Dental Patient Case Studies

Notes from the Patient
March 2007
I kept my eyes shut for most of the operation. Not from fear, although I was rather apprehensive, it's tricky in the dentist's chair - if you suddenly open your eyes it signals pain and everything stops and then has to restart when all the reassurances are done. I prefer to focus internally in the hope that it will fast-forward the horrible bits. When I heard the words "this is the last stitch" I felt relief. The cutting and drilling is over. The implant is in place. I listen carefully to Adam's instructions "you must not blow your nose for 6 months - if anything drips out of your nose, wipe it away"; "the stitches should come out in 2 weeks time, until then avoid biting in the area"; "when the numbness wears off you can eat and drink what you want". The internal conversation begins: red wine or cold beer? Red wine is in the lead. "Use an icepack to help reduce the swelling".

That is how my evening meal came to be 2 glasses of Dreher beer and an assortment of ice cream - in the Brauhaus Kempinksi - watching weightlifting on Eurosport. Budapest is a city that provides many surreal experiences and this trip is no exception.

My introduction to the phenomenon I call "post dental high" was over 2 years ago. Having spent many hours in "the chair" (getting 50 years of UK neglect not exactly put right, but repaired as much as technically possible) followed by the Diclofenac kicking in as I floated down the steps from Buda Castle to the Danube, was for me a formative experience. Who needs Amsterdam.

Back to the implant. Technically it was upper left 5, the tooth had been loose for months and was declared unsaveable and it was extracted in February, two months ago. The implant went in two days ago, I am now home. I have a swollen cheek, my tongue wants to play with the new stitches and tomorrow it's back to work.

Once the stitches are out I will try not to think about this stuff until the results are released in October. Will the implant have taken and if so it's on to the crown stage.

Total cost so far: implant and bone granule mix and membrane was 1300 euros; still to come is the zirconium implant crown (I want the best) which is 470 euros. The desired end result - a new tooth that doesn't wobble and won't rot!

Technical Notes
A very difficult implant to place. The patient had very little bone to work with and the sinus membrane was visible. For this reason Bio-oss bone grafting material and a membrane were used, the stitches will need to stay in for 2 weeks which is one week longer than normal and the patient will have to be very careful not to blow his nose for the next 6 months.

October 2007
Back in Budapest for my zirconium oxide implant crown.

First appointment - panoramic xray to show exactly how the implant was lying, couple of injections to numb the area, a small incision in the gum to expose the implant (some bone had grown over the screw so this had to be scraped away), the internal screw was taken out from the implant and replaced with a different screw called a healing attachment. It felt strange to have someone working in my mouth with a screwdriver.

Second appointment - 2 days later for the impression for the implant crown. Surprisingly no injection this time. The healing screw was taken out and replaced by the real attachment that the crown would be fitted onto. A couple of mouthfuls of “goo” to make the impressions and then everything sent off to the lab for the zirconium work. The healing screw was put back in. Five days to wait until final fitting

Third appointment - I wanted a descale and polish as part of my work so to avoid being rushed on my last day I opted for this two days before the crown fitting. It turned out to be a bigger procedure than I had expected, I have never had such a thorough clean up, it was the dental version of sand blasting, afterwards my teeth gleamed but I had a sore tongue for a few days. I also had an old amalgam filling replaced in the molar next to the implant. Back to the diclofenac for a couple of days!

Fourth appointment - At last the final fitting of the implant crown. A small injection to numb the area and suddenly the gap was gone.

Different views of the lab work, lower right and lower left shown. The finished zirconium oxide crowns look very natural.