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Pain in dental implant/ extract ?

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  • 02-06-2020 10:12am
    #1
    Nicknamed
    Registered Users Posts: 360 ✭✭


    I have severe pain and inflammation in my incisor dental implant with tinnitus
    The X-ray, CT shows some bone loss
    The dentist said get gum cleaning procedure that may result in gum recession, bone grafting
    I feel like I want to get them removed ASAP
    Has anyone been through above ?
    Which dentist in Dublin experienced you remove implant ( it was implanted 10 years ago )
    Is this a complex procedure ?


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    #2
    Dianthus
    Moderators, Science, Health & Environment Moderators Posts: 933 Mod ✭✭✭✭Dianthus


    Removal of a titanium implant is quite different to extraction of a natural tooth.
    Your best bet would be to consult with a periodontist(gum specialist). Your dentist should be able to arrange a referral.
    Also you'll need to decide what is possible to replace the implant with should you choose to remove it- a denture, a bridge, or leave a gap?


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    #3
    Oral Surgeon
    Registered Users Posts: 3,240 ✭✭✭Oral Surgeon


    Nicknamed wrote: »
    I have severe pain and inflammation in my incisor dental implant with tinnitus
    The X-ray, CT shows some bone loss
    The dentist said get gum cleaning procedure that may result in gum recession, bone grafting
    I feel like I want to get them removed ASAP
    Has anyone been through above ?
    Which dentist in Dublin experienced you remove implant ( it was implanted 10 years ago )
    Is this a complex procedure ?

    Tbis is likely "periimplantitis" (inflammation of the tissues around the implant, loss of gum height and then bone and then exposure of the metal implant implant fixture (that should be encased in bone) and then the problem often gets legs and gets worse.
    in my experience, cleaning and grafting implants rarely works so is usually pointless, expensive and just delays the inevitable loss of the implant....
    waiting often leads to loss of more tissue in the meantime...

    Removal of implants is not straightforward and must be done by someone who has done it before..... this is no time to go to someone cheaper or less experienced. Often they can be unscrewed but sometimes need to be drilled out. Either way the surrounding bone can react in unpredictable ways... Some heal with no drama, some not!

    The options after are. denture bridge or implant depending on whats left after healing.

    your tinnitus is not caused by your implant, look elsewhere for the cause and solution to this.....

    Good luck.
    OS


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    #4
    Nicknamed
    Registered Users Posts: 360 ✭✭Nicknamed


    Oral Surgeon wrote: »
    Tbis is likely "periimplantitis" (inflammation of the tissues around the implant, loss of gum height and then bone and then exposure of the metal implant implant fixture (that should be encased in bone) and then the problem often gets legs and gets worse.
    in my experience, cleaning and grafting implants rarely works so is usually pointless, expensive and just delays the inevitable loss of the implant....
    waiting often leads to loss of more tissue in the meantime...

    Removal of implants is not straightforward and must be done by someone who has done it before..... this is no time to go to someone cheaper or less experienced. Often they can be unscrewed but sometimes need to be drilled out. Either way the surrounding bone can react in unpredictable ways... Some heal with no drama, some not!

    The options after are. denture bridge or implant depending on whats left after healing.

    your tinnitus is not caused by your implant, look elsewhere for the cause and solution to this.....

    Good luck.
    OS

    Do you have any recommendations for where to get the implant out ? My original implant was in another country more than 10 years ago. Many thanks


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    #5
    Nicknamed
    Registered Users Posts: 360 ✭✭Nicknamed


    Nicknamed wrote: »
    Do you have any recommendations for where to get the implant out ? My original implant was in another country more than 10 years ago. Many thanks

    Still haven’t found a dentist in Dublin who can remove the implant without causing surrounding extensive damage. Any knows if any clinic using this or similar to remove implants? https://www.swallowdental.co.uk/neo-biotech-implant-fixture-removal-kit.html

    Should I travel to another country ? Budapest I have heard ?


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    #6
    Dav010
    Registered Users Posts: 14,004 ✭✭✭✭Dav010


    Nicknamed wrote: »
    Still haven’t found a dentist in Dublin who can remove the implant without causing surrounding extensive damage. Any knows if any clinic using this or similar to remove implants? https://www.swallowdental.co.uk/neo-biotech-implant-fixture-removal-kit.html

    Should I travel to another country ? Budapest I have heard ?

