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  • Writer's pictureFayette Williams, DDS, MD

How can my teeth be replaced?

Updated: Mar 12, 2021

One of the most frustrating aspects of treating jaw tumors involves the loss of teeth. These teeth are usually "innocent bystanders" which are removed because they sit in the affected jaw bone. Unfortunately, we must prioritize tumor removal over saving teeth. It's rarely a good idea to take chances and risk tumor recurrence in order to save teeth.

The greatest challenge to replacing teeth after tumor surgery is not the bone, but the soft tissue. Changes in the shape, thickness, and quality of soft tissue make the lining of the mouth different from the normal gums. This can be due to scarred tissue, missing tissue, and thickened tissue such as skin from the leg (you fibula patients know what I mean). This often prevents the use of traditional dentures.

These soft tissue challenges can usually be overcome with dental implants. Rather than having a denture sitting on mobile soft tissue (which only produces a mobile denture) the implants provide anchors in the bone to secure a bridge of teeth. Dental implants can be thought of as "artificial roots" which allow crowns or a bridge to be attached.

The greatest challenge to replacing teeth after tumor surgery is not the bone, but the soft tissue.

Additional soft tissue challenges include mobile tissue around implants. Your normal teeth emerge into the mouth through gums which are fixed to the underlying bone. These "fixed" gums are more durable than the thinner tissue that lines the cheek. Unfortunately, the more durable gums often have to be removed with the tumor to ensure complete removal. When this less durable mobile tissue surrounds implants, this usually results in irritation, pain, and inflammatory tissue growth as the mobile tissue rubs against the implants. There are multiple ways to place more durable tissue around implants including grafting from the palate and sometimes from skin of the thigh.

Remove Your Tumor, Replace Bone and Teeth in One Procedure

In many cases, it is possible to perform an immediate reconstruction of the jaw bone as well as the missing teeth. This involves placing dental implants into the new bone and attaching new teeth at the same time. These teeth are temporary and are later replaced with the final teeth after the implants have fused to the bone. These temporary teeth allow smiling and soft chewing during the healing phase which lasts 3-6 months. With digital technology and 3D printing, Dr. Williams has developed new techniques to provide this surgery and performs it routinely. This procedure was first performed in England by Dr. Iain Hutchison and Dr. Andrew Dawood in 2007. Almost a decade later, the "Jaw in a Day" name was trademarked.

Before surgery, all the teeth are intact but a tumor fills the jaw under the surface.

Xray before surgery showing ameloblastoma in the chin region

Several hours later, the patient wakes up with the tumor gone and new bone, dental implants, and new teeth in place.

Dr. Williams lectures across the USA teaching other surgeons how to perform this surgery. He has published his technique which is the first to use in-house 3D printing to expedite treatment and lower costs. Traditional methods for immediate implants and teeth require 3rd party dental labs which only cause delays and extra costs. His surgical group is the first in the country to build their own 2000 square foot 3D printing surgical lab specifically for complex dental implant reconstructions. Dr. Williams is the course director of an educational course to teach other surgeons how to perform this surgery at .

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