Has anyone had experience with dental implants either individual teeth or for dentures? ??? infection or failure v long term success?
I've had CLL for 15 plus years
had FCR in 2018
V + O for 18 months ending in August 2024
I'm now missing 8 teeth due to failed crowns root canals etc and All my teeth have issues and I know they won't last through the next treatment for CLL I'm guessing will come in 3-4 years with further immune compromise. 4 have broken off at gum line in past few months just chewing gum.
front 16: 8 top had all enamel scrape off backs and 8 bottoms had tops wear down to bone within 2 months of starting V + O. they were covered with composite to buy time. During V +O had nearly every remaining tooth filled for decay despite following all the recs to avoid cavities and tons of work done in the preceding 3-4 years
Various docs have vastly different recs
Doc 1 dentures with implants in a day no big deal but oncologist says risky
Doc 2 says implants with bone graft and no rear 12 molars for 8 months while healing after graft followed by implant placement and no partial denture during those 8 months because it would interfere with healing SO JUST eat purée for 8 months
Doc 3 afraid to put in implants due to immune compromise
Everyone says non-implant dentures will lead to malnutrition
Anyone have any data or experience with this?
Thx
Skipro
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skipro
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I have had CLL for 16 years but am asymptomatic and my WBC and Lymph counts are in the 40s Still in Watch and Wait Have had an implant a year and a half ago with no problems.
Best of luck to you. I have had 1 implant prior to treatment. No bone graft. I had lots of inflammation and had to have a redo. I keep praying that my teeth hold up during my treatment. Best time to do it would between your treatments. Let us know how your tooth journey goes. Very relevant to a lot of people.
Hey sorry to hear that Skipro. I wonder why everyone says non-implant dentures would lead to malnutrition? I find it strange? My mum is 66. She had to make a similar decision last year. She doesn't have CLL (thanks God). After a lot of consideration, she decided to go for non-implant dentures. She was very worried and it was really hard mentally ...but she said it was the best decision and that she should not have waited for so long. She is very happy with the final result. I have to say that even with the non-implant dentures it was a very long process. It took good 6-9 months before she got her final "design" and it settled and became pain free...she can eat better now than for the last couple of years before she got her dentures as she had periodontitis, lots of missing teeth, wobbly and painful teeth.
I thought sharing her positive experience might give you a different perspective.
In theory with non-implant dentures you only have "20%" of bite, with removable implants 40% and with implanted 80%. I've only known 4 people with non-implant dentures and they were NOT malnurished ???????
I get that your bite isn't as strong as your real teeth/implants but that doesn't effect how much you eat? And how nutritious your meals are, does it? My mum can't eat certain things because it's hard to bite/chew - e.g. chips🙂 - since those are not very "nutritious" she isn't missing out. I personally think the malnutrition thing is a nonsense which helps to sell the very expensive implants 😀good luck whatever you decide to do🙏🏻
hi Skipro ,,,my mother in law who had dentures 60 years ago was at least 50 pounds over weight when she died .. ..my grandmother had NO teeth and was a normal weight when she died .. so this malnourished statement is really a mystery to me ... thanks for posting your experience ... I have had real problems with my teeth since starting treatments as well .. I noticed the steroids really started the rapid deterioration of my teeth .. they are even decaying under my crowns .. hope you find a durable solution ..🙏 blessings , James
I have been on watch and wait 10 years. Last year decided denture not implant. Only after paying was I told that the denture can cause plaque under it but I reduce that to a minimum by using denture only for eating. I wear mask when seeing people so it's not a problem for me. I still wouldn't want an implant, but it's a personal choice
I've had two successful implants while on W & W. One included bone augmentation, not bone graft. No problem with infection and I'm very happy with the results. Have you spoken with an orthodontist?
I spoken to several dental and oral surgical specialists as well as my oncologists. Some are super cavalier about implanted dentures while others warn of high catastrophic failure rates.
I've had chemo in 2018 and again 2023-2024 and was severely immune compromised by the treatments. So I'm concerned about infection.
I’ve had three implants over six or seven years, two with bone grafts. No problems at all. For one I had to pause treatment for a week either side to avoid the risk of excessive blood loss during surgery. All three cleared by different hematology consultants.