    I think you are going to struggle to find a dentist to remove an implant that they haven’t placed unless they have the equipment for that particular brand of implant. Certainly if they have to order a universal removal kit like the link you provided, you would have to bare the cost of the kit as they may not use it again. The only other option would be to use specialised troughing instruments to remove it, but that would involve removing bone around the implant.

    If you are willing to travel abroad, is there a reason why you aren’t considering going back to the Clinic where it was placed? Obviously they would have the complimentary instruments necessary to remove the type of implant they placed.


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    #7
    Oral Surgeon
    Registered Users Posts: 3,240 ✭✭✭Oral Surgeon


    Nicknamed wrote: »
    Do you have any recommendations for where to get the implant out ? My original implant was in another country more than 10 years ago. Many thanks

    Most clinicians I know don't take out many implants and often do so in a destructive manner.... I've taken out quite a few, 5 in the last 2 weeks alone, take from that what you will.....
    Nicknamed wrote: »
    Still haven’t found a dentist in Dublin who can remove the implant without causing surrounding extensive damage. Any knows if any clinic using this or similar to remove implants? https://www.swallowdental.co.uk/neo-biotech-implant-fixture-removal-kit.html

    Should I travel to another country ? Budapest I have heard ?

    That implant removal kit is relatively expensive and filled with mostly unnecessary components....

    You don't need to go abroad to have this done. You will need to consider what you now want to replace that tooth with and aim to coordinate having this done too....


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    #8
    Nicknamed
    Registered Users Posts: 360 ✭✭Nicknamed


    Oral Surgeon wrote: »
    Most clinicians I know don't take out many implants and often do so in a destructive manner.... I've taken out quite a few, 5 in the last 2 weeks alone, take from that what you will.....



    That implant removal kit is relatively expensive and filled with mostly unnecessary components....

    You don't need to go abroad to have this done. You will need to consider what you now want to replace that tooth with and aim to coordinate having this done too....

    I think I need your help. I will PM you. Worried about infection spreading.


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    #9
    Nicknamed
    Registered Users Posts: 360 ✭✭Nicknamed


    Thank you. Travel to that clinic/country is not possible. It was done before I came to Ireland many years ago. Straumann 4.1 mm is the name of the implant that needs to come out.
    Dav010 wrote: »
    I think you are going to struggle to find a dentist to remove an implant that they haven’t placed unless they have the equipment for that particular brand of implant. Certainly if they have to order a universal removal kit like the link you provided, you would have to bare the cost of the kit as they may not use it again. The only other option would be to use specialised troughing instruments to remove it, but that would involve removing bone around the implant.

    If you are willing to travel abroad, is there a reason why you aren’t considering going back to the Clinic where it was placed? Obviously they would have the complimentary instruments necessary to remove the type of implant they placed.


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    #10
    Dav010
    Registered Users Posts: 14,004 ✭✭✭✭Dav010


    Nicknamed wrote: »
    Thank you. Travel to that clinic/country is not possible. It was done before I came to Ireland many years ago. Straumann 4.1 mm is the name of the implant that needs to come out.

    Straumann is a popular implant and there are many Clinics in Ireland both North and South who use them, I’m surprised that none of the ones you contacted were willing to remove them. Are you asking for a guarantee that the bone will not be damaged during removal? Why are they declining to remove it?


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    #11
    Nicknamed
    Registered Users Posts: 360 ✭✭Nicknamed


    Dav010 wrote: »
    Straumann is a popular implant and there are many Clinics in Ireland both North and South who use them, I’m surprised that none of the ones you contacted were willing to remove them. Are you asking for a guarantee that the bone will not be damaged during removal? Why are they declining to remove it?
    Been shuttle cocked from couple of places. Had ct done from one place and they are talking about attempt to save the implant by some lifting of flaps and clear outs etc. I think it just needs to be taken out as soon as possible as infection seems to be spreading. No I’m not looking for a guarantee that no bone will be damaged but from my research online it seems high torque tool method is better than trough burr cutting device.


