Former Cancer Patient to Receive All-on-4 Dental Implants

I encountered an interesting challenge a few days ago and did the follow up consultation yesterday. This patient was a healthy active 72 yr. old gentleman missing only a couple of teeth that had been replaced with fixed bridges and his remaining teeth were all crowned. Most of this work had been completed about 7 yrs ago and was beautifully conceived, planned and crafted. Unfortunately, there was recurrent tooth decay under almost every crown and several teeth were actually broken off.

The medical history revealed that this gentleman had been treated for cancer on the border of his tongue about 15 years ago with radiation and chemo. Dry mouth and other factors related to this treatment regimen lead to his rampant tooth decay. Neither he nor I had any confidence that if we removed and replaced all of his existing crowns and bridges that the result would be lasting. That combined with the need for surgery and dental implants, even if we did attempt a crown and bridge solution, led us to favor an approach that would ultimately involve removing all of his existing teeth and replacing them with implants and a non-removable set of teeth that would attach to them. This would require hyperbaric oxygen for the lower arch but not the upper.

We decided to do the upper arch this Monday with the classic All-on-Four procedure and work with the lower in a few weeks. Monday, I will extract all of his upper teeth, place four implants, and construct and deliver a full set of non-removable teeth.  It will take most of the day, primarily to make the new teeth, but he will be sedated, so the day will go quickly and easily for him. 

The primary risk for this patient is the possibility that I will not be able to attach his new teeth to the implants the same day and he may have to wear an upper denture for six months first.  This risk is greatest when most of the upper teeth remain and require extraction on the day of implant placement. The tooth sockets leave little bone to engage the implants and sometimes, approximately 3% of the time, the implant cannot be placed sufficiently tight and I must wait before attaching anything to it. I’ll try to give you a report next week on how this goes.

Visit www.NoDentures.com to learn more about the All-on-Four Dental Implants procedure.

Dr. Brueggen

Houston Dental Implant Dentist