How did they stage or time the steps for your implants?
Do you mind my asking which type of treatment you had and whether you had low IgG, or low Neutrophils or platelets?
2 of the docs I've seen said stage 1 extract and bone graft followed by 4 month wait, stage 2 insert implants followed by a 4 month wait, stage 3 finally get the teeth attached after 8 months with no rear molars.
Two docs pushed dentures in a day, and their counterparts said these have high failure rates????
Hi Skipro. I was on FCR and then Venetoclax at the times concerned. The implants seemed to take forever, but not as long as they’ve told you. One at a time as teeth became compromised, and each one staged over about four or five months to allow the gum to heal and bone graft to take.
I had poor readings for IgG and platelets. Because of the latter they took special precautions during the surgical part. Extra padding, more time in the chair etc. But I was fine.
I would always go for a permanent implant solution myself.
I have had 4 implants while on W&W. My dentist gave me a course of very mild antibiotics after each procedure. He was worried in case of bleeding but the Hospital told him that there should be no problem.
How did they stage or time the steps for your implants?
Do you mind my asking which type of treatment you had and whether you had low IgG, or low Neutrophils or platelets?
2 of the docs I've seen said stage 1 extract and bone graft followed by 4 month wait, stage 2 insert implants followed by a 4 month wait, stage 3 finally get the teeth attached after 8 months with no rear molars.
Two docs pushed dentures in a day, and their counterparts said these have high failure rates????
They checked my bone and said I couldn't have an implant towards the back was too shallow. That would have needed a bone graft. But all the other areas were fine. I had two done on one side, then two on the other. Each side needed the titanium "pole" to be inserted and allowed the gum to grow round for 2/3 months, then the actual porcelain crown bit was capped on.
I had my teeth extracted and the denture put in on December 13. I am just started to be able to chew meat due to canker sores that the dentures rub against. I'm very happy with these new teeth and know that once they're lined in March they will not wiggle around and cause sores.
I had my dentures put in right after extraction of all my teeth. Unfortunately I ended up with canker sores from the freezing injections (I always did). This was done on December 13th and I'm still having problems with mouth sores. I get the dentures lined on March 17th and I'm hoping that my sores have healed by then. I still wear my dentures every day with denture adhesive to minimize slipping. The gums healed from the extractions within weeks and I wear the dentures to make sure that the gums keep the shape of the dentures. I'm swishing with Peroxide to heal my canker sores, but I keep getting new ones.I could talk right from day one and can't yet chew because of the sores. My experience, of course, is not normal. Without the canker sores, I would have been fine in less than a month.
I two cents worth on timing of dentures. I had 16 teeth pulled at one time so gums were sewn up, making healing better without infections/dry sockets. I did not have teeth put in until after 2-3 months allowing the swelling to go down in gums which provided a much better fit. As a result I never had denture relined or altered for 43 years until they wore out. I suspect dentists make a psychological analysis of patient to see how they would react to people seeing them without teeth for extended time.
I did a fair bit of reading before the procedure. It seems "immediate denture placement" is what most dentists are now doing. As I said my gums healed within 2 weeks of the 18 extractions. It's the darn canker sores which I have always been plagued with. Wearing the dentures part time is helping them to heal along with peroxide swishing.
I have no id0000ea about the problems due to CLL, but i can say with certainty the dentures do not have to result in malnutrition. I have 6 bottom, front teeth ...... that's all. And that is since 1963. I eat anything I want. Of course I may have made some adjustments that I am not aware of over the subsequent 67 years.
I do hear that some folks have problems with dentures fitting well. Maybe that's a matter of insisting that your dentist keeps working with you til they get it right. It cound be that some jaw bones just will not take to dentures well. Talk to several dentists about this.
I had all my uppers replaced with implants 12 years ago had fcr in 2017 was in remission for 7 years but now just had my first rituximab infusion on a v+r treatment plan. Never a problem with the implants love the implants.
So upper implants about 2013ish, FCR in 2017 and just started V + R?
