Tailor Made

Long before computers became small enough to sit on your lap, Elena Fontanazza worked for IBM, testing and developing many of the systems that allowed Big Blue to become one of the worldwide leaders in modern information technology.

Elena Fontanazza needed special dental care following her oral cancer surgery. She got it from Dr. Fatmi.

Elena is very happy with the personalized care she receives from Dr. Fatmi

“I was a supervisor working with all the older IBM machines, and I really enjoyed it,” says Elena, a Brooklyn, New York native who later married and moved to Fort Lauderdale, where she became a beautician and eventually a homemaker.

Now 76, Elena also spent some time helping her husband run their family’s jewelry store before retiring about 16 years ago. It wasn’t long after she settled into retirement that Elena found herself back at work, this time fighting oral cancer.

“I had this tiny lump under my tongue, and I had to have surgery to remove it,” Elena says. “But they also had to remove some of my jaw bone, the back four teeth on the bottom left side of my mouth and a portion of the left side of my tongue.”

The portion of Elena’s tongue that was removed included the small membrane that attaches it to the floor of the mouth. To compensate for that loss, Elena’s tongue was attached to the left side of her jaw in a fixed position.

In the wake of her surgery, Elena underwent extensive radiation therapy to ensure the cancer did not return. It hasn’t, but the radiation treatments have greatly compromised the structural integrity of her jaw bone and remaining teeth.

Those issues have combined to make Elena a challenging case for any dentist to do even the most routine work on her. She learned just how challenging when the passing of her dentist forced her to look for a new one shortly after she recovered from her surgery.

After visiting with several potential replacements, Elena discovered that she would need “something of a specialist” going forward. The specialist she eventually chose is Naved Fatmi, DMD, of Regency Court Dentistry in Boca Raton.

Outside the Box

“With someone like Elena, you just have to think outside the box a little bit because you are limited in the number of extractions and procedures you can perform. You need to be very careful not to cause the patient any more harm,” Dr. Fatmi explains.

“You can’t just pull a tooth, for example, because the density of the jaw bone is much less than normal as a result of the radiation. Not only that, but her teeth are a little more brittle than usual as well, so all that has to be taken into account.”

Dr. Fatmi did take all of those issues into account immediately upon meeting Elena, who at the time needed to replace a failed upper left second bicuspid and needed crowns on her upper left lateral incisor, her upper right first molar and her lower right second bicuspid.

She also needed a filling in her lower right wisdom tooth, which Dr. Fatmi chose to keep in an effort to avoid doing further damage to her jaw, as well as a heavy fluoride treatment to reduce the chances of further cavity development.

The biggest challenge Dr. Fatmi faced was in replacing the failed upper left second bicuspid because it required removing the failing tooth – which could cause damage to the already weakened jaw bone – and replacing it with either a bridge or implant.

Implants are screw-like bodies that are surgically placed into the jaw bone. Over time, the implant fuses with the bone and becomes a solid unit upon which an abutment and eventually a crown are placed to give the patient a new tooth.

Dr. Fatmi’s recommendation, which Elena agreed to, was to replace that tooth with an implant. The implant, he reasoned, would provide more biting power than a bridge, which could damage the support teeth because it would have to be removed regularly for cleaning.

Depending on the patient, an implant needs three to six months to fuse with the bone. That’s why Dr. Fatmi chose to do that procedure first. While Elena’s implant fused, he repaired her other teeth, eventually completing the restoration in about a year.

Since finishing that initial round of work in 2013, Dr. Fatmi has continued to treat Elena regularly, about every three months, providing mostly cleanings and fluoride treatments. He reports that her overall oral health has improved markedly since then and is now sound.

“One of the things we wanted to make sure of with Elena is that she can smile and speak and chew her food properly so that she can feel confident leaving the house and being in a social atmosphere,” Dr. Fatmi states. “We achieved that goal.

“She’s not insecure about leaving the house or speaking to people or about the aesthetics of her situation at all. She’s very happy and in control and says she’s grateful she met us because she was being pushed from doctor to doctor after having her surgery.”

An “Excellent Job”

Happy may be an understatement. Elena says Dr. Fatmi has done an “excellent job” of keeping her teeth and gums healthy and has proved to be very conscientious and considerate of her special needs.

“I’d recommend him to anyone because when I first went to see him, he knew everything my surgeon had done and exactly how to proceed from there,” she says. “And he was very confident he could take care of my situation because he has the right tools and know-how to do it.

“For example, with me, he uses this special x-ray machine that doesn’t give off a lot of radiation. That’s very helpful for me, and it’s things like that that make me feel very comfortable with him. Dr. Fatmi is so good, even my husband is impressed with him.”

“That’s true,” confirms Paul Fontanazza. “Dr. Fatmi is a phenomenal dentist. He’s already saved two of Elena’s teeth, and he completely understands and provides the special care she requires as a result of her surgery.

“After we first met Dr. Fatmi, I said to my wife, You’ve got to stick with this guy, and now, she won’t go anywhere else. Her needs are met above and beyond with Dr. Fatmi.

“She’s absolutely enamored with him, and I see why, because he’s exceptional.”

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    • Regency Court Dentistry

      Regency Court Dentistry understands the importance of maintaining the health of your smile. This is why they offer a number of comprehensive general health and restorative dentistry services. From regularly scheduled teeth cleanings and den... Read More

    • Naved Fatmi, DMD

      Naved Fatmi, DMD, received his Doctor of Dental Medicine degree from the University of Florida College of Dentistry in Gainesville. Dr. Fatmi is an adjunct professor at Palm Beach State College. He is a member of the American Dental Society, t... Read More