Expert: Joel S. Teig, DMD, Diplomate ABOMS, retired - 12/14/2009

Question
QUESTION: I had 3 implants on the upper right 3 yrs. ago.  When the final caps were put on, I had a burning sensation where the cap met the gum tissue, but only on the pallate side.  The dentist removed the caps and placed a temporary bridge using the same temporary cement used originally since I didn't have the problem then.  That was one year ago.  I still have the temp bridge on because the final bridge never fit properly.  Just recently, a few weeks ago, the tissue on the pallate side around the implants is receding rapidly.  I had another implant since then, by another surgeon and he can't figure out why I would get this burning feeling.  I have been to at least 12 different dental people, and no one knows why I would have the burning sensation.  The implants are secure.  Someone suggested I get a bio-compatibility test to see what materials I may be allergic to.  I brush, floss, use a water pik, and I still have burning on the implant side, and just in the last few weeks, the gums are receding that I could see some of the metal abutments.  What are your thoughts and suggestions.  Thank you



ANSWER: Patricia - Your gum recession, although not very common when the implant placement is done properly can occur if you are allergic to or not bio-compatible with the metal material of the implant.  I don't know which type of implants were placed, but different materials are used in different implants.  If oxygenation of the metal used in your mouth occurs, then that alone can produce the inflammation to cause recession.  

I agree with the person who advised you to get a compatibility examination done.  My suggestion for this would be to contact an allergist and see if the doctor can do it or refer you to a doctor who can.  I hope they can find the cause.

---------- FOLLOW-UP ----------

QUESTION: The implants used are Astra. Throughout the entire healing process of about 6 months, my mouth felt fine.  When the temp caps were placed, I felt fine.  From the very moment the final caps were cemented, the burning began.  I thought at first it was caused from removing the excess cement, but it never went away.  This may be an absurd question, but could the tool that was used to remove the excess cement have caused a galvanization effect of some sort?  (various metals coming in contact with each other?)  Or, if oxygenation has now occurred, what can be done to alleviate this problem?  Someone told me that you have to be your own advocate when it comes to your health, so I am still trying to solve the mystery.  After seeing 12+ dental professionals, nothing unusual is seen on the x-rays, they all say the gum tissue looks healthy, etc., but like I said previously, in the last few weeks the tissue at 2 of the implants sites is receding and the metal is showing.  It may only be less than a mm, but it worries me.  I am constantly aware of the implants from the moment I wake up, until I fall asleep. It is difficult to enjoy life. The sensation is actually causing me to have anxiety, so I am taking Xanax.  

Answer
Patricia - One thing that I did not say in my last answer, but might be a possible cause of the problem is the crown placed.  You did not say the type of crowns used, but if the crowns were made of a porcelain material fused to metal, then that may have caused the problem.  Two different metals when touching can cause a problem (almost like producing a battery or the mixing of metals could produce a corrosive coating.  

Rather than the metal instrument used to remove cement, I think you first need to discover the type metal used for the crown.  That combination of two metals could be the problem.  

If oxygenation occurred, I am not sure anything can be done. So the initiator of the problem could be two metals.  That is possibly reinforced with the removal of the metal crowns and replacement with the temporary crowns.  I am not a metallurgist so I cannot tell you if that is the cause.  How you find help with this is difficult for me to say.   You might want to contact Astra and ask which metals could possibly produce a problem.

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