After 2 or 2.5 years of reverse extraction work, I felt that there was still long ways to go before I got enough space between the roots, and the first surgeon even made it sound like it might not be possible to get enough space and that I may have to settle for a bridge.
One thing I learned through this process was to not trust doctors statements blindly as the truths. The first surgeon called me a month after the first consultation after many attempts to try to reach him and basically told me he was refusing to take on my case because he was concerned with thinning of the bone in the front teeth because we had expanded them forwards. But this is done all the time in orthotropics, yes if you move one teeth far out, you run the risk of moving the teeth out of the alveolar bone and the bone can reabsorb causing one to possibly lose a teeth. But if you move a group of teeth together, the alveolar remodels and follows where the teeth are moved to. The bone will get thinner during the remodeling process and moving teeth around. To this the surgeon did not provide me satisfying responses. But by then I had already decided not to go with him because he had been so slow at getting back to me and the fact that I didn’t really want titanium implants but was looking into ceramic ones for various reasons including below which are some of the advantages advertised:
- Bioinert material which supposedly trigger less chemical reaction. Apparently Titanium implant can corrode and its material migrate to other parts of the body and research has found some to migrate even all the way to the lymph nodes, ceramic implant does not erode or migrate.
- Esthetics – sometimes when gums get thinner the titanium implant can show some darkness through the gums because of its dark surface color. Ceraroot is white thus mimicking real teeth in esthetics and does not face this discoloring problem.
- some people are allergic to metal, Ceraroot is supposedly non-allergic
- non metal or bioinert meaning if there was such thing as meridians and energies that run in the body and mouth, Ceraroot is supposed to not interfere
Some more advantages can be read here 10 reasons why choosing metal free, Zirconia (cermaic) implants.
First the Ceraroot surgeon, Dr. Dexter Flemming, looked at the previous CT scans taken 2 months prior and began telling me similar thing about there not being enough room between the roots in the upper. Then I told him for the past two months my orthodontists has been putting kinks in the wire to move the roots. Dr. Flemming decided 2 months was significant enough amount of time to take second set of CT scans, luckily at his office they had their own CT machines where as for previous surgeon I had to go to a different office to get one done which cost $275. Anyway at D. Flemming office they did a new scan right there on the spot at free of charge.
Once the scan was made, immediately he commented that there was noticeable changes already in the last two months, and I stood there watching over his shoulder as he played with the computer program, positioning models of Ceraroot into the 3D imaging of my jaws. It reminded me of Tony Stark from Iron Man playing with his 3D computer system JARVIS.
Dr. Flemming has told me the Ceraroot is a bit thicker than some of the other types of Titanium implants available but because he understood my desire for the ceramic ones, he was using the thicker model in the program.
Ceraroot requires at bare minimum 5-6 mm of space, 7 mm is more of the ideal space.
He said I have enough space in the lower jaw to implant Ceraroot without a sweat.
And to my surprise, the upper right bicuspid was tight but he could fit the implant fairly easily still. You can see in above picture, how the bottom has plenty of space between the roots, while the upper is more narrow.
Now the upper left, as you can see above, was the very tight one and he said it will be a challenging case but he has done spaces narrower than this, so he told me he will be able to do it with special guided procedure that gets mapped out by an external laboratory and it will be an procedure in which he will be sweating a bit. But I was surprised by his willingness to take on such a challenge, and I could guarantee that the previous surgeon I saw will not accept this. Which leads me to the conclusion that oral surgeons come in all different ranges of skill levels.
To be honest, I was quite surprised he was telling me that all 4 bicuspid extraction spaces were ready for implant already if I so chose. Where as 2 months before the first oral surgeon was telling me I wasn’t even close and he started telling me perhaps I may need to go with the bridge route. and eventually calling me back to tell me my case was too challenging and he politely refused.
It was a bit disheartening at the time but I already understood that there will be other oral surgeons out there that can take on my case.
So it was definitely exciting to hear from Dr. Flemming that he was first of all willing to take on my case but not only that but there was already enough space for him to do the procedure now if required. I had gotten lucky because he was only the second oral surgeon I had consulted so far, and the only one near me carrying Ceraroot.
Now it has only been two months since my orthodontist began creating space between the roots by torquing the teeth and up righting the roots, I believe there is still room for the roots to upright more and create even more space so Dr. Flemming can perform the surgery easier.
Next step is to take the new CT scans to my ortho next appointment and continue the progress of creating more space between the roots.
There are some other positive news I found out from Dr. Flemming.
I have excellent bone density
- According to the CT Scan, I had excellent bone density, above average, and there will be no need for bone graft.
I’m not sure why I have great bone density, first thing that came to mind was all of the chewing I have been doing lately which definitely will increase jaw bone density without a doubt but he was talking about bone density where teeth was absent. Then how would chewing affect that area?
Then I thought about it and came up with two theories.
- if the two teeth on either side of the space is getting plenty of stress daily then you can imagine that bone has to get dense around the root and this “area effect” is spilling over to the extraction space.
- Or maybe that the act of chewing puts stress on the whole jaw bone and alveolar, causing general increase in density throughout.
Some other causes?
One other thing to note is that I have been taking cod liver oil and butter oil blend pills (2 pill twice a day, morning & night) but I only started this like 1 month prior, so I doubt this was the main contributing factor if at all.
The other factor, could certainly be the use of acceledent the past 2 years.
Or some other factor I don’t know about, and I just got lucky… Age does play a part but at 25 years old I’m above the average of that age group.
Personally I do think it might be the chewing that has affected even the extraction sites. And Acceledent is playing a role in how fast the teeth and the roots were able to move while preventing root re-absorption as advertised and to the oral surgeon’s liking.
Picking the right oral surgeon for implant?
I had been reminded once again, how different one doctor from the next can be in their diagnosis and treatment plan. One doctor can tell you with a dead serious face that “it can’t be done” while another will say “it is possible”. It is important to not get discouraged by few consultation in which the doctor tells you “you can’t” and continue to persevere till you find one that tells you “it is possible”
Picking the right doctor for you is not easy, you have to do your due diligence and have enough research on hand so that you don’t let the Dr. title scare you into believe everything they have to say.
A good place to start is to find doctors that are carrying more state of the art treatments such as biobloc or ceraroot, those doctors are usually the ones that are more open minded as they took time out of their busy schedule and spent their own money to learning something outside of what they were taught in dental schools.
It seems I was pretty fortunate this time around to have found a good oral surgeon to my liking my second try, carrying my preferred ceramic implants.
Can implants be removed later on?
I asked the doctor this question with the thought that what if in the future they come out with technology that can grow real, brand new teeth? And yes, according to the doc, it is possible to remove / extract implants.
With 2.5 years of reversing extraction orthodontic work, I have officially reached a place where I now have enough space for full implants in 4 bicuspid spaces. In the face of many doctors that told me it can’t be done or at best I would require bridges, my case proves that it is possible to regain the extraction spaces after they have been closed.
I am not there yet as I’d like to reach more ideal amount of space, but Dr. Flemming provided big confirmation that Dr. Gibbs’ ortho work has been successful. While I also believe my incessant practice of oral posture and chewing has been a factor to the progress.