Radiation and Implants

Q: Dear Dr. Crapo: Twenty years ago I developed a lump under my jaw. I went through the tests and it was discovered to be a lymph node cancer. I went through surgery, chemo and what seemed to me massive radiation.

Today I’m alive and healthy but over the years following the treatments I lost a lot of my saliva capacity and suffer from dry mouth. In that time, my teeth have been lost. We’ve tried to save them but the decay was so aggressive that the dentist couldn’t keep up with it. The decay got into the nerves then I needed root canals and then crowns. It was the only way to keep teeth in my mouth. But then I started having decay below the edge of the crowns and the dentist would try to fix that. No matter what was tried I’d get decay, so now I’ve got a mouth of sharp shards sticking out of my gums.

I asked about implants, in fact I’ve had an implant in the front of my mouth that has worked but he said that the bone that received all that radiation may not be strong enough or healthy enough to take the implants. He said it’s mostly the back of my jaws that were affected, so I don’t really know if something can be done with implants for the front part of both my upper and lower jaws.

A: Extensive radiation to any part of the body produces adverse effects. Large amounts of radiation to the head and neck may well produce permanent damage that results in pain, extreme dryness to the mouth, speech impairment, rampant decay and deterioration of the bone that supports teeth. It compromises the body’s capacity to heal – present and future. Can the body come back over time? In some cases, yes to a certain degree. In your case, you may have not received near the exposure in the front of your mouth. The fact that you’ve had a successful implant is a good sign. When reconstructions are done so that your bad teeth are removed and new bridgework inserted on the same day, the implants are placed in the area just behind the eyeteeth in such a way that the attachments supporting the bridgework may be sitting two teeth back. It is designed this way because this is generally where the best bone is. The teeth you receive on the surgical day are put in place until the bone heals to the implants. When healing is complete a very strong titanium bar is constructed to ensure the bridgework can support a full set of teeth. You may find this a very workable solution.

If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

Based on actual patient cases

 Calvin Ross Crapo

Victoria Implant Centre

778-410-2080

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My Implant Broke!

Question: Dr. Crapo: A number of years ago I had a lot of dentistry. I had four implants put in. Two of them held a bridge on the upper left back teeth and two held separate crowns on my upper right eyetooth and the tooth beside it and to the front. I also had a crown for my upper left eyetooth and then two years later I lost an upper left tooth between the eyetooth and the front tooth, so they put a crown on the left front tooth, attached the tooth beside it and braced it against the eyetooth. A month ago the tooth fixed to one of the implants beside the upper right front tooth, went funny – I mean it went all bucked poking into my lip. I saw a dentist – he took an x-ray and said the implant broke. He showed me the break and I said - what do I do? He said he thought the implant would have to come out but said he didn’t do that and would refer me. I saw another dentist and he said that my own upper front teeth were loose. He said it looked like I have a very strong bite and that might be a reason for the implant breaking. He also said he didn’t deal with broken implants and said he’d refer me to someone who might. I’ve already gone from dentist to dentist – one to put the implants in, another to put the teeth in and the dentist who did them in the first place is retired. I’m afraid I’ll be without teeth when the broken implant comes out. Is that right?

Answer: It is very unusual for an implant to break but when it occurs it is almost always due to extreme forces. In your case, if there is movement on your other front teeth, that implant tooth has taken repeated and excessive forces when you chew and swallow.

As far as removing the implant, in this area of the mouth it may not be advisable as a good deal of bone may be lost. It is often better to remove the broken portion and if there is no disease around the remaining implant, leave it and let the bone and gum grow over it.

If the three remaining front teeth are only slightly mobile, they can be connected with each other and to the implants, making a bridge.

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