Did you get the kind that they call "dentures in a day" or did you have to have it all staged? I'm asking because
2 of the docs I've seen said stage 1 extract and bone graft followed by 4 month wait, stage 2 insert implants followed by a 4 month wait, stage 3 finally get the teeth attached after 8 months with no rear molars.
Two docs pushed dentures in a day, and their counterparts said these have high failure rates????
And no infections in the teeth during FCR??? Any Neutropenia with FCR?
I had FCR in 2018 and became Neutropenic for a year and only completed 3 cycles. I also developed a nearly fatal inner ear skull fungal infection that has since cleared.
I took the long route did exactly as you 1st Dr described he did a really good job kinda pricy but after having temporary upper plate these implants are just like your real teeth with none of the problems. When I had FCR I would give myself a nulasta shot to jump start my neutrophils I did six cycles without problems. I’m curious about your ear fungus , I’ve been having problems with mine and can’t figure out what it is. I did have a lung fungus because of low neutrophil but have that under control. What was your symptoms for your ears ?
skipro, so sorry to read about your various dental travails. Glad you've reached out to get some ideas, advice, questions to ask, etc.
Chemo and those other treatments you've had will make a bad situation worse, immune system wise. And a damaged and/or non functioning immune system can lead to lots of problems, including increased inflammation, vulnerability to infection, etc.
So here are some questions for you:
Your bloodwork probably includes immunoglobulin tests. Look for the IgA, IgG, and IgM values. Are they below the normal ranges?
have you had your immune system checked by an immunologist?
In addition to the dental challenges, are you frequently getting colds, etc.?
Other signs of frequent infections?
Excessive fatigue?
If you're immune system numbers are low, and you've had lots of colds or infections, you may want to ask about getting gamma globulin infusions to improve your immune system.
Like you, i've been dealing with CLL for more than a decade. I've had traditional chemo as well as several of the new targeted therapies. And i've had several crowns installed during this period. Never had any issues with the crowns or the teeth themselves deteriorating and i was on various therapies. And my platelets were/are lousy, so i've got that bleeding risk, too.
Also, has anyone mentioned biotin as a supplement that may help promote bone growth, including teeth? I use it for other purposes--chemo did a number on my scalp and ibrutinib did a number on my fingernails.
During V + O, I was neutropenic for 7 of the 18 months on treatment.
I have had NO IgA or IgM for a decade and starting in 2018 get regular IgG infusions to keep trough above 600. Oddly, normal is about 800 to 1700 so I don't know why they strive for such a low trough.
I had a bunch of tests done recently by an immunologist. I have NO functioning B cells, and while I have good CD4 and CD8 T-cell numbers, the T cell function test showed poor function.
Waiting for immunologist to tell me what it all means.
Wow, you've had a really rough road. Even with regular infusions only getting to 600-700 units shows the deep hole you've been in. My own immunologist set a goal of 1000 units when i was below 400, and i was able to exceed it within four months. She just switched me off of any infusions to see what happens "naturally." Since my CLL is growing and i'll need treatment soon, i suspect my IgG will be back in danger territory and i'll be getting infusions again.
Good luck with the immunologist and with your journey.
My son is going through this now. He had a tumor in the jaw. It was removed along with several teeth. It took almost a year for bone graft to heal. He tried lower dentures, but did not like them at all. He is going to a company called Clearview Dental . The reason he likes this company,is because they have everyone on the staff that he needs to see including an oral surgeon. He does not have CLL so he does not have the complication that you have to be concerned about. The cost were just getting the lower done because of how complicated it is for him in particular is $21,000 unless you have a lot of teeth that need to be pulled and you bleed easily probably is not anything to be concerned about.
Thanks. I've been quoted anywhere from $4-6K for a single implant and $60 K for implanted dentures and about $25K for non-implanted dentures. I have medicare and the only dental plans I have found cap out payment at $2500 with $1200 annual premiums so I would be completely cash pay.
I found out that they only accept cash and no insurance at these offices. They will give you the papers and information to file if you have dental insurance, but they do not do it for you. They expect cash upfront. Thank goodness, my son has a nice mama.
HI skipro,Like you during V & O many of my teeth failed. Brand new gold crown had to be pulled 3 months later due to infection. Three crowns broke off at gumline and a two or three others kept crumbling as my dentist described it.
