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Question:
Loss of bone - dental implants: I lost my two front teeth and had a bridge. 10 years later I got two front teeth implants but there was lots of bone and gum loss, giving me a whistle through speach.
2 years ago I had a third front implant placed and that seemed to make my speach much worse in terms of whistling. Is there anyway of building up bone and gum around these implanted teeth?
I will try anything because they are ruining my confidence. I am willing to travel anywhere to have this problem addressed. I have been told about stem cells injections. I have no idea if that is true, but will try anything.. ... Visitor from NY
Answer:
In general, to grow bone and tissue around implants that are already in their final position and in function is very difficult. The best chance for bone to grow around an implant is right after placement.
Tissue can be added to the cheek side of the implant to make the gum tissue more thick and durable but these procedures will not add height of tissue. Unfortunately, gum tissue will only grow so high around a dental implant. This height depends on what is next to the implant supported tooth. Unfortunately, two implants next to one another results in the shortest height of tissue (average of 3 mm).
Solving your problem may be as simple as remaking the teeth supported by the implants. I am unsure of the appearance in your mouth or on an x-ray. My big question is, "Was the third implant placed because one of the implants failed?" I will guess that is what happened. If so, then they probably restored the single too.
I am guessing that the third implant was placed because one of the implants failed. Then, I am guessing they made a new single crown on the "new implant." Unfortunately, the tissue can change drastically in the whole area. This will necessitate a remake of both of the crowns to compensate for this change in gum contour. In other words, the cause of your whistling is space between the replacement teeth and the remodeled gumline. If new replacement teeth can be made to this new gumline your whistling should stop.
This solution has a good chance of working if the implants have adequate supporting bone. However, I am real concerned that there may not be enough bone to support this solution. They sound like they are really stretching their brains for a solution to wonder about stem cells. Are you sure you understood the reference to stem cells correctly? Perhaps they were referring to platelet rich plasma which is known to enhance soft tissue healing.
We have a saying,"the tissue is the issue but the bone sets the tone." Without adequate supporting bone, adequate tissue bulk cannot exist. You will need an adequate amount of tissue above the junction between the abutment post and the top of the implant.
If you have lost too much bone and tissue, this junction point will be above the gumline. Once this happens the solution becomes more difficult. This means that the implant itself is exposed. Bone and tissue will have great difficulty growing up against an implant surface that has become contaminated with normal oral fluids.
The big question you need to find out is, "Where is the junction point between the abutment and the implant?" If the junction is still hiddent by the tissue then a remake will likely solve your problem. If the junction is above the gumline, the solution gets more difficult. There are solutions but without seeing the entire case it is difficult to tell you what is possible and what is not possible.
Edward Brant DDS, MS
447 Lake Avenue
St James, NY 11780
(631) 584-4395
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