Mary, a dental patient, from Virginia asks:
I am a 45-year old woman in good health and I have excellent oral hygiene. I am looking to get two dental implants to replace extracted molars.
I have had two consults already, but due to the limited opening of my mouth, 33 mm, the tools that the dentists are using do not allow enough room. Are there any dental implant systems that can be used on someone with a limited mouth opening like I have? What else can you suggest? I don’t want to continue to spend money on consultation fees if nothing exists that can help me. Thanks.
Its a big problem,try to find a dentist who places disc implants.Those are inserted from the side and not the top.
Good luck.
Dear lady, why don’t you go to an oral and maxillofacial surgeon to place your implants under general anesthesia(GA)? I think that neither you nor him/her will face any problem.
Dr.jafari,
What do you suggest for restorative and maintenance phase?
Sir, I have to withhold my suggestions untill the time I can get more clinical data about the patient’s gnathic system. But under GA, the oral and maxillofacial surgeon has the chance to even explore the patient’s TMJs surgically or find out about any other cause of jaw movement limitations by direct inspection or any other means.
Dear Satish, Sir,Your insight and professional opinion is perfect. But by maximum mouth opening of 33mm, it sounds to me that this lady is suffering from a chronic closed lock of the jaw.In that case, the OMS can perform an arthroscopic lysis and lavage with some mechanical releasing of old fibrous adhesions under general anesthesia.If the diagnostic arthroscopy does not confirm that diagnosis,then the surgeon can go ahead to open the joint for an exploratory surgery while the patient is still under (GA).Whatever happens, when the patient comes out of the (OR),there will be no problem with restorative and maintenance phase of treatment.
Limited opening sounds like a closed-lock condition.
An Oral & Maxillofacial Surgeon has a number of tools at their disposal to diagnose and treat your condition.
Under General Anesthesia, the surgeon can mobilize your jaw further in order to facilitate the placement of the dental implants.
Once the implants are properly in place, your restorative dentist should be able to restore them in much the same manner they would a traditional crown.
Mary from Virginia,
The Nobel Biocare system can be used with your limited opening. Many other systems have instruments that are used for all different lengths of implants. NobeBiocare Replace select has instruments that are implant size specific thus 10 mm implants will be insertable in your molar agea. Dr. Kraut
I understand that still in many parts of the United States the Metric System is overshadowed by the old measurement system (Mile,Yard,Foot and Inch).I also understand that these two systems may sometimes cause some confusion in measuring distances for those practitioners who are mostly familiar with the old system and not the internationally accepted Metric one.I place Replace Select implants occasionally (and not usually) but I cannot imagine how it is possible to place one of these (or other) implants at the posterior of mandible or maxilla of a patient with MIO of 33mm which is a little bit more than one Inch.Maybe I am the one who is confusing science with commerce.
Diagnose and treat for restricted mouth opening, observe couple of months if at all restored function with balanced occluson and then better go for Implant, if the patient seeks for. Chitta
If it is determined that there is no TMJ problem additonal opening may be possible by using moist heat therapy bilaterally to the TMJ region. There are many products that will give the deep moist heat for the proper length of time for proper treatment. Moist heat prior to a patient having their mouth open for an extended time will eliviate muscle tenderness and pain after the procedure.
With limited mouth opening of 33 mm I would suggest referral to an Orofacial pain specialist to evaluate and perform conservative treatment prior to surgical intervention. Something as simple as a lavage of the joint is not as innocuous as it seems! Once the range of motion is restored and the alleviation of pain, if present, is eliminated I would then proceed with treatment.
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I couldn’t understand some parts of this article, but it sounds interesting
Mary,
Often restricted mouth opening is a congenital anomaly that can be treated. One possible reason for the restricted mouth opening for example is called Coronoid Hyperplasia. In other words, the hinge of the lower jaw is “hitting” the cheek bone and thus preventing the full normal rotation. A fairly simple recontouring of this part of the jaw bone can greatly improve your opening, even possibly doubling it! To see if this is actually the problem with your case, you’ll need to get a CT scan of the Jaw and confirm this. Not only will this let you have the implants done but it will also improve your ability to eat, chew, etc. If you have any further questions, please don’t hesitate to contact me!