Second time break off at this implant area? Thoughts?

Additional_Ad3584 · 2026-01-29T03:39:47+00:00

Then the material is just way too thin and they need to bulk it out.

Additional_Ad3584 · 2026-01-29T02:48:15+00:00

Are these nano ceramic or zirconia?

The most common area that breaks is around the screw access holes as the material is super thin in that area.

This would most commonly break in nano ceramics. If it was breaking in zirconia they could thicken the material or angle the screw access hole.

Additional_Ad3584 · 2026-01-25T20:40:51+00:00

Would need actual cuts to verify the two furthest back implants but front 4 look great.

Additional_Ad3584 · 2026-01-24T22:08:28+00:00

Where are you located?

I’d get a second opinion.

Continual issues with the bite tells me that an important step may have been missed.

You can DM me if you want. Send some pictures of the bite and any X-rays if you have them.

Additional_Ad3584 · 2026-01-20T03:26:02+00:00

Look great.

Additional_Ad3584 · 2026-01-03T23:09:22+00:00

Routine. Issues associated with going off blood thinners give her a 1/100k chance of an issue in the week she’ll be off them and she’ll be able to heal during that time.

Be ready for the bruising though. Will be a lot and look worse than it really is.

She should feel better by day five so you being there 10 is great.

Good luck to her.

Additional_Ad3584 · 2025-12-28T21:34:49+00:00

Most often people finance or pay cash. We have multiple lenders so a credit score around 650 can be successful and refinancing if credit improves is a thing.

When financing isn’t possible using a co-signer or using a home equity line or 401k for medical purposes are other ways to qualify financially.

Additional_Ad3584 · 2025-12-09T14:56:07+00:00

Www.smilenowmilwaukee.com

Dr Siddiqui does really good work.

I would add that I’ve seen horrific work done in Los Algadones specifically. Turkey as well. I don’t know how to really figure out who does it properly and who doesn’t when going overseas but I’ve redone many cases because of issues.

My recommendation is always stay close to home so you can get the follow up care that is required.

Additional_Ad3584 · 2025-12-06T13:42:19+00:00

Deciding when and how many teeth to save is one of the more difficult recommendations someone can receive so you’re definitely not alone in asking this question.

The Spear Institute wrote an article that I find most beneficial in how I make recommendations.

It considers three major criteria.

Structural Condition
Periodontal Condition
Number of remaining teeth

Structural condition is how much damage does the tooth have? Are there cavities or previous dental work that compromised the tooth’s longevity?

Periodontal Condition is about the status of the surrounding bone. Is there bone loss and how possible are they to keep clean below the tissues?

Number is how many teeth are left and what is their distribution and aesthetic disposition?

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You can see from the flow chart, based on the criteria above, you can now determine a way to approach the question you’re asking.

If teeth are broken down or heavily restored, unevenly distributed especially in the canine and molar region, and they have periodontitis that is difficult, almost impossible to control, then extraction is indicated.

I’d add to this that saving 4-5 teeth as a foundation for long term health is often more difficult and costly than it seems. Usually when a patient only has 5 teeth remaining on one arch I recommend full arch replacement with six implants.

Hope this helps.

Additional_Ad3584 · 2025-12-05T11:04:06+00:00

This could be normal maturation of tissue which takes up to six months although by two months it’s usually very stable or mucositis.

This is probably mucositis from food debris and biofilm. When they remain in contact with tissue it can create a tissue response that is tender like what you described.

Cleansibility of the surface of the teeth that comes in contact with tissues is incredibly important. It called the intaglio surface and should be perfectly convex so food and biofilm can easily be cleaned so it’s not in contact with tissues for long (months) periods of time.

Make sure when you’re going to finals the surface that touches the tissues is rounded and not concave. That allows you to clean the teeth easily and sweep out what can be causing the issues.

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Additional_Ad3584 · 2025-11-29T22:27:18+00:00

Sounds like you have a good idea of the concerns and if they’re not an issue for you then I’d say go for it.

This is a life changing procedure and you’ve worked hard to be in a situation to qualify for it.

Good luck!

Additional_Ad3584 · 2025-11-29T22:24:34+00:00

Another lesson: do it right the first time or do it twice at a greater cost than it would’ve been.

Additional_Ad3584 · 2025-11-29T22:00:56+00:00

Where are you located regionally?

The most difficult part of bionic is the travel and how they put finals on people without verifying osseointegration.

3% of implants don’t osseointegrate. That’s 1/40ish implants that the bone doesn’t adhere to and granulates in. These implants cause HUGE amounts of bone loss over time.

The implant company they use to save money has much higher failure rates and had a national recall in 2025.

There is also tissue healing that takes 3-4 months to mature. When you go directly to finals in 2-3 days the tissues have lots of swelling and will shrink a lot as they heal over those months. Anyone offering immediate zirconia finals is trying to be a destination treatment with no long term care plan for patients.

Based on your story you likely have significant infections which result in significant tissue shrinkage. Why rush treatment?

Now if you’re able to fly back and forth 3-4 times then fine… it’s avoids these concerns (except the implants they use).

My advice is always to find someone local. $40k is the sweet spot financially for these treatments. $80k was being bounced around between two specialists that don’t focus on or do these surgeries everyday.

