PROSTHESIS- The concluding part
After an interval of 10 days, I reported to the prosthodontist for further work.
First sitting:-
As the time stipulated for the healing of the sutures had elapsed, the prosthodontist removed the sutures first after numbing the site with a spray of aerosol.
He smeared the metal tray with puttee and clapped it on to my gums and took the impression.
Since I was seeing him for the first time, I had to pay his consultation fee. A certain amount was charged towards the laboratory charges to make them prepare the model in such a way as to prevent occlusion (clogging of the pores). I was asked to come after 4 days for the second sitting.
Second sitting:-
1st stage :- 4 days later I reported to the prosthodontist. The wax model of my gums had been just delivered by the laboratory. The doctor put it on my gums and kept on trying and shaving it with a knife heated on a spirit lamp till it fitted without a gap. But what scared me was the smoking knife brought near my mouth for the final, finer shaping. Thank God, I did not get scalded or singed! This synthetic gum had been prepared to give the laboratory people an estimation of the height and not to cover my real gums.
2nd Stage:-In the next stage he removed the healing caps and fitted screws of different diameters into the holes in the implant. He smeared a transparent blue gel on the puttee on the impression tray and took the impression of my upper jaw with the screws and let it solidfy slightly. It was then removed from my mouth. Next, he removed the screws one by one from my mouth and fitted them in to the abutment and stuck them where the implant was located in the plaster model. This process had to be repeated as one of the abutments would not fit into the implant analog.
The process was repeated for the lower jaw without much problem. Though the process did not entail any cutting or suturing, tolerating all that hardware for nearly two hours without a strong local anesthesia was a bit tiring. Moreover, the prosthodontist’s weapon (sorry, instrument, in this case it was a screw driver) would sometimes impinge on my soft skin making me burst into small involuntary groans. The small screws also would sometimes slip from his gloved hands and land-sometimes inside my mouth and sometimes on my sterile apron. Fortunately I did not swallow any of the expensive hardware.
Finally after getting a satisfactory impression, the screws were removed and replaced with the healing caps. Incidentally the healing caps were like mushrooms and had long stems which would go into the titanium implant preventing them from slipping off.
The impression was sent to the laboratory for fabrication and I was asked to come four days later.
3rd sitting:- The third sitting four days later was an anticlimax in that it hardly took any time. The doctor had come all the way just to mark the line of symmetry on the plastic model of my upper gum. Unfortunately he had to consider the line from my forehead as my nose was not located dead centre of the face due to a deviated septum. He however asked me to come two days later when he promised (threatened!) that I would have a longer session.
4th sitting:- After a week and what seemed to be a long wait for me, the metal prosthesis was delivered to my clinic from the laboratory in Kerala and I was summoned to the clinic on the same evening to meet the prosthodontist.
While the doctors, located locally, were ever prompt and punctual, the prosthesis was forever in arriving. The German specialist technicians working in the laboratory at Kerala being sticklers to precision would rather take more time than deliver an imperfect product.
However, the doctor first removed the healing caps and put in the screws. The prosthesis was fitted on the upper jaw and tested. Then the prosthesis was clamped on the lower jaw. Later both were fixed together and tested. Every time the gadget was prized off my gums, I would experience great pain. This was in addition to the pain caused by the screws impinging on the soft tissue. On the whole, it was quite a groany(!) session of 45 minutes, to put it mildly. One of the abutments was drilled inside my mouth.
Once the doctor was satisfied with all the bite tests, impressions on a thin waxy sheet were taken of the front teeth bite and of rear teeth blte.
Then the doctor removed the prosthesis and the screws. The healing caps were screwed back in place. The color of the enamel was chosen to match my complexion.
I was then sent home on the promise that my next session would indeed be the final one. As three quarters of fabrication had already been done and as such only the metal had to be covered with ceramic enamel, it was expected to take not more than 3 days.
5th sitting:-
The denture had been delivered after 4 days. The next day, the prosthodontist removed the healing caps, screwed on the abutments and fitted the denture on the upper jaw. Being a fixed jaw, the denture was in one unit. Since my gum had receded at one place, the technicians had added an extra bit above the implant and behind the denture so as to make the arch look perfect from the front. Bite tests were taken. Some of the teeth on the right side had to be trimmed to match the left teeth. Similarly the lower jaw, which was movable had to be in 3 units. After fitting them on the mandible, the bite tests were taken.
Then both the jaws were tested together .
In the final stage cotton bits were kept in the abutments, the denture was smeared with permanent cement and clamped on.
Hey, Presto, I had my lovely white, pearly set of teeth and a good smile.
Except for the fact that I have to get used to the clackety clack of the ceramic impact, I am sure I would gradually come to think of the hardware in my mouth as much part of myself as my specs.
**** THE END *****
Acknowledgement:-
Replicating God’s creation in a live, complex mechanism such as a human body is indeed a mighty task. I am grateful to Dr.Deepak, Dr. Harish for the excellent work they have done. I thank Dr.Kusuma, the office staff and the serving staff of Narayana Hrudayalaya Dental Clinic , Banashankari, Bangalore for the ‘gentle care’ they rendered to me. I also thank the specialist technical staff at the laboratory in Kerala for their innovative and precision work.
The graphics are courtesy bing.images.
Copyright:- Vimala Ramu
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