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07.06.2024

Gum plastic surgery in the area of ​​a fallen crown on an implant

Patient Alena
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Time
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Complaints: a crown falling out from a previously installed implant in the area of the missing lower first molar on the left. Objectively: Deficiency of soft tissues (thickness + attached gum) on the buccal side. Treatment: a connective tis...
Complaints: a crown falling out from a previously installed implant in the area of the missing lower first molar on the left. Objectively: Deficiency of soft tissues (thickness + attached gum) on the buccal side. Treatment: a connective tissue graft was transplanted under local anesthesia, the fallen crown was fixed back onto the implant.
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Initial situation

Before

Patient Alena contacted the clinic with a request to fix the crown that had fallen out a few days ago back to the implant, which she had installed 4 months ago in another clinic in the area of ​​the missing lower first molar on the left. She brought the crown itself in her hands.

Before-X-ray

On the X-ray, you can see the installed and healed implant, on which there is no crown.

Before-contour

The easiest way, of course, was to simply fix the fallen crown in place. However, upon careful analysis of the edentulous area, one may notice a deficiency in the gingival contour on the buccal side. Lack of thickness and contour of the soft tissues surrounding the crown on the implant is always a high risk of problems in the future: gum recession (gum loss) and peri-implantitis (inflammation of the bone around the neck of the implant). If we leave this deficiency unattended and simply fix the crown back, then Alena will have difficulties with oral hygiene due to constant food getting stuck in the future.

Progress of treatment

Grafting procedure

Therefore, first, under local anesthesia, a small gum graft was transplanted to thicken the soft tissue on the buccal side of the implant.

Treatment – crown

At the same visit, a crown was returned on the implant, access to the implant was closed with a temporary filling, a control X-ray was taken, and Alena went home with the tooth.

After 2 weeks

After 2 weeks, the patient came for sutures removal and the filling blocking access to the implant was changed to permanent. Intraoral photographs show that the wound has healed successfully and the soft tissue appears healthy.

After 2 months

After another 2 months, the patient came for a follow-up examination, at which we saw that the transplanted graft had given the desired growth, and the contour of the gums in the area of ​​the crown on the implant did not differ from the neighboring teeth.

Comparing the initial situation and the result obtained, the difference between the initially “recessed” gum contour and the “smooth” gum contour obtained after transplantation is clearly visible. Now Alena will be able to easily care for her crown, and thick soft tissues will reliably protect the implant, allowing it to serve for many years.

Duration – 40 minutes

Cost – 1500 AED

Doctors who treated

Dr. Aleksandr Siniakov
specialist Oral Surgery, implantologist, periodontist;
languages: English, Russian
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