Woman gets 1st lower set of prosthetic teeth in state

Donna Hamilton got a reason to smile Friday. And a new smile, too.

Hamilton, 53, became the state's first person to get a full bottom set of prosthetic teeth implanted during a minimally invasive, 90-minute surgery, according to the maker of the new technology.

The Tuscaloosa mother of three and grandmother of five, plagued all her life with tooth problems, has been without her top teeth for eight years and bottom teeth for three. She has worn dentures since then, but the bottom set doesn't work well and pops out easily, which is a common complaint.

She has lived with sore gums and having to use a sticky glue to affix the bottom dentures. Even so, the dentures move or fall out when she eats.

With her new, permanently installed prosthetic teeth, Hamilton said Friday, she is looking forward to biting into an apple without having to cut it into small pieces. But mostly, she just wants to feel good when she smiles.

"I feel like I'll be more confident, have more self-confidence," Hamilton said. "With dentures, I don't like to have an open-mouthed smile. These new teeth look so real. They're just beautiful."

Dr. Kevin Sims, a periodontist, did the surgery in his Hoover office and Dr. James Sanderson, a general dentist, installed the prosthesis with the help of Dr. Holt Gray, a prosthodontist.

Hamilton had been considering teeth implants for some time. But the traditional implants are for one or a few teeth, and she said a full set would be prohibitively expensive. A single implant can cost up to $3,000.

An arch of prosthetic teeth like Hamilton's runs about $12,000 to $15,000, although she got a discount because she is the first Alabama patient to get the device made by Nobel Biocare of Sweden. (The parties involved wouldn't disclose the cost to Hamilton.) Insurance typically does not cover the cost.

The standard technique for installing a tooth implant takes six to 12 months, and often involves peeling back gum tissue for dentists to see the patient's jaw to determine how to proceed.

The new technology includes computer software that turns CAT scans and other images into a 3-D computer model. The surgeon uses the computer model to plan placement of the implants and sends the design to the company.

Nobel Biocare then creates the titanium arch for the prosthetic teeth and a surgical tool identical to the patient's jaw to guide the placement of the implanted screws. The teeth are added onto the titanium bar in a laboratory. The procedure got approval from the U.S. Food and Drug Administration in 2004.

Instead of months of healing between steps of installing the standard implants, a patient gets the images done on one visit and, once the prosthesis is ready, the teeth installed the next visit in a 90-minute surgery under local anesthesia and intravenous sedation.

"This will revolutionize the whole implant industry," said Sims, also an adjunct professor at the UAB School of Dentistry.

There are some limitations, however. A patient without sufficient bone into which to install the implant would still need a separate surgery to build up the site of the implants. Also, some patients are not able to get the prosthetic teeth installed on the same day the implants are placed.

Hamilton will continue to use dentures on the top; they are new ones made to match her new bottom teeth. Her upper jaw would need a bone graft to hold an implant, and the uppers would have added to the cost. For Hamilton, as with most wearers of dentures, the lower ones caused the most problems.

Sanderson, her dentist, said the kind of prosthesis Hamilton has can be life-changing.

"The mouth is a tremendously intimate part of the body," he said. "Having confidence in and around your mouth, in and around your smile, helps in tremendous ways."