Q: Two years ago, I came to the realization that my teeth, my lower teeth wouldn’t make it through much more indecision.
They were starting to get loose, trap food and were painful to clean. Though I’m a medical professional myself, dentistry has never been easy. Finally, I screwed up enough courage and had my hopeless teeth out and teeth put in that same day. It went better than I thought and today my speech, my smile, my chewing ability is better than I can remember.
Having said that I only have eight teeth on top. They’ve been crowned but are in bad shape. The dentist told me there is decay creeping out from the edges and also the old porcelain on them is cracking.
They were repaired with bonding, but unsightly staining has appeared. They must be redone but my main question is what do I do for back teeth? Now I’ve got all these good lower back teeth I need uppers to chew with.
The problem is my sinuses. They are large which has thinned the bone where implants should go. I’ve been told that I can’t have implants because my bone is too thin. Do I go with a partial denture? I tried one on the bottom but it was a no go--I couldn’t wear it. I spent the money and the dentist couldn’t make it comfortable. I’m nervous about trying that again. Are there any other ideas?
A: Upper partials often function better than lower partials because they are out of the way. Cheeks, tongue and floor of the mouth muscles are affected by a lower partial. Sometimes one’s anatomy isn’t roomy enough to permit the comfort and stability needed for a partial to work in the lower jaw.
Having said that healthy sinuses offer an excellent opportunity to enlarge the needed bone for implants. The earliest pioneer of sinus grafting (Dr. Hilt Tatum) to enhance bone volume for implants started in 1974. I had the opportunity of seeing the master of sinus augmentation perform a number of sinus grafts in recent years (2018-2019). I was aware of his technique he finally settled on over thirty years ago. I have been using that technique for the last five years though I’ve been performing the procedure for over twenty.
It predictably allows bone to form in about five months. Then implants are placed into that newly formed bone and about four months later teeth can be made to fit the implants. In your case, grafting, then placing two implants on each side would give you posterior chewing power to greatly enhance your eating experience. If you start now your upper teeth will be as good as your lower in about nine months.