Implant Adventure

[cheiden]

I've previously posted about my dental woes but only in threads by others. Thought it might be useful to others to share in a post that'll be easier to find.

Some time back a top front tooth had to be extracted. For anyone who ends up in the same boat, here are the major milestones.

Mid 2018 a top front tooth (#9, I think) became infected and painful. It had been a problem for quite a while. Was referred to a musician-friendly dentist, then to an oral surgeon, the to a periodontist, then to an orthodontist. Did I mention that this is expensive?

Extraction
The tooth was extracted and they discovered infection extending from the bad tooth all the way past the tops of several other teeth down one side. The infection caused significant bone loss. The doctor extracted the tooth and cleared the infection (about as fun as it sounds) then grafted bone to compensate. There was also gum grafting. Then there was some months for healing. Needless to say I had to quit playing for a time.

Braces
My teeth were crooked enough to interfere with the pending implant so I was sent to an orthodontist. I wound up with Invisaligns. In my case that has taken around 18 months. When my periodontist cleared it I resumed playing which I could do with the top Invisalign in place. It wasn’t too much of an adjustment. I wasn’t at my best but good enough for some important gigs (award show, musical theater gig, new year’s eve rock gig).

Implant
Once my teeth were straightened enough I returned to the periodontist and received the implant. Had to quit playing again for a time. Then there is a 3 month wait for the jaw to secure the implant. I’m in the middle of this now. Projecting forward…

When that is done impressions will be done to produce an abutment which is a device that attaches to the implant in the jaw and has a post that extends out of the gum line. Sometime later they will install that abutment then I think there’s some additional waiting.

Crown
I believe that this will be the typical impression taking, waiting for them to make it, and then installation. I suspect that I can resume playing shortly thereafter, hopefully before Christmas. At some time before the crown I will need to have my teeth whitened.

Quite a ride.
_________________
"I'm an engineer, which means I think I know a whole bunch of stuff I really don't."
Charles J Heiden/So Cal
Bach Strad 180ML43*/43 Bb/Yamaha 731 Flugel/Benge 1X C/Kanstul 920 Picc/Conn 80A Cornet
Bach 3C rim on 1.5C underpart

[JVL]

Patience and courage Cheiden !
All the best

[Vin DiBona]

That sounds like a true nightmare!
I hope everything heals properly and you can get back to playing.
R. Tomasek

[cgaiii]

And I thought getting the bridge across my front teeth (6 teeth total) was difficult! (Right now I have a temporary one that is just enough out of place to mess up my playing. I have found some workarounds but am warning the dentist of the problems with the temp.)
Best wishes for your recovery and resumption of playing.
_________________
Bb: Schilke X3L AS SP, Yamaha YTR-6335S
C: Schilke CXL, Kanstul 1510-2
Picc: Kanstul 920
Bb Bugle: Kanstul
Bb Pocket: Manchester Brass
Flugel: Taylor Standard
Bass Trumpet: BAC Custom
Natural Tr: Custom Haas replica by Nikolai Mänttäri Morales

[Rod Haney]

I went thru 2 sets of implanted full top sets both different from originals or each other. Big adjustments were required but I used each to try to improve original emb.. all I can advise is to just try to sound good and eventually you will quit thinking about the differences and things will fall into place. I went from slight underbite to slight overbite, to even. They each required me to change, but in time things got better than before.
Good luck, it’s a pain in the a$$ but can be worth it if you are a hacker like me And not making your daily bread
Rod

[Chuck's Committee]

I had braces for about 9 months then got implants for all my upper teeth a couple of years ago in Cary, NC. Not only are the new (zirconia) teeth beautiful, my trumpet playing is exactly the same as before. No worries.
_________________
Chuck Cox
1949 Martin Committee Deluxe #2 bore
1951 Martin Committee Deluxe #3 bore
1953 Martin Committee Cornet #2 bore
Do something with every note you play. Sometimes the rests are more important than the notes

[Jeff_Purtle]

Please take pictures. I had my crown redone on my front left tooth. I started the process in December 2018 and we finished before the 2019 ITG Conference in Miami.

