This is monumental for me. Where do I begin? Maybe at the start, eight years ago when I lost my front teeth and my marginal mandibular nerve, causing my left lower lip to droop. This was during a couple of ops for head and neck cancer, a cancer that had occurred for the third time.
A prosthodontist in the Oral Health department made me dentures but I was only able to wear the top one and my left lip gave me a crooked appearance, a tendency to bite it and awful dribbling.
An implant to support my lip was ruled out by the cash-strapped department where we were told that head and neck cancer patients were very unlikely to get implants in the public system. Also, they said, an implant would fall out or possibly cause osteoradionecrosis because I’d had radiotherapy after the surgery.
Gradually, over the years after advocacy from patients and a review of HNC treatment in Auckland, more funds were given to the Oral Health department and implants were no longer ruled out. I saw a new surgeon because of my upper teeth traumatising my flap and he referred me again to Oral Health for possible restoration of my lip via supportive bottom teeth.
I think but I don’t know that the HNC team became a little less reluctant to put implants into patients post radiation as long as the area of operation was not radiated too heavily.
This time, just before Covid, they came up with a plan to insert four implants in my mandible from just left of centre to the back right. On those implants would be a plate cantilevered to fill most of my bottom jaw. The screws would go into the part of the mandible that wasn’t badly radiated.
Covid put paid to that plan for a year or so and then I had ANOTHER primary HNC, this time in my throat between my tonsils and voice box. Removable and replaceable with a flap from my thigh. Ghastly business but what kept me going was their decision to go ahead with the implant plan. I had the four implants inserted during my October surgery. They were buried under the skin but a few months ago one of them made its way through the gum.
So, yesterday, six months after the insertion of the implant screws I had them exposed and abutments screwed on them. It was a brutal experience – for the max fax surgeon. After three local injections I didn’t feel any pain. I just felt the ugly sensation of screws and screwdrivers and the surgeon and his assistant struggling mightily with the task. I’ve got bad trismus and it was so hard for them to get a good angle on the scalpel and screwdriver.
I felt like a frustrating furniture kitset. At one stage another young surgeon came in and said to my surgeon: “Good problem solving, dude.”
Today, 24 hours after the procedure, I feel fine. As expected there’s some swelling in my lips and one spot feels a bit sore where an incisor seems to press on my lip but it’s much less onerous than I expected. After all, they were going to do it under a general anaesthetic until I objected. Even with all the difficulty, it took just over an hour.
I’ll go back in a couple of weeks and have an impression made for a denture. Apparently the abutments will be unscrewed for that but the hardest part is done.
I have four bright and shiny metal plugs in my bottom jaw and so far they look just fine. Phew.