Implant process as an HNC patient

I wasn’t given a detailed plan and there is very little to nothing on the internet. Each patient is different but there are some common factors. 

My plan – several years after multiple surgery and radiotherapy – was to have most of my teeth out, leaving four at the top to hold a partial metal denture in. 

My timeline is a lot slower than would be the case in the private system or in a patient without rec urrent cancers like mine. 

Step 1: Insertion of implants November 2021 Implants screwed into the jawbone: metal screws that come up to gum level and have little tops on them, often buried under the gum. (Done during cancer surgery) This is usually done by a maxillo-facial surgeon and a prosthodontist. It can be done under sedation but I was having surgery anyway.

Step 2: Uncovering of implants and addition of healing abutments May 2022 After 5 – 6 months the implants should have integrated themselves into the bone – not so good in the radiated patient but I have had no problems. The gum is sliced open, tops of the implants unscrewed and abutments or caps that rise above the gum were screwed on. (Very difficult for the max fax because of my trismus.) This was done under local anesthetic and I had no trouble healing at all. 

Step 3: Impression-making with dental copings July 2022 After 2 – 6 weeks of healing, the abutments were unscrewed and metal posts that rose to or above normal tooth level were screwed in – called dental “copings”. An impression was made with these posts showing the location of the implants. . 

Step 4:  Waxy baseplate/waxy model September 2022 A waxy base plate for the bottom jaw was made. I couldn’t see exactly what the prosthodontist  was doing but he had the devices pictured, unscrewed two of my four implant caps and screwed the base plant or waxy part of it down with one post.

He had made a waxy model for my upper jaw too and while that wouldn’t stay up, it did fill in all the gaps and for a few minutes I had both sets of gums filled with waxy stuff that gave me the feeling of a complete set of teeth.

I knew surgery had to be scheduled to cut away scar tissue before finishing the teeth and I KNEW this would take ages even to be BOOKED, but I left that appointment feeling upbeat.

The prosthodontist said he understood how good it must have felt to have my lip pushed out (after 8 years of paralysis!)

Step 5: bridge screwed onto my implants November 2022.  I finally had the dental bridge screwed onto my four implants. This was part of a two hour surgery to create a new gap between the lip and gum and a bit of a new gum too. It was called “sulcoplasty with a full thickness skin graft”.

The implant-anchored dental bridge had little teeth on it and was initially bolstered by putty to keep the lip out. For 10 literally stomach churning days I was in an ng tube with a diet of 6 Fortisips a day.

I now had a full arch on my lower jaw, some of it over a skin graft and it felt good then and still feels good now. For the first time since 2014 my left lip was pushed out and doesn’t droop down. 

Getting the upper partial metal denture: February 2023

This was a long day at Middlemore having a denture fitting and then having to go away and come back as it was adjusted. I found a nice little spot on a concrete block wall under a tree where I had a coffee during my first wait and a frappe during the second.

We got there by 4 pm. The teeth are not perfect. They don’t match the adjacent ones and one of them is longer than others but crikey they are an improvement on having no top teeth at all! I can drink with them but can’t eat and they impede my speech a wee bit. 

Current Status: August 2023 I’ve had another little cancerous lesion removed from my right inner cheek. Scar tissue was rubbing on the resin covered bottom plate and I’ve had to have it filed down. It is still a work in progress as it’s still a resin covered plate. My upper teeth are uncomfortable and I have to talk very carefully to make people understand me. My four remaining top teeth are not in perfect shape and will have to come out eventually after which they have offered me implants in my upper jaw. 

If it does happen, I hope it doesn’t take as long as the bottom ones did!

But I remain grateful. 

Maureen Jansen