As you know, my journey to dental implants has not been the smoothest of travels. We’ve had to fight to get insurance coverage. I mentioned in my Journey to Dental Implants Part 3 post that we do finally have letter in hand, from Blue Cross Blue Shield of Illinois (our insurance carrier) stating that the surgery is medically necessary. They’ve also agreed to will cover a portion of the charges. Which brings us to the next stage in my journey!
The Journey to Dental Implants Part 4
Dental Implant Surgery
Before Dental Implant Surgery
With that letter in hand, and at long last, I finally had my surgery for zygomatic implants and mandibular dental implants Friday, October 5th, 2018 at UIC . Just 455 days after submitting the treatment plan. We had to arrive the day before for a pre-surgical consult with my prosthodontist, Dr. Stanford.
We did have to pre-pay $17,500 out of pocket for my surgery. $16,000 was to UIC, and the other $1500 was to the anesthesia company.
For what it’s worth, it only takes about 2 minutes to spend $16,000. #sigh
After we were finished in clinic for the day, we went to the Embassy Suites by Hilton Chicago Lombard Oak Brook. It would be our little home away from home for the weekend of my surgery. Because of the nature of the surgery, and the fact that I had to follow up in clinic on Monday, October 8th, it just made sense for us to stay close by. That said, we chose the Oak Brook location because hotels in the medical district are crazy expensive!
The morning of surgery we had to be at UIC bright and early. I signed a bunch of paperwork, chatted with my surgeon, Dr. Miloro (he’s
the Chief of the Department of Oral and Maxillofacial Surgery at UIC), and then handed over my dentures.
The implants I received are made by Nobel Biocare. Nobel Biocare is the developer of the NobelZygoma process, which is an amazing clinical option for patients like myself who are not candidates for complex bone-grafting procedures, or for those who wish to avoid those bone grafts. With NobelZygoma implants, the implants are anchored in the zygomatic (cheek) bone. Nobel Biocare also has the All-on-4® treatment concept, which is a cost-efficient, graftless solution that allows patients to leave with a fixed full-arch prosthesis on the day of surgery.
The National Foundation for Ectodermal Dysplasia (nfed.org) has worked with other implant developers in the past to secure implant donations for patients like myself, so before my surgery I reached out to Nobel Biocare. I explained our situation with the insurance denials, out of pocket costs for surgery, and the fact that our son will one day need the same kind of surgery and asked if there was any way they could help. Lindsey, a representative from Nobel Biocare let me know that she’d submitted an application for hardware donation on my behalf.
She arrived after I’d been placed under anesthesia, with hardware in hand. Since I’d already taken ussie’s with both Dr. Stanford and Dr. Miloro, Hubs knew how important it would be to me to document the occasion, so he grabbed an ussie with her. The donation of the hardware should reduce our total of pocket by about $1500, which is a HUGE blessing!
I am not required to mention the hardware donation from Nobel Biocare, but why wouldn’t I?
After Dental Implant Surgery
Initially we were told that surgery should last around four hours, with the goal of placing the four zygoma rods and four mandibular implants in that time. Due to the amount of scar tissue from previous facial surgeries, the zygoma implants took four hours by themselves.
This is my face with the implants. Because I have so little facial bone, they had to reconfigure the placement of the zygoma implants.
While Dr. Miloro was working on installing the zygoma implants, Dr. Stanford was working on modifying my existing top denture to be a temporary fixed plate. After the both the zygoma implants and mandibular dental implants were placed, I was roused and taken from the oral surgery clinic to the implant clinic.
The plan had been to install the upper temporary fixed plate while in the operating room, but the surgery ran so far over that they weren’t able to install the upper while I was knocked out. So, with the aid of a few numbing injections, the upper plate was installed in clinic.
Dr. Stanford had to keep my lower partial denture over the weekend in order to modify it into a temporary fixed plate. Since it had originally had openings for the two natural teeth I had (which were extracted during surgery), those areas had to be filled in and the entire bottom surface had to be redone since it would need to sit atop my gum rather than mold around it.
The progression of swelling and bruising in my face from Friday to Monday would have been comical, had it not been somewhat painful.
Initially I had minor swelling and one black eye. By Monday, the swelling was significant and had I had two black eyes. I spent a lot of time with ice on my face in the hotel room. I don’t think most people swell and bruise as much as I did, but most people don’t have the amount of scar tissue that I had, either. I’d had my jaws broken and moved twice, bone grafting placed, and then had the titanium plates/screws removed from my face years before this surgery.
On Monday, we returned to clinic, where my lower denture was reinstalled as a temporary fixed plate. Just as my face had swollen, my lower gum had swollen, so a few more numbing injections were required to install the lower plate. After that was installed, we drove home from Chicago to St. Louis.
I felt a bit better each day, with the swelling and bruising both improving progressively. At two weeks post op I am beginning to feel like myself again. I can sort of smile. I am still on a liquid diet because I can’t chew anything and I can’t open my mouth wide enough to get a spoon into it, either.
The implants have to osteo-integrate (i.e. bone has to heal around them) before we can start the next step, which is to take impressions for my final fixed dentures. I’ll return to clinic on January 4, 2019. At that time, the temporary plates will be removed and the incisions, etc, will be examined. I’ll have xrays done to make sure the bones are doing what they should. IF it’s safe to do so, we’ll start impressions. If not, we’ll wait another month or two and go from there.
Once upon a time I said that I wanted dental implants so that I could sing in worship without having to worry about picking my teeth up off the floor. I cannot wait until I feel like singing!