A Reason to Smile

12 Years After a Car Accident, Implants and New Bone Grafts Leave Young Patient Smiling

Why did you undergo dental implant surgery?

As a teenager on the East Coast in the early 90s, I was in a car accident. Among other injuries, I lost three front teeth and sustained severe bone damage throughout my mouth.

Thankfully, I received excellent care while undergoing major surgeries for my mouth, mandibular joints, back and ankle. When it came time for dental implants (two years after my accident), my surgical team wanted to pursue the least invasive methods possible to rebuild the bone in my mouth. They chose to use bone from a cow rather than take bone directly from my body. After the bone graft healed, the placed the implants.

Why did you have to have the work done over?

Unfortunately that bone graft never developed beyond the initial growth during the healing process. In 2002, bone fragments began to work their way out of my gums.

By this time I had moved to California so couldn’t go back to my original team. A friend recommended Dr. Peter Wöhrle who did a thorough exam, contacted my previous doctor and concluded that the bone was probably deteriorating. Dr. Wöhrle referred me to Dr. Oded Bahat, who confirmed the deterioration.

The prospect of additional surgeries made me nervous. I was no longer under parental supervision and this was the first time I had to make a major health decision on my own. While I was initially impressed with Drs. Wöhrle’s and Bahat’s knowledge and experience, after all I’d been through I wasn’t sure who to trust.

I called my original team to see what they recommended. One of the doctors said, “Those guys (Dr. Bahat and Dr. Wöhrle) are world-renowned and if you can get them in with them, you should.” So I did.

How did they handle your case?

During a follow-up consultation, they outlined what would happen:

Dr. Fontanessi recommended that we use bone from my own hip to rebuild my upper mouth so the bone to maximize the chances of acceptance. He joined the team to assist Dr. Bahat as they preformed the graft.

Even after deciding to go forward with this team, I was a demanding patient. It was my mouth and the front teeth are the first thing people see when they meet you—you can’t hide them like you can hide a flabby belly.

5 of the 8 surgeries I’d had in my teens were around the top of my mouth, so I was worried that my gums wouldn’t fully recover and that there wouldn’t be enough gum to cover the implants. There’s always a risk with multiple surgeries in the same area.

Being 27, I was also concerned about the scar on my hip. Dr. Fontanessi was very understanding about this, knowing how important it was to me. He was very strategic about the placement of the incision and talked to me a lot about it before the procedure. He never treated me as if I were being vain or worrying about something trivial. He was both caring and careful. You literally cannot see any scarring now, even when I’m in my bathing suit.

The whole team understood that the little things matter when it comes to putting your body through such a massive ordeal. They clearly cared about me. I also took a lot of comfort in knowing they were the best and take pride in their work. There is something to be said for the drive that made them experts in their field.

After the bone graft procedure, my face was swollen for at least a week. I had bruises around my mouth and nose and some pain. Walking was a bit painful the first day after surgery as my hip was sore from the bone removal. The pain medication they prescribed worked well (I slept a lot for a week or so as I healed).

My top lip remained slightly swollen for a while, though no one seemed to notice it but me. My husband (new at the time!) thought I was crazy, but looking back at photos now I can see a slight difference for a few months. This was probably because I’d had so many surgeries, but I couldn’t help but wonder if it would ever return to normal.

Six months later, after the bone graft had healed, it did return to normal. That’s when Dr. Bahat placed the implants. That surgery was much easier and I was only swollen for a few days.

Once the implants fused to the new bone completely, in about 6 more months, Dr. Wöhrle placed the final prosthetic teeth (I’d been using a temporary set during healing). I could not have been happier to finally have “normal” teeth again! To bite into things and not worry about my teeth breaking or coming out or someone noticing—oh that feeling. It’s amazing.

It’s been 8 years and as of my last x-rays, the bone has actually grown. My teeth look and feel great. I have zero concerns. It’s hard to express how good it feels not to have to worry about my teeth and smile.

In retrospect, is there anything you would change?

I might not worry so much about the money. In the long run it really doesn’t matter. Friends had mentioned doctors who charged less. Everyone seemed to think any dentist could do implants. But I’ve seen people who have noticeable implants and I hear horror stories of the permanent damage done by doctors who aren’t properly trained. It seems silly now that I would have ever considered price shopping for something like this.

What would you recommend to people who are considering implants?

It’s ok to have a conversation with your doctor. Ask a lot of questions. Your doctor should be proud to tell you about their experience if they are among the best in their field. I knew who my doctors were, where they received their education and training and how many similar surgeries they had performed—and performed successfully. I went in knowing everything I needed to know. I understood the risks, the likely healing time, and the overall process from graft to final prosthetic.

Do a lot of research on the team—so much information is available online now. You can find out if your doctors have published in professional journals, where they studied, what postgraduate training they’ve had. But nothing replaces face-to-face conversation. Ask whether they’ve ever had issues or failures and what success looks like to them. Make sure that’s what success looks like to you, too. And settle for nothing less than the best when it comes to your mouth.

Make your own dental implant story.