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Dentistry/Dental Crowns on Implants

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Question
I had a bridge on 13-14-15. Last year the rear and outer side of 15's porcelain chipped off. My dentist recommended dental implants on 14 and 15 with a crown on 13. Went through the entire bone graft and dental implant process. Porcelain implants were put on 14 and 15 and within hours, the porcelian chipped off 15 in the same spot as it did with the bridge. The crowns were remade with mostly metal and porcelain only on the outside of the teeth. Now 2 weeks later, the porcelain chipped again in the same spot - middle rear of 15 to center of outer side of 15.

What could be causing this that I can tell my dentist to be aware of as it seems he must be missing something?

Answer
Chris -  Of course, without examining you I cannot be completely sure, but the repetitive breaking of the porcelain usually means that the breaking is occurring from a mistake in the design to fabricate the crown.  The cracking and breaking of porcelain almost always occurs by the dentist's failure to balance your bite in the fabrication and placement of the crowns.  Too heavy of hitting of the teeth against the crown will frequently cause the porcelain to crack and fall off.  The dentist needs to be honest and properly repair and fabricate a knew crown.  He needs to be sure to balance the bite, not only when closing down, but when sliding the teeth.  

So the dentist is missing and he needs to understand and properly remanufacture or refer you to a dentist he knows who could do it properly.

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Joel S. Teig, DMD, Diplomate ABOMS, retired

Expertise

I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.

Experience

Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

Organizations
American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

Education/Credentials
BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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