I was very apprehensive to do it but the father of one of my local students is a cosmetic dentist and a former trumpet player and we discussed it with a plan. Mine wasn't an implant. How much was your total expense? Mine was $1300 and I am totally happy. It looks better and didn't change my playing at all like the original crown did before studying with Claude Gordon.

Where is your embouchure? More top lip? Mine is about ¾ on my top lip and toward my left centered over the tooth that used to stick out more. My issues before Claude I believe were because I used to play about ¼ on my top lip and when the crown was put on it was about 2mm thicker and 1.5mm longer than what I think it was before. The crown had basically taken away even more of the vibration of my top lip. When I moved my embouchure up with Claude my playing was so much better after a little getting used to it.

When we redid the crown we made it the thickness of the other tooth and made the length similar. We did a series of molds with the original crown and a temporary crown and revisions we did with the temporary until I was happy.

I went into the dentist's office with just the dentist, his wife as an assistant, my girlfriend, and myself with my trumpet. We did the mold at first and then he grinded on the old crown until we got it thinner and shorter. I played various things and it actually felt very good. That was a Saturday.

On Monday I went to the office after playing 3 days on it. Then, he made the temporary and I played on that about a week and I came back and we took off some more and I played on that for maybe another month and it felt awesome. He made the temporary crown completely by hand and it was great.

I did teeth whitening a month before all of this so when he matched the color for the temporary crown it was the color of my true tooth color.

The mold of that went to the lab with a 3D computer imaging system to copy the mold. We got it back and I didn't think it felt the same. I used it for another month or so and we took off some more and he agreed it wasn't exactly the same. Finally we took off so much that the color didn't look natural because of the opacity of the enamel finish on it.

We ended up sending it back to another lab where they did it again completely by hand and it was great. We are both happy with it. We also did some bonding to fix some discolored areas of my teeth too. He said that discoloration was from the antibiotics used at the time when I was a child.

The end result is great. It feels very normal unlike the previous crown and my playing wasn't effected at all.

Take your time and speak up if something doesn't feel right even if it's subtle. This dentist was so excellent to work with. My previous dentist for the original crown was when I was in high school and he didn't listen to me and thought it just looked good enough.

I really think my embouchure change with Claude helped this not be an issue too. There are some things that felt even better with the new crown. I also feel less self-conscious about my smile now. It was money worth spending.

Jeff
_________________
Jeff Purtle
Trumpet Lessons Online since 2004, teaching since 1983
MultiTouch book on Claude Gordon
+1 864-354-3223 iPhone w/ FaceTime
Skype: jeff_purtle

[blbaumgarn]

That you are willing to go to the lengths you are to return to playing the horn speaks volumes about how much you much enjoy it. Our prayers for a speedy recovery to playing and enjoying!
_________________
"There are two sides to a trumpeter's personality,
there is one that lives to lay waste to woodwinds and strings, leaving them lie blue and lifeless along a swath of destruction that is a
trumpeter's fury-then there is the dark side!" Irving Bush

[ackmondual]

Ugh.. I'll need invisilign, then about 1.5 years later, an implant. I'm told the recover times after an implant is minimal. I played when I had braces when I was younger. I'm assuming having invisilign should be similar.

[JonathanM]

Great thread with some nice contributions - thanks very much for sharing.

I had an Uncle that used to say, "We'll all die of cancer - if we live long enough." He was, as you can imagine, rather strange. But his thought process is right on. Our lives are extending so long now; they say many of us will live to near 100. We are living longer than our teeth (and some other body parts) can last.

Glad you've kept up with the horn; kudos to you. Best wishes, and again, thanks for posting.
_________________
Jonathan Milam
Trumpets: 18043B, 18043*, 18043 Sterling Silver +, 18037 SterlingSilver+, Benge 4x, Olds: '34 Symphony, '47 Super, '52 Recording
Flugle: Strad 182
Puje: American Belle
Cornet: Olds Recording & Super

[cheiden]

[Shark01]

I broke off a top center front tooth this Summer and my Endodontist recommended a post with a crown.....I told him to use a damn nail so I could play with full confidence. Now both top center front teeth have posts.

