist. There are so few in the country. Patients of my dentist fly in from Florida, Texas, etc. frequently as there are no dentists who know how to treat them. Many were former patients who moved away and still return to this dentist because in their new location there is no dentist to treat them.
I must ask you about my recent problems with my facial injections. I'll post a new thread tomorrow. I need your advice.
Thanks again
Hope you had a nice Easter
Sydney
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Old 04-15-2007, 12:24 AM #8
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Hi Sydney,
Sorry for the delay in my reply. Since I work 90 miles from home, I stay in a hotel the nights that I am working and I don't have a lap top to take with me. So my replies will usually be on a weekend or on a day that I am home.

With regard to monitoring the healing progress of dental implants with xrays....... it just makes sense to do so, but alot of dentists do not think it is necessary. We don't charge the patient for these xrays and it only takes a few minutes to do.

Biological dentistry originated in Germany sometime during the 1960's. I believe dental schools in Sweden, Austrailia, Italy, England and a few other countries actually incorporate it as a part of their dental curriculum. In the US, you have to seek this type of education on your own from outside sources, in addition to dental school because it is not a part of the traditional curriculum. In fact, it is shunned upon by conventional dentists because it is more than just "tooth carpentry", it is whole body dentistry.

Biological dental care takes into consideration how dental treatments can affect the immune system along with a persons overall health. Treatment is usually very individualized as we all have different needs and various things going on healthwise. People who seek this type of care, usually are very health conscious and well informed about the hidden dangers of various toxic materials commonly used in dentistry and they want no part of that. Or they are very ill and concerned about the possible link between their illnesses and their oral health. It is common for a patient to have a physician who provides various therapies to coincide with their dental treatments. As with any business, there are some who don't necessarily practice what they preach. Not all Biological dentists shy away from root canals as they are more comfortable riding the fence on controversial subjects. It's always difficult to be considered different amongst your peers........ some people prefer to stay neutral and others are leaders and pioneers in what they believe in.

You could do a search on biological dentistry on the net. You will find a wide variety of issues, some will make sense and others will seem very far fetched. To each his own........

Be well......
Bryanna
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