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    #12
    Dav010
    Registered Users Posts: 14,004 ✭✭✭✭Dav010


    Nicknamed wrote: »
    Been shuttle cocked from couple of places. Had ct done from one place and they are talking about attempt to save the implant by some lifting of flaps and clear outs etc. I think it just needs to be taken out as soon as possible as infection seems to be spreading. No I’m not looking for a guarantee that no bone will be damaged but from my research online it seems high torque tool method is better than trough burr cutting device.

    I would be inclined to listen to, and take advice from the expert surgeons who do this type of work rather than relying on your own research online. Implant surgeons often have to spend a considerable amount of time explaining how the material you read online does not apply to a particular patient’s situation. I’ve restored thousands of implants over the past 15 years, but I still defer to the expertise and knowledge of the Surgeons who place them, I have often looked at xrays and patients mouths and thought that implants are/aren’t possible, only to be informed that I was mistaken by the Surgeon, that is why they do all that extra training in this speciality. So, rather than going in armed with research that may not relate to you, listen to the expert, you might save yourself a lot of treatment and money.


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    #13
    jrosen
    Registered Users Posts: 1,629 ✭✭✭jrosen


    Having implant issues myself and starting to get really irritated at my dentists lack of response. He cant tell me why it hasnt healed as he would have hoped. Ive had one infection and based on the X-ray the implant seems to have fused/healed perfectly well at the top but there is a gap along both sides.

    I had the implant done last year, permanent implant fitted in August after 3 months of having the temp one in.

    My dentist has said he is referring me to a periodontist to explore further. Ive followed up now 3 times since March and still nothing. Feeling very deflated, ive spent 2500 to have this tooth done. Its an incisor so totally visible all the time.
    Ive sent one more email today.


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    #14
    SuziXX
    Registered Users Posts: 86 ✭✭SuziXX


    jrosen wrote: »
    Having implant issues myself and starting to get really irritated at my dentists lack of response. He cant tell me why it hasnt healed as he would have hoped. Ive had one infection and based on the X-ray the implant seems to have fused/healed perfectly well at the top but there is a gap along both sides.

    I had the implant done last year, permanent implant fitted in August after 3 months of having the temp one in.

    My dentist has said he is referring me to a periodontist to explore further. Ive followed up now 3 times since March and still nothing. Feeling very deflated, ive spent 2500 to have this tooth done. Its an incisor so totally visible all the time.
    Ive sent one more email today.

    Many dentists are still only seeing emergency’s or prioritising patients according to need, periodontist’s are only just open in the last week or so, many may not have opened yet and will be prioritising patients who were mid treatment when they shut. They need to clear the backlog so there will probably be a wait. . .


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    #15
    jrosen
    Registered Users Posts: 1,629 ✭✭✭jrosen


    SuziXX wrote: »
    Many dentists are still only seeing emergency’s or prioritising patients according to need, periodontist’s are only just open in the last week or so, many may not have opened yet and will be prioritising patients who were mid treatment when they shut. They need to clear the backlog so there will probably be a wait. . .

    Yes your correct, they had closed which I had kinda forgotten. They have been able to squeeze me in for next week thankfully.


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    #16
    jrosen
    Registered Users Posts: 1,629 ✭✭✭jrosen


    Nicknamed wrote: »
    I have severe pain and inflammation in my incisor dental implant with tinnitus
    The X-ray, CT shows some bone loss
    The dentist said get gum cleaning procedure that may result in gum recession, bone grafting
    I feel like I want to get them removed ASAP
    Has anyone been through above ?
    Which dentist in Dublin experienced you remove implant ( it was implanted 10 years ago )
    Is this a complex procedure ?

    Ive just had my consultation. Feedback was I have some bone loss and I have a few options.
    1. Do nothing (not recommended)
    2. Remove it altogether and have a denture or bridge fitted. Its not the easiest to remove he said.
    3. Lift gum flap, clean out and use platelets and or bovine bone to bone graft.

    Im probably going to opt for the bone graft tbh. I dont want a denture, I also dont want a bridge.