[cheiden]

[texasdav]

What a great dentist you managed to find!! One that understands brass playing. Lucky.

I am coming off a Smile Direct (like Invisalign) teeth adjustment. My lower teeth had been bowing out--and through the Smile Direct trays, the teeth have been pull back in.

It affected my embouchure, and several months later, I am still adjusting. Lost upper range--buzz point/mechanism changed.

Trying to sort our what to do with my lower lip--which used to be pushed farther out.

I could never play with the Smile Direct trays on my teeth--had to take them out.

Patience with yourself I recommend...and don't over practice. If something hurts...stop.

[cheiden]

The saga continues...

Saw the periodontist. First thing he asks, "Have you been playing the trumpet much?". To which I responded "no" because you never told me I could! Grrr. Anyway... Got a clean bill of health. To my surprise he didn't take impressions for the abutment as scheduled. Turns out my dentist told him she preferred to do so at the same time she takes impressions for my crown. Problem being that I can't see her until mid-December. Big delay. So much for having my face back in one pieces before the end of the year. And somehow I ended up with a $400 out-of-pocket for an envelope with some mystery hardware that I need to deliver to my dentist. Wouldn't be that bad but I was pretty sure I'd already paid for the entire procedure. More research is needed but I'm not amused.

Saw the orthodontist. Still have a tiny gap between two back teeth so three new Invisaligns. Oh well. Also found out that her office no longer routinely does whitening which is curious because the dentist who originally offered whitening and later declined told me specifically to have whitening done at the orthodontist. That said, she offered an at-home kit for $450 but no guarantee that it will do the job intime for the crown fitting. Not amused. After some research I've decided on DIY whitening with a well-reviewed kit from Amazon. Hopefully get that this week since whitening needs to end at least two weeks prior to crown color-matching.

Scheduled with my dentist to have my abutment and crown impressions mid-December. Out-of-pocket is a bit higher than expected probably due to the abutment which I thought I had already paid for. Again, not amused.

I still like my team but we need to work on communication.
_________________
"I'm an engineer, which means I think I know a whole bunch of stuff I really don't."
Charles J Heiden/So Cal
Bach Strad 180ML43*/43 Bb/Yamaha 731 Flugel/Benge 1X C/Kanstul 920 Picc/Conn 80A Cornet
Bach 3C rim on 1.5C underpart

[cheiden]

Update:
Late December I finally got my abutment and implant installed. Wasn't too dramatic but it left me fairly tender. They wanted me to play in the office but since they numbed my top lip that didn't work out so well. Later that night I did play for a bit but was too tender to do much.

After a number of days I played a bit more and felt that it took more effort to produce a buzz. A buzz cam easier when I made a more exaggerated effort to play with a "poo" articulation. Otherwise playing was alright and didn't hurt, a nice change. Soon thereafter I took a short vacation and opted not to play. when I returned I had a somewhat linger practice and still felt I need to "poo" my articulations.

A week ago now I had a follow-up with the dentist and discussed my playing. She spent a good while looking at the crown and filed off a tiny bit in the inside edge and to my surprise I got most of my ease of buzzing back. I also had her shorten the new crown to make it more even with the adjacent natural tooth. Getting much above the staff is still a chore but I'm not going to pass judgement until I've had more time to try and rebuild.

Saw my periodontist a few days ago for him to evaluate the abutment and crown installation. They observed noticeable swelling of the gum and concluded that excess cement was likely aggravating the tissue. For the better part of an hour they scrapped and picked below the gum line at the place where the crown meets the abutment picking out all traces of excess cement. Yeah,...about as much fun as it sounds. I'm now waiting for the swelling of this last procedure to abate before returning to playing.
_________________
"I'm an engineer, which means I think I know a whole bunch of stuff I really don't."
Charles J Heiden/So Cal
Bach Strad 180ML43*/43 Bb/Yamaha 731 Flugel/Benge 1X C/Kanstul 920 Picc/Conn 80A Cornet
Bach 3C rim on 1.5C underpart