All on 4 Dental Implant Experience - Edinburgh, Scotland

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I have been invited to share my experience of...

I have been invited to share my experience of dental implants which I have done 7 years ago. Unfortunately my story so far has gone from one of joy to despair. I previously had dentures for many years and felt I could afford to do something I had aspired to for many years.

I thought that I was unsuitable but had researched this on the internet and found several implantologists who were promoting dental implants even for the most difficult cases. I chose an implantologist who had a reputation as being an expert in his field for many years and decided to go and have a consultation. From the first meeting I was advised that I should be suitable but would require a full assessment but was very encouraging. I agreed and all the necessary procedures were carried out e.g. x-rays, impressions etc. plus background information re my health and social habits e.g. smoking.

I was given advice on the importance of good hygeine and follow up care following the procedure. I asked pertinent questions about the longevity and any potential problems I may encounter. I was told that the procedure was very successful and as long as I followed protocol I they should last a lifetime. In hindsight I should have asked for more explicit information about any potential problems such as what if the procedure fails, what are potential complications short and long term. I presumed that if there were any problems that this information would have been given to me to enable me to give informed consent or declinel to go ahead.

The procedure was carried out in stages and the implantologist was very competent as far as I was aware and I had every confidence in his abilities. The implant procedure was uneventful and everything was successful. I made a good recovery and was very happy with the outcome. Things started to go wrong about a year following the implant surgery. One of the teeth on the fixed prostheses broke and when i attended the dental surgery it was another dentist who I saw and at that time he noted that I had my own bottom dentition and said that my own teeth had caused excessive force on the bridge and had caused this. He highlighted at that time that my own dentition would cause a lot of pressure on the implants and bridge.

Things went OK for a while until I experienced a crack on the fixed bridge which I had repaired ,only to follow shortly afterwards with a complete break of the bridge when eating a morning roll. All my colleagues at work heard it. It was a real shock. I visited my implantologist again and he asked what I had done. I explained that I was eating normally. It was sent to the technician and repaired at a cost of £570 ($913), Around another year later the bridge cracked then broke again. This time I was angry and said to my implantologist that his should not be happening and again asked how long should this last. He replied 'a lifetime'. He took responsibility and I had another bridge done with reinforced metal (another band of metal placed at the back of the teeth) and was given the repaired bridge.

The new bridge was placed and I visited the implantologist a year later. On examination one of the distal implant screws was found to be loose. This was tightened and the bridge put back on. I was asked to return in 2 years. In another 1 1/2 years (two months ago) the bridge cracked quite severely along one edge. I arranged an emergency appointment with my implantologist and was advised that it would be sent for repair in another two weeks when the technician was contacted to arrange he repair. On removal of the bridge two weeks later I noted that the distal implant around the area of the cracked bridge was loose (the one that had been loose previously). On examination the implantologist found that the screw was fractured. He told the nurse and not directly to me. He placed the spare bridge on the implants and asked me to come back the following week and advised to be very careful because my bridge was sitting on only 3 implants and not fully torqued. The week turned out to be 4 weeks because the dental nurse telephoned me to say that because the implantologist required to hire the screw removal kit my appointment was delayed. I wasn't happy but had no alternative.

On return to the surgery my implantologist asked me if I was aware the screw had fractured and part of it was inside the implant. I said yes and he said that he would try to remove it. He attempted this but after a time said it was stuck and couldn.t remove it. He had given me a local anaesthetic and the procedure was quite traumatic. I felt that the implant must be damaged by the pressure that was exerted. He placed the bridge back on the 3 implants and told me that I would just have to use 3. I asked how realistic this was and he said that as long as I didn't eat things like toffee that would pull the bridge down that it was strong enough to take the forced of eating up and down. I asked if it could be replaced and enquired whether any of the implant system was covered (as I had read on the Nobel biocare and Straumann sites that implants were covered for a minimum of 10 years to a lifetime. He said no and that the reparatory work would be too complicated and would probably necessitate extensive work and the bridge would have to be readjusted or replaced. He said I could have the screw for nothing but that was all. He would not give me any reassurance that he could do anything and said we should just wait and see.

On leaving I asked when I should return as my check up appointment should have been May. I was told by the nurse it would be 18 months as normal. I left devastated. I was telephoned at my workplace the next day and the dental nurse asked me how I was and said that the team had been talking when I left and had found another tool in the kit that they could try rather than just leaving it. I was advised not to get my hopes up as it may not work.

Since I have become very depressed and have found that I cannot eat properly as one of the other implant sites is sustaining pressure from my bite and chewing motion and the bridge is moving. I had told the dental nurse this when she had spoken to me and she said that that was fine it was because the screws had not been tightened fully. I am also experiencing a foul taste in my mouth frequently which is coming from the affected implant and worry that there is an infection. I have lost weight and continue to do so because of both my physical and mental state at present and don't see any way of resolution. There are a lot of happy outcome stories about these types of implants and I felt that not enough is known about the adverse consequences of failure of these. I cannot foresee my own outcome and envisage the worse scenario wearing dentures being a nightmare, as the all on 4 procedure entails taking a lot of the bone away to allow room for the bridge to be inserted.

My previous problems with dentures can only be worse. I will continue to publish the my experiences and outcome. The most positive would be the removal of the screw without damage to the implant. However I would always be fearful of it happening again and having to endure these feelings again. I live in Scotland and had the procedure done in Edinburgh

My appointment to allow the implantologist to try...

My appointment to allow the implantologist to try again to remove the fractured screw from the implant was again unsucessful and I have now been advised that the implant itself requires to be removed.

I have now been given 3 choices for further treatment, which is an improvement from my previous visit.

I have been given 3 options. the first being to remain with 3 implants, undergo a new procedure where an implant is placed immediately on removal of the implant with the fractured screw (there are no guarantees of the success of this), or revert back to dentures. He asked me to consider these 3 choices and let him know. There was some conversation around these options and my present situation and cause. This I cannot discuss as I feel at the present time it should remain confidential due to potential outcome of treatment. I will require to make a decision after the holiday period.

I feel at least I have some choices now where previously I felt at a loss with no way to move forward with a resolution. I feel very disappointed that the screw cannot be removed as all the implants are sound and have integrated well within my jaw bone. I feel that the major manufacturers of implant systems should address this potential flaw in their product as it can have devastating consequences to the recipient. They do provide screw removal kits but in my case and probably many others are not effective.
Name not provided

Do not wish to rate my implantologist as have too many mixed feelings at present

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