I did have two molar implants installed side by side a year prior to CLL treatment. I have had no problems with them what so ever. Almost a year post treatment now. I am planning to replace 4 to 6 teeth with single implants. One at a time so I make sure there are no problems with rejection. No more teeth breaking at this point. So I feel confident about starting the restoration work.
V & O was brutal on my teeth.
Hope you come up with a great plan that works for you. All the best to you.
I asked my doc about the effects of V + O and he said it wasn't related, but within 1-2 months of starting, only a rare tooth has escaped breaking or having all the enamel disappear
As an orthopedic surgeon, the only joint replacement surgeries that developed late infections I've seen in over 30 years were in patients who underwent cancer or lymphoma treatment.
A couple of cavalier docs said they could do dentures in a day with implants and that they "never get infected, even on chemo" cuz the mouth is different. There is supposedly a high neutrophil count in gums but both times I was on treatment I became neutropenic. So just wondering about the implants in the mouth being safer than say a hip or knee or shoulder?????
Second,
2 of the docs I've seen said stage 1 extract and bone graft followed by 4 month wait, stage 2 insert implants followed by a 4 month wait, stage 3 finally get the teeth attached after 8 months with no rear molars.
Two docs pushed dentures in a day, and their counterparts said these have high failure rates????
I have had partial and full dentures for 54 years. I have had very little issues with dentures, biggest issue is people get gum sores and don't want to wear their dentures enough to get used to them. Some people also wear their dentures 24/7, never giving their gums time to heal at night, due to concerns about how they look. I personally would not get implants due to possible MRI requirements down the road and they also weaken the jawbone. Maybe down to coin flip. Blessings.
i would call DR. Ramos office in algodones , Mexico near yuma . az. and talk to Christine and find out how much the dentures would cost .. a crown is $350 .. I have had 12 or 13 crowns and a bridge done in Mexico over the years .. its 2 blocks from the border .. you park your car in a large very secure parking lot and then you can just walk across..you need your passport card to come back ... I think I will call myself on Monday ,, I know I will be at your stage probably sooner or later .. thanks again for all your questions to other members .. this is such a great forum .. 🙂
Just had what upper teeth I remaining( after 2 crowns deteriorated ) removed, decided to go with denture at recommendation of dentist and oral surgeon. Hx 24 yrs with CLL, age 83, on second trial BTK degrader AB-V 101 cycle 6 Phase 1A. Previous trial Pirto for 3 1/2 yrs, multiple other treatments. I based my decision on concern for infection,although healthy due require IVIG 4x yr. Did not want to interfere with clinical trial as often as implants would require. Oral surgery went well, healed fine. Dentist felt I should wait 6-8 wks for healing and she has done several molds,making adjustments. She insists this is important and may take several months till we get it right. I think I made the decision because I believe in her.😳Life is really a journey. Fran
I just went through this in the last two years in close to the scenario you posted. I was in remission from CLL/AIHA but the blood numbers were trending wrong. At the time my WBC was over 10,000 and platelets were around 80 to 90. I decided to go the route of "All on 4" implants. My dentist, who specializes in implants checked with my oncologist and they both agreed that the risk to me was not great, so I "bit the bullet" (so to speak) and decided to do the full on implant bridge.
My experience was not bad though not exactly what I expected. I ended up with no health issues related to my CLL/AIHA but the transition to the implants was not exactly what I expected as I had to utilize dentures for about 9 months as I needed bone grafting and then time to heal the gums from that. Additionally, I had to give the implants (which turned out to be five) time to heal.
I have had my implant full bridge in place now for about 8 months. I am still getting used to the "bulk" of bridge and the change in my bite but generally I am satisfied with the results. I will say the "All on 4" implant route is not inexpensive, but my options were limited. Having experience with both the dentures and implants, I would choose the implants again, though the bridge does require maintenance and upkeep.
As far as my health during this whole process, I was given antibiotics before and after procedures and never had any problems with infection or rejection of the implants. It is very important (read critical) if choosing implants that the Dentist doing the work is experienced and good at his/her craft and that quality materials be chosen for the implants and new teeth.
Good luck to you on whatever route you choose. Dodger47
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