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18.08.2023

Correction of an incorrectly fabricated implant crown

Patient Natalia
Date 05.08.2023
Time
Price

Patient Natalia came to the clinic with a complaint about a loose implant crown that had been fabricated and fixed 3 weeks ago. The patient had the crown placed in Russia, so she had no physical possibility to go to the previous clinic.

Diagnosis

Diagnosis. On clinical examination we see a ceramic crown in tooth 4.6 area, which is fixed to the implant with a screw connection. It is this crown-implant connection that has loosened and there is loosening of the ceramic restoration. This is a common problem with this kind of restoration. But it is not worth being afraid and worrying about it, because it can be easily eliminated with timely treatment. The main thing is to make sure that there are no accompanying problems.

Treatment progress

On the first visit, we performed the removal of the crown from the implant. Upon visual inspection of the restoration, it became clear that an incorrect titanium restoration base had been chosen, which could exert excessive pathologic pressure on the bone and soft tissues around the implant.

To make sure of this, it was decided to place the crown back and take a targeted X-ray. The image clearly shows that the crown does not fit into the implant and is pushing on the bone with its base.

What happens in such cases and, in fact, what has happened in the three weeks since the restoration was placed? When excessive pressure is applied to the bone, bone loss occurs because the bone tissue cannot resist such pressure. The pressure that the crown was pushing on has gone from underneath the crown and the restoration has come loose. If we were to fix the crown back in the same way now with the base resting on the bone, the bone would lose even more in a couple of weeks and the problem would be back. Eventually, this could lead to inflammation of the tissue around the implant – peri-implantitis, fracture of the fixation screw of the crown or possibly even loss of the implant. The patient was recommended to have a new crown made but she did not have the opportunity to do it now. We decided to correct the existing restoration. The crown was sent to the laboratory for the necessary corrections. In the meantime, a healing abutment was placed in place of the missing crown.

Treatment result

A couple of days later, we invited the patient to try on the corrected restoration. We placed the crown in the implant and took a control image. Radiologically, it is now clearly visible that the crown sits tightly in the implant, there is no pressure on the surrounding bone tissue. The patient notes that this time the placement of the crown was painless, unlike the first time, when she felt pressure and pain for a long time.

Recommendations

The patient was advised to have a new crown fabricated after all. At the very least, because this crown is now “seated” deeper and out of bite.

Timing

The whole process of working on this tooth took 4 days.

Cost

Correction of the crown on the implant – 800 AED

Doctors who treated

Dr. Eduard Ziganshin
general dentist, prosthodontist;
languages: English, Russian
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