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    #17
    Oral Surgeon
    Registered Users Posts: 3,240 ✭✭✭Oral Surgeon


    jrosen wrote: »
    Ive just had my consultation. Feedback was I have some bone loss and I have a few options.
    1. Do nothing (not recommended)
    2. Remove it altogether and have a denture or bridge fitted. Its not the easiest to remove he said.
    3. Lift gum flap, clean out and use platelets and or bovine bone to bone graft.

    Im probably going to opt for the bone graft tbh. I dont want a denture, I also dont want a bridge.

    Don't think I've ever seen this work well.... Often it just slows the inevitable IMO....
    Please report back with your experience.....


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    #18
    jrosen
    Registered Users Posts: 1,629 ✭✭✭jrosen


    Oral Surgeon wrote: »
    Don't think I've ever seen this work well.... Often it just slows the inevitable IMO....
    Please report back with your experience.....

    Oh really? How come?


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    #19
    Oral Surgeon
    Registered Users Posts: 3,240 ✭✭✭Oral Surgeon


    jrosen wrote: »
    Oh really? How come?

    Honestly, I don’t think that I have the energy to explain why....
    it’s just a stupid concept to try to salvage a failing treatment thought up by clinicians who want to salvage their failing case and bought into by patients who don’t want to accept the failing treatment and the alternative options that it brings....


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    #20
    Dav010
    Registered Users Posts: 14,004 ✭✭✭✭Dav010


    jrosen wrote: »
    Oh really? How come?

    Firstly, your Periodontist is the person best placed to advise you on your treatment, he/she has the benefit of being able to examine the site and your x-rays. Any opinions/advice here can only be based on what experience tells us is the most common outcome.

    Unfortunately the prognosis for the implant in cases where they fail to integrate after 6 months is usually questionable. Due to infection, a layer of fibrous tissue tends to form around the implant which prevents the bone growing around the threads. It is difficult to clean 360 degrees around an implant when the flap is raised so some infected material may remain. Also, there is usually no guarantee the graft will be successful in the long term. So, in a high percentage of cases, the best course of action may be to remove the implant, allow the site to heal and reassess in 3-6 months with a view to placing another one of possible. There are some factors which can contribute to failure to integrate, the most important ones are smoking, diabetes, poor bone, poor healing responce, poor oral hygiene, excessive loading of the implant etc.

    Some small piece of good news is that most reputable clinics will give you a refund or Re-place the implant free of charge, provided you yourself did not contribute to the failure.

    So, discuss with the Periodontist the chances of success with the cleaning/grafting, if they are limited, consider removal and ask if it would be possible to try again after the site has healed.


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    #21
    jrosen
    Registered Users Posts: 1,629 ✭✭✭jrosen


    Dav010 wrote: »
    Firstly, your Periodontist is the person best placed to advise you on your treatment, he/she has the benefit of being able to examine the site and your x-rays. Any opinions/advice here can only be based on what experience tells us is the most common outcome.

    Unfortunately the prognosis for the implant in cases where they fail to integrate after 6 months is usually questionable. Due to infection, a layer of fibrous tissue tends to form around the implant which prevents the bone growing around the threads. It is difficult to clean 360 degrees around an implant when the flap is raised so some infected material may remain. Also, there is usually no guarantee the graft will be successful in the long term. So, in a high percentage of cases, the best course of action may be to remove the implant, allow the site to heal and reassess in 3-6 months with a view to placing another one of possible. There are some factors which can contribute to failure to integrate, the most important ones are smoking, diabetes, poor bone, poor healing responce, poor oral hygiene, excessive loading of the implant etc.

    Some small piece of good news is that most reputable clinics will give you a refund or Re-place the implant free of charge, provided you yourself did not contribute to the failure.

    So, discuss with the Periodontist the chances of success with the cleaning/grafting, if they are limited, consider removal and ask if it would be possible to try again after the site has healed.

    Thank you.

    He laid out the options today but certainly didnt recommend one over another. I will follow up and ask what he thinks prognosis will be. Ive spent some time tonight trying to research that.

    I certainly dont want to waste money and time on a treatment that wont work. Its already cost me 2650 between the implant and the appointment today. My dentist who fitted the implant has said he doesnt know what to do with it so unlikely he can fix it. Meaning im looking at possibly another 1400-1500.


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