Expert: Rafael Mosery,D.D.S. - 6/15/2009

Question
Dear Dr. Mosery,

I am getting an implant bridge for tooth # 22,23,24,25,26 and 27.(All six teeth are missing due to decay from a previous bridge that was on for over 20 years) The implants are on tooth # 22,24 and 27. My periodontist put the implants in and after 3 months he put in the permanent screw retained abutments and torqued them.  I have the Branemark System.  Tooth# 22 is a MKIII 4.0x15mm, tooth# 24 is MKIII 3.75x13mm and tooth # 27 is MKIII 4.0x15mm.  The Abutments are Nobel Biocare Multi-unit 1mm RP.  I am now in the process of getting the implant crown.  My Dentist is trying to charge me for custom Abutments even though my periodontist put in the Nobel Biocare Multi-unit 1mm RP and torqued them.  I have already paid the Periodontist for the abutments that he put in and torqued.  My dentist said she still has to put in custom abutments.  Is she correct? I am getting the screw retained implant bridge.  Dose this Branemark System call for multiple abutments?  I feel that I have already paid for 3 abutments and now she is trying to charge me for 3 more abutments.  

Thank you in advance for any help you may be able to provide.

Thank You,
Vivian

Answer
The dentist and periodontist should coordinate what gets placed on top of the implant.It should be the restoring dentist's call as to what type of restoration is finally placed and what type abutments used.At this time have the two of them communicate(which is what they should have been doing all along).Perhaps the periodontist could remove what was placed and give the restoring dentist the platform to place what would be necessary for the final restoration.The fee should be adjusted accordingly.Just my two cents.