DENTAL IMPLANT-Part 1
‘Implant’ has been a word which has come into vogue more recently. Though nose implant, breast implant and tooth implant etc have been in use, dental implant (correct usage) is the most misunderstood term by the lay persons including yours truly. A case of the dental implant was said to have been discovered in the cadaver of a woman in twenties from Mayan civilization with three tooth shaped shells placed in the sockets of missing teeth. What is more, the radiological study revealed that the bone had accepted the implant showing that the implantation had taken place when she was alive (ref Wikipedia).
Not withstanding this, the modern usage of the dental implants started in 1950’s. I was under the impression that implant meant our own decayed tooth would be cleaned and cleared and the empty shell put back. How wrong I was!
‘Dental implant’ is a screw made of Titanium which would be embedded in the jaw bone to which artificial denture or individual tooth or bridges could be screwed on. This relieves the wearer from removing the denture every time.
In my case, the whole dental set had to be screwed on to the implants.
It all started with the erosion of my teeth due to the prolonged effect of Rheumatoid Arthritis and its medications, in spite of regular visits to dentists and in spite of bridges, fillings and root canals carried out at regular intervals. Finally when the chewing teeth were gone, I started using the front teeth for the purpose which left them broken, worn out and altogether sinister looking. That’s the time I thought of implanted teeth. But I was shocked to hear that each implant cost Rs 25,000 and so gave up the idea.
I went back to the free dentist at our family welfare centre.
The dentist shook every tooth. Mournfully shaking his head, he decried the civilian dental work, “What has he been doing for your teeth apart from making you pay through your nose?” and gleefully removed 6 teeth on one day and 3 on the other and gave me a partial denture set costing Rs 54.
After about an year, finding myself not happy with the partial denture, lower one of which gave me ulcers and the upper one needed cleaning every time I snacked on some thing, I decided to go to an implantologist and risk the whole process.
Fortunately I found that a branch of the state of the art chain of dental clinics run by prestigious health care organization located very close to my house.
When I approached the dental surgeon, he had a look at my teeth (the absent ones), tut-tutted the work of the welfare centre dentist and explained the steep expenses involved in the implantation process, each implant now costing Rs30, 000. He promised to get a senior citizens’ discount and left me to decide. With the permission of the finance sanctioning authority aka the husband I decided to take the plunge.
The implantation was done in two phases. In the first phase, I was first asked to get an OPG ( ortho pantomograph), a two dimensional radiograph of the skull in the special place which caters for such special radiology and it was e mailed to the doctor. He saw it and fixed the date for the implantation of the upper jaw only. I was asked to get a fresh blood sugar report on the morning of surgery. The prosthetist met me the previous day and took the impression of my mouth for measurement.
On the scheduled day when the process began, the surgeon invited my husband into the operation theatre to witness the process which he kept explaining at every step.
When the numbing injections, six I presume, were given I felt only the first two and afterwards I was just an inert recipient of the whole thing, It was only my husband’s account later that told me what was done.
First of all one ‘mobile’ tooth in the upper jaw was extracted. For implanting, a slash was done in the gum and flap was held back by a retractor. In the recipient bone that was exposed, 6 holes were drilled following the OPG closely parallel to the direction of the teeth. Ice cold water was being sprayed continuously and suctioned off. Six implants were placed one in each of the holes.
The ‘implant’ was imported from Israel. It looked like the lead jutting out of the wooden part of the pencil. It was encased in a metal spring. After placing the implant in the hole, the spring was wound out. The flap on the gum was closed and sutures put which were removed 10 days later. A period of 4 months’ gap was given for the implant to osseo-integrate at the end of which the ossification would have taken place and the implant would have merged with the main bone (which was possible only with titanium which for reasons unknown does not get rejected as foreign material). The swelling of the mouth was rather dramatic with all blue and red color making me look like monkey God for four days. No pain was felt during this period thanks to the painkillers and other medications.
After about a month,when I went to the doctor for the second phase, he sympathised with me, “If only you had come to us one year earlier, we could saved your teeth” and promptly extracted 7 teeth from the lower jaw and put the sutures , leaving me in a totally edentulous state except for two teeth one at each end of the upper jaw. 40 days were allowed for the healing of the extraction. Later one more OPG was taken, one more blood test was done fresh and the process of implantation was repeated for the lower jaw with 6 implants. The swelling for the lower jaw was not much. Ten days later the sutures were removed. A three months gap was allowed after which the denturing part would be done.
The intervals between the steps in the procedure are taken totally at the discretion of the implantologist.The payments are also taken in instalments.
So having lost the God given smile, I am waiting for the dentist given smile at 76 years of age.