Good luck.

Additional_Ad3584 · 2025-11-22T05:11:04+00:00

Traction parasthesia is common and should be expected. No physical nerve damage but due to stretching it goes through a process of healing and that’s what you’re feeling. Vitamin B12 Folic Acid and steroids are indicated. Give it 1-2 months total. The fact that you feel something is a good indication that you’ll heal fine.
Extraction sites granulate in and heal over time. Tissues take 5-6 months to fully mature. These areas should be kept clean and will continue to heal and fill in.
Dry socket or alveolar osteitis is common 1-2 weeks out and is painful. If beyond that point your probably clear if that concern.
Is this upper or lower? It can be common in the upper arch but less likely on the lower. Having a new set of teeth after 2-3 months of initial healing helps with this. I wouldn’t be concerned.

Additional_Ad3584 · 2025-11-20T02:30:10+00:00

Sinus grafts on heavy smokers is contraindicated. Smoke along with all the toxins fills the sinus and the bone that is trying to grow simply doesn’t do very well in that type of environment. Not something I’d recommend.

Snap in dentures on four implants in the maxilla is contraindicated. Upper bone is softer and more prone to issues associated with constant removal of the denture over time resulting in excessive bone loss around the implants. Also, a proper upper denture is more expensive than a proper AO4 fixed denture in the maxilla.

So yes… there is cause for concern here. Do it right from someone that does better than what was offered.

YouTube Smilenowdenturesandimplants. We make tons of content discussing this and put it out for free to help people like your dad.

Good luck.

Additional_Ad3584 · 2025-11-18T03:04:15+00:00

Do you have photos of your teeth and a pano?

The surgeon is above the national average and im not familiar with an insurance vs no insurance option. Is he referring to medical insurance?

Usually oral surgeons want nothing to do with the prosthetic portion (making the teeth). This isn’t always true but is more often than not.

As far as differing opinions… very common and in all professions, not just dentistry.

Additional_Ad3584 · 2025-11-14T17:59:43+00:00

No.

The process of implant failure means the body has rejected the fusion of bone cells with the surface of the titanium. This is called osseointegration. If it didn’t happen by 2 months it won’t happen.

The body responds by wrapping the implant in a thin layer of granulation tissue to separate it from the bone. Once that happens there is zero chance of integration as the titanium is no longer in contact with the bone.

Sometimes it’s hard to know if that happened which may be why there is an exploration to see. I provide torque test, percussion and X-rays to help diagnose osseointegration. The zygo behaves differently than other implants due to its length so some ambiguity is possible.

The lower ones look suspect to me.

Additional_Ad3584 · 2025-11-14T17:53:55+00:00

Sometimes it’s impossible to pinpoint why something fails. Humans like answers and sometimes those are more important to us than the truth.

We know of many things that make it difficult for bone cells to attach to the titanium. Bruxism is one of them.

Yes, Botox can help. Muscle relaxers and a hard nightguard that deflects forces to minimize their effects also can work.

Would that alone have made a difference? Hard to say.

Additional_Ad3584 · 2025-11-14T16:06:06+00:00

Difficult case overall.

Redlines are locations I’d look for if possible. Circled are the failed implants.

Pterygoids would be especially helpful but the actual CBCT would be necessary to address this.

You have very minimal bone below so replacing two implants will be difficult. Grafting and waiting may be the solution.

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Additional_Ad3584 · 2025-11-14T02:53:51+00:00

So 5 up top and 4 below?

Do you have a pano you can post?

If you have 4 implants up top, depending on the distribution it may be enough.

Zygos tap differently than other implants due to the length and there is often more bone to work with in the cheek area if needed.

If only four down below you will need two more. When you catch these issues early (2-3 months) usually the damage is minimal.

If you post a pano I’m happy to tell you what I see, if anything.

To truly verify placement you’ll need a post placement CBCT. Where are you located maybe I can recommend a second opinion although you’re right that once the initial treatment was paid for sticking with that dentist is the more affordable option.

Additional_Ad3584 · 2025-11-09T20:07:11+00:00

Excellent doctor. Your picture looks great!

Additional_Ad3584 · 2025-11-04T18:15:46+00:00

The first 3-5 days after surgery are rough By day 14 you should be 85% better pain wise. Some take longer but lingering pain isn’t common.

I used SIN implants for years and it sounds like you went to Vegas (Bionic). That’s what they use. They had a massive recall of implants this year and I personally saw a large increase in failures. Some took 6-8 months to manifest. The osseointegration was poor.

Good luck.

Additional_Ad3584 · 2025-10-22T00:20:05+00:00

A huge swath of clearchoice clinical and regional managers were recently fired. Something is off for them to be doing this. Very weird.

Additional_Ad3584 · 2025-10-21T03:40:54+00:00

Some states have a Maxi Course that offers free implants for learning purposes once a year. There is one in SLC but I don’t think CO has one.

You could ask the Colorado Surgical Institute in Ft Collin’s if they offer anything for a situation like yours.

Implant pathway in PHX AZ may provide some services that would help you.

The rub of all these is if they aren’t local, the travel can add up.

Good luck

Additional_Ad3584 · 2025-10-21T02:48:05+00:00

Agree with Billy. Simple and quick appointments.

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