Yes, there is a question at the end, but without context, it would be difficult for one to respond. Please read on ...
New crown for tooth # 14 in Mar-24. No problems with prep or temporary crown. However, sensitivity post the permanent crown, which eventually led to an abscess. Took antibiotics for a week, but still no change. A faculty periodontist felt it was caused by the jaw bone being too close to the crown. A faculty oral surgeon did a “clinical crown elongation, hard tissue”.
While shaving down the bone between tooth # 14 and 15, the surgeon found significant loss of bone between 2 of the 3 roots for tooth # 14. This did not show up on the x-ray because it was being shadowed by the bone structure behind it. The surgeon then did a bone graft, and prescribed more antibiotics. A few weeks later, the sensitivity was still there. The surgeon re-opened the gum and found the infection was still there; he removed the failed bone graft.
Both student dentist and faculty members had no idea why the infection was still there. Supposition was that there might be a tiny fracture that was not showing up on the x-ray. The plan was to wait until a new 3D core beam x-ray machine was installed and retake the x-ray.
3D core beam machine arrives, x-ray is taken, and it shows there is still significant inflammation. But still nothing definitive to say whether it was being caused by a tiny fracture, inflammation possibly coming from the sinus, or a necrotic tooth.
Alternatives presented were:
1. Root canal with outside dentist (school will not do one through a crown). But no guarantee this would resolve the problem. Plus there is bone loss between 2 of the 3 roots, so I might eventually lose the tooth.
2. A bridge once the jaw bone heals.
3. An implant one the jaw one heals.
Alternative # 1 could be a $$ sinkhole. It might not resolve the problem, and could, in time, lead to alternatives 2 or 3.
Alternative # 2 involves additional work on 2 other teeth that are not currently compromised, and I am not a big fan of bridges, having had 2, 1 of which eventually failed.
Alternative # 3 is the way I decided to go.
This led to an extraction for tooth # 14, and a “bone placement graft for ridge” done to fill in some of the bone loss. The faculty member noted there was a 90% chance of this graft being successful when done immediately after an extract.
In summary, the after insurance payments to date are:
• $129.00 - Core buildup. Dental insurance also paid $129.
• $362.50 - Porcelain/ceramic substrate. Dental insurance also paid $362.50.
• $ 72.50 - Tooth extraction. Dental insurance also paid $72.
• $382.00 – Bone placement graft for ridge. Dental insurance paid $0.
$946.00 – My total costs for a crown that only lasted 6 months. Arg!
Through no fault of either the student dentist or the various faculty members, this happened. At no additional cost to me, they tried everything they could to resolve the problem (i.e. numerous follow-up visits with x-rays, various faculty inspections, a bone graft placement and removal when it failed). What happened to this tooth was, and still is, a conundrum for all!
Even after inspecting the pulled tooth, it was not clear there was a fracture (none could definitively be seen), nor any idea why this happened. Regardless, it did Fail!
The cost of the implant will be $2,510. After insurance, my cost will be $1,642.
• $145 – Core beam CT capt&inter
• $169 – Radiographic / surgical index
• $895 – Surgical placement of implant
• $1,301 – Implant supported porcelain / ceramic crown
$2,510 – Total crown cost
Question: Given the circumstances, is there a case to be made that the dental school should absorb some of the cost of the now needed implant? And if so, what implant procedures should they write off or discount?
Or asked another way: What, if any obligations should the dental school have toward giving me some dollar discount on the cost of an implant?
New crown for tooth # 14 in Mar-24. No problems with prep or temporary crown. However, sensitivity post the permanent crown, which eventually led to an abscess. Took antibiotics for a week, but still no change. A faculty periodontist felt it was caused by the jaw bone being too close to the crown. A faculty oral surgeon did a “clinical crown elongation, hard tissue”.
While shaving down the bone between tooth # 14 and 15, the surgeon found significant loss of bone between 2 of the 3 roots for tooth # 14. This did not show up on the x-ray because it was being shadowed by the bone structure behind it. The surgeon then did a bone graft, and prescribed more antibiotics. A few weeks later, the sensitivity was still there. The surgeon re-opened the gum and found the infection was still there; he removed the failed bone graft.
Both student dentist and faculty members had no idea why the infection was still there. Supposition was that there might be a tiny fracture that was not showing up on the x-ray. The plan was to wait until a new 3D core beam x-ray machine was installed and retake the x-ray.
3D core beam machine arrives, x-ray is taken, and it shows there is still significant inflammation. But still nothing definitive to say whether it was being caused by a tiny fracture, inflammation possibly coming from the sinus, or a necrotic tooth.
Alternatives presented were:
1. Root canal with outside dentist (school will not do one through a crown). But no guarantee this would resolve the problem. Plus there is bone loss between 2 of the 3 roots, so I might eventually lose the tooth.
2. A bridge once the jaw bone heals.
3. An implant one the jaw one heals.
Alternative # 1 could be a $$ sinkhole. It might not resolve the problem, and could, in time, lead to alternatives 2 or 3.
Alternative # 2 involves additional work on 2 other teeth that are not currently compromised, and I am not a big fan of bridges, having had 2, 1 of which eventually failed.
Alternative # 3 is the way I decided to go.
This led to an extraction for tooth # 14, and a “bone placement graft for ridge” done to fill in some of the bone loss. The faculty member noted there was a 90% chance of this graft being successful when done immediately after an extract.
In summary, the after insurance payments to date are:
• $129.00 - Core buildup. Dental insurance also paid $129.
• $362.50 - Porcelain/ceramic substrate. Dental insurance also paid $362.50.
• $ 72.50 - Tooth extraction. Dental insurance also paid $72.
• $382.00 – Bone placement graft for ridge. Dental insurance paid $0.
$946.00 – My total costs for a crown that only lasted 6 months. Arg!
Through no fault of either the student dentist or the various faculty members, this happened. At no additional cost to me, they tried everything they could to resolve the problem (i.e. numerous follow-up visits with x-rays, various faculty inspections, a bone graft placement and removal when it failed). What happened to this tooth was, and still is, a conundrum for all!
Even after inspecting the pulled tooth, it was not clear there was a fracture (none could definitively be seen), nor any idea why this happened. Regardless, it did Fail!
The cost of the implant will be $2,510. After insurance, my cost will be $1,642.
• $145 – Core beam CT capt&inter
• $169 – Radiographic / surgical index
• $895 – Surgical placement of implant
• $1,301 – Implant supported porcelain / ceramic crown
$2,510 – Total crown cost
Question: Given the circumstances, is there a case to be made that the dental school should absorb some of the cost of the now needed implant? And if so, what implant procedures should they write off or discount?
Or asked another way: What, if any obligations should the dental school have toward giving me some dollar discount on the cost of an implant?
