[DVY]

(04-12-2013 01:36 PM)tjuan Wrote:  

How can you make a dentist, or periodontist, accountable for their quality of work? Legally, I've learned there is a lot of leeway in what is acceptable, regardless of what they were hired to do.
I had implants placed that everyone shakes their heads at, placed too facial, required bone grafts (when placed they broke through the bone facially), the temp caps are still on because the ceramist does not know how to work with them, temps being thinner than ceramic the temps are aesthetically better.. What I learned through my lawyer is that since the implants do not need to be pulled -- they are functional, but not aesthetic (the reason they were placed, the reason I went through years of orthodontics only to have a botched implant job) -- it is considered "good", the periodontist has fulfilled his roll, there is nothing I can do. So, my understanding is as long as the work is "functional", as long as that implant is not going to wiggle or fall out, it is not malpractice, even though desired goals were far from achieved, the margin of error seems extreme to me. If I ever have a dental work again, I want greater accountability for their quality of work than law finds acceptable.
Interesting thread, thanks for taking the time to answer the posts.

@tjuan- I am sorry to hear of your unfortunate experience. This type of behavior really pisses me off. From your case, it sounds like you had a diastema (space in front of central incisors), they moved the teeth to accomodate space for implants.

I wish I could offer advice, but this case sounds like a case failed by poor diagnostic planning. Each specialist took a bite out of your wallet, and yet blame is hard to lay, because each person did "his job".

Heres how I see it. Orthodontic guy did what he was asked. What he didn't warn you about is that bone thickness might not be enough for implant placement. In his mind, he just creating space for the implant.

The periodontist was responsible for placing an implant in a correct orientation but didn't have enough bone, so he placed it at angle. The ceramist didn't have a way to properly restore these implants in aesthetic manner. Fail. Bigger Fail. Forehead Slap.

What is done is done. And there is no use crying over spilt milk. I would go to the periodontist and explain the situation.

"The implants were placed at an extreme angle and the buccal bone fractured. According to the laywer I consulted, I believe this is below the "standard of care". I am fairly upset that I went through this procedure and you failed to mention that I might need a bonegraft prior to implant placement. I believe I am entilted to a refund for the implants placed "

Very often, my father and I refuse to take implant cases because of insufficient bone or insufficient space to restore the case.

One option is to leave everything as is.

Very likely, in your case, the best option for aesthetics and fucntion is a bridge or bridges. You can cheat a little on the dimensions/space limitation because you now involve 3 or more teeth instead of 1. This same principle is why veneers look good- take a little here, give a little there.

Use the money from the periodontist and tell the general dentist that you are upset that this case worked out so poorly, but would like him to fix it. Is their any chance they can give you a break on the work? Usually, theyll give you some kind of break.

Thats how I would play it...

Disclaimer- I haven't neither seen your case personally, nor do I know all the facts. Based on what you have told me, I think this would be the best option for all parties invovled. Send me a PM if you would like to discuss this further.