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Dentistry - Trying to improve results
Expert: Jeff Dalin DDS - 11/8/2009
Question
Hi, I had implants in #8 and #9 about a year ago. #8 was knocked out about 35 years ago, and #9 was extracted (year and a half ago) because of failed bridge. The oral surgeon who placed the implants said I didn't need any bone grafts. He used the 6 month method of osseointegration. This past summer I had porcelain fused to metal (high noble) restorations performed by general dentist. Last week I had a PFM (high noble) crown on #7 (for cosmetics-natural tooth didn't size up well with #8. The #7 crown has a gap between it and #8. If it matters my age is 44.
A different oral surgeon said that a bone graft should have been done before implants were placed. He suggested that I now get the crowns removed and that I get the bone graft, followed by bone contouring, and then have crown restorations. Do you know of non-surgical ways to help close this space?
I am seeing the general dentist this week and wondering if should I ask him to remake another crown? (I thave temporay cement on the crown he placed last week.) If I do nothing, is this gap a problem? Will this open space cause harm? I've attached a digital photo of crown on #7.
From what you see in the photo can you tell if the dental lab did a good job on #7? Also, do you know if nickel is a usual component of high noble crowns, and should I be concerned about it?
Thanks, Paul
Answer
paul
from what i can see, the contour on #7 looks okay. what i see is the concavity on #8. but that is not the fault of the dentist or the lab...it is the nature of an implant. sometimes this is unavoidable and the dimension of the implant is narrower than the dimension of the original root. what what i can see, the only way to get rid of this space is to redo the crown on #8 and make it more convex. i hope this makes sense to you. will bone grafting help? i am not sure. and your final question: nickel is not in high noble crowns. high noble crowns are made out of gold, platinum, and paladium. nickel is in the nonprecious metal crowns.
jeff dalin, dds
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