Serious Bone & Gum Recession Around Multiple Implants

Discussion in 'Periodontics' started by OligodontiaMan, Jul 20, 2018.

  1. OligodontiaMan

    OligodontiaMan

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    Hi, I am in my mid 40's and have had multiple implants placed years ago in the upper and lower jaws. The ones on the bottom have serious bone and gum recession around them. I was wondering if anyone has had this issue and had it treated successfully? A Periodontist wanted to do gum grafting, but what didn't make sense to me was how would that treat the serious bone loss around the implants? Another Periodontist wanted to use the Lanap laser procedure on me. Are bone grafting and gum grafting ever done together? That would seem to make sense. Or to have them done separately. I would appreciate hearing from anyone that has had to deal with this issue. The x-ray shown here is just one example of what my other implants look like.

    Thanks!
     

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    OligodontiaMan, Jul 20, 2018
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  2. OligodontiaMan

    honestdoc Verified Dentist

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    You will encounter different opinions. Do you have certain medical conditions such as diabetes, immune compromised, etc.? Are you a smoker? Has anyone mentioned to you about possible grinding/clenching? If you have any of these factors, implants may not integrate as well.

    If definitive treatment is planned, I think it would be more predictable to replace the center one and consider replacing the right one as well if finances can be accommodated. The right one is marginal with poor integration around the bone level.
     
    honestdoc, Jul 20, 2018
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  3. OligodontiaMan

    OligodontiaMan

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    I have none of these issues other than than the grinding/clenching being mentioned to me by the dentist.
    Those implants were placed in 1999 or so. But since there is so much bone loss wouldn't there need to be some grafting, especially if I would be replacing the implants?
    thanks.
     
    OligodontiaMan, Jul 21, 2018
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  4. OligodontiaMan

    MattKW Verified Dentist

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    Doesn't look good to me. I can't see that any bone grafting will make any difference to the implants that are still in place. Once the implant surfaces have been exposed, they're contaminated. You won't get any meaningful reattachment with bone (or gum) surgery. I would sever the middle crown, remove the implant, and replace it as a free-standing single implant. I don't know how well the others will go in time.
     
    MattKW, Jul 21, 2018
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  5. OligodontiaMan

    OligodontiaMan

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    Can the surfaces be decontaminated with cleaning or laser? All of the other implants I have have bone loss around them as well.
     
    OligodontiaMan, Jul 21, 2018
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  6. OligodontiaMan

    MattKW Verified Dentist

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    No reliable treatment is available, although many have been tried. Your best bet might be to try and halt progression on the better implants, but be prepared to lose some like the central implant in your Xray. You can't retreat implants to the same perfection as the industrial treatment. You've only shown a small part of your bridges and implants. If the other areas are similarly affected, maybe you should consult a prosthodontist about the best path to follow.
     
    MattKW, Jul 22, 2018
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  7. OligodontiaMan

    OligodontiaMan

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    Thank you for your response. If that implant or another has to be removed, could bone grafting help before possibly putting in a new implant? Would consulting a Prosthodontist make more sense than seeing a Periodontist? Or should I see both?
     
    OligodontiaMan, Jul 22, 2018
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  8. OligodontiaMan

    MattKW Verified Dentist

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    A periodontist is the first to assess the gums. If you're in need of long-term replacement options, then a prosthodontist would be good, and they would work in conjunction with the periodontist. I wouldn't suggest you worry about bone grafting till a perio has had a look, and also a prosdo. You need an idea of where this is all going, and what your options could be before you make any steps.
     
    MattKW, Jul 23, 2018
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