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My 17yo daughter had a fall and traumatized teeth 8-10. Teeth 8 and 10 have had root canals. Tooth 9 has been extracted and implant placed. Temporary pontic for 8-10 is in place and has been remade 2x for breaking and will only stay in for about 2 days before coming out again. After 1 month check up to periodontist, have been informed that part of her implant has loosened (I am assuming the temporary abutement since I do not see that structure in place any longer)but they will not remove implant to look into further until february as to not disrupt healing process. Periodontist states temp. bridge keeps coming out because lower teeth are putting pressure on it and this is a problem that they will have to try and figure out what to do because they state if the temp. keeps doing this then the finals will too. My daughter informed me that the dentist she went to see last week to have her temporary cemented back in filed her bottom teeth. She agreed to see her without parent present but did not get my permission to file her bottom teeth. Is there a chance that her implant is failing and if this keeps happening to her temps, what else can possibly be done to not have this issue constantly re-occuring. During implant procedure she had gum grafting done as well. Informed that in beginning of the year, she will have to have her gums lifted and rounded a bit more so finals will look proper. Any advice will be helpful at this time.

It's really hard to give an answer without physically examining the implant and the teeth next to it or at least seeing photos.
When anterior implants are placed they have to be placed in the correct position in relation to the teeth next to it and the opposing teeth (the lower teeth in your daughter's case).
In a 17-year-old what we usually expect is that the clinical crowns of teeth are short ie the length of the tooth from the gum line to the edge. Cement-retained crowns on implants need room for the abutment and then the crown itself. When we have space issues the ideal thing to do, assuming that the implant is in the correct position, is to use a screw-retained crown rather than a cement-retained crown. The reason being is in screw-retained crowns the crown and the abutment are one piece while in cement-retained crowns the two are separate and that's why it occupies more space.

Hope this answers your question.
Dr. Elsafi


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Mohamed Elsafi, DDS, MS, FACP


I am a board-certified Maxillofacial Prosthodontist. I do head and neck prosthetic reconstruction for patients with congenital and acquired defects. This also includes trauma and cancer patients. I can answer questions about prosthetic rehabilitation of the head and neck area. I am also a board-certified prosthodontist and can answer questions about dental reconstruction including crowns, bridges, veneers, partial and complete dentures and implant restorations. I can also answer questions about TMJ problems. I can not answer about surgical reconstruction.


I am a board-certified prosthodontist and maxillofacial prosthodontist and have been practicing denitstry for over 15 years.

American Academy of Maxillofacial Prosthetics. American College of Prosthodontists.

I received my dental degree from University of Southern California. I did my prosthodontics residency at University of Florida and my maxillofacial prosthetics fellowship at MD Anderson Cancer Center in Houston.

Awards and Honors
Chief Fellow at MD Anderson Cancer Center.

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