Implant Phase II

Well, mediaeval dentistry continued unabated today with the second phase of the implant procedure. No tooth yet though.

The summary is that the implant appears to have taken successfully, some metal is visible in my jaw now, and I should have a new tooth within 6 weeks or so.

Click for gory details if you desire.

You will all remember that the first phase involved planting (basically) a titanium wall anchor into my jaw bone. At that time the gum was closed back up for 5 months of allowing it to fuse with the bone. Today was the day to uncover it.

The next step of the procedure is to place a healing abutment. Basically, a permanent hole is made in the gum, and the abutment is screwed into the anchor piece that has been buried all this time. It’s a healing abutment because its purpose is to hold the hole open in the right shape until the gum heals. This is essentially the cosmetic step that makes the gums look right once the final tooth is in. It looks something like one of these:

Now, I was told that the procedure would last about 40 minutes, and that it would be way less unpleasant than the last one. Unfortunately, I have to say that I was cruelly mislead on this point. (I guess I shouldn’t say cruelly because it implies maliciousness rather than misinformation.)

First, the freezing. A lengthy procedure consisting of needles being poked into your gums, and – in a procedure called a nasopalatine block – jammed into your palette. It started to look bad at this point, because the nasopalatine block didn’t take. So it had to be done again. Damn.

That wasn’t the end of the anesthetic issues, however. Several times during the procedure things began to wear off. And it’s a funny situation because you believe that you’re psyching yourself out. “I can’t be feeling that… it’s frozen… or is it? Perhaps I’m feeling it a little… nah. Oh – yes. I can feel it. Ack.”

Even with all of this, there was extra surgical time involved because of the positioning of the implant itself. See, back in Phase I the surgeon had to put the wall anchor in at an unusual angle because of the shape of my jaw bone. That means that the structures that will eventually support my new tooth will have an angle in them. That, in turn, means that the healing abutment (which remember is supposed to have the same shape) needs to have that angle… but they are not manufactured in angles, so the dentist had to grind the abutment into the right shape. While it was in my mouth. That added about 30 minutes to the procedure.

In the end, the surgeon decided to do some gum “reshaping” (i.e. cut some of it off to change the shape) which then required a bunch of stitches. All in all, the 40 minute appointment lasted 90 minutes. (I’m sure the other patients waiting were not impressed!)

Afterwards, I looked in the mirror and my gum looked like a bit of a train wreck. A far sight from the supposedly “cosmetic” aspect of the Phase 2 process. However, within a few hours things settled down. While it still looks like a surgical site, I do have to admit that it shows much more similarity to the gum around my existing tooth than it did before all of this.

In two weeks I go back for a checkup, and if all is well I begin the final phase – restoration. This is where I go back to my family dentist to get a brand new tooth installed!

So… how am I doing? Actually, I am doing much better than with the Phase I operation. The incision is much smaller, and is between my teeth rather than behind them. This means talking and eating are possible. I’ve been staying away from hot foods, and chewing at the back of my mouth, and that’s been working OK. Despite this, I’m still taking painkillers every 3 hours or so, and I have no plans to stop that for a few days. Also, I wouldn’t say that I’m feeling up to running a race tomorrow. So, I guess things are going a bit worse than I expected, but still much better than the last time.

Protect your teeth… all of this due to a stupid moment on a bike I didn’t know how to ride when I was 13.

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› health     2004-06-16 21:36   ...0