Major dental reconstructions for patients who have lost most or all of their teeth is a difficult, expensive and time consuming process. I have spent the last 25 years of my professional career (now approaching almost 40 years) in trying to perfect my techniques in this area of dentistry. The one thing that I know for sure is that nothing is totally predictable in this field and every single patient is different from every other. this means that I am always evaluating and re-evaluating my steps in treatment to get to my desired outcome. Sometimes, everything proceeds rather straightforward. Other times, there are lots of problems encountered.

My feelings in this particular patient treatment is that the rather large, avascular mandible contributed significantly to the failure of implants. It is also possible that surface contamination was a contributing factor as well. I have seen many implants now from many different systems where techniques used to enhance the surface activity of an implant actually worked to prevent integration. this is one reason that I am still not impressed by manufacturer's claims about their implant surfaces. I also imagine that there would have been tremendous problems medico-legally if I had originally attempted to do this treatment as an immediate load sitatuion....SRD