E-consultation: Implant cap responses

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Implant cap responses

Implant cap responses
Added: June 04, 2007 - 5:56 PM
By: Patient Email Withheld, Pembroke Pines, FL

Need Dentist / Specialist: Yes
Provide Cost Estimate: No
X-rays Available: Yes

Case Summary

Crown
Teeth: 18
Last Full Mouth X-Ray: 2006
Last Cleaning: dec 06, apt june 7

Case Description

Thank you all for responding. I went to see the dentist (periodontist) who wrote the clinical update on splinting. He agreed that the implant cap should not have been splinted to a natural tooth and called my prosthodontist to fix the situation. I will see him on Wednesday. By the way, I am not Mrs Cook and the tooth is #19. The consultant advised that the implant was too narrow. He said that it was also loose. He felt that the size of the implant has caused the implant cap to come loose. My prosthodontist also thought this. He advised a wider abutment or redoing the implant or putting in two implants. The xray shows bone loss beside the implant. Another suggestion was building this up. I have had other opinions on this matter on this site. Some dentists think that the width of the implant should not matter if the implant cap was fitted correctly. Any opinions on this.

The implant was put in by a very fine dental surgeon. I find it hard to beleive that he did not put in the correct implant size.

Does anyone have an opinion on this new matter. I really do not have pain now, but it is not entirely comfortable.

I have advised the two dentists to confer, since I am sure the dental surgeon will say that it is the prosthodontists fault.

I have spent over $2500 on this tooth and am entirely frustrated.

M.K.

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Reply: Implant cap responses
added: June 04, 2007 - 7:30 PM

My apologies. I am often asked to be a consultant on many cases and a well known dentist in your area had forward some documentation about a patient problem. At anyrate, in regards to your current situation. Implant failure is a problem especially when bone loss is beginning to appear on the radiographs. For the most part the surgical procedure is very straightforward. It is often ideal to place an implant according to the size of the missing tooth, but there are times that a less than ideal size has to be implemented due to anatomical insufficiencies. Now certainly I cannot completely grasp all the details why the implant surgeon placed a smaller than ideal implant and why he did not augment the area prior to surgical placement, but the end result is that the prosthodontist has to be the team leader in the placement and restorative phases of treatment. If a smaller implant is placed, then the restorative dentist has to put a subanatomical crown to restore the area. Otherwise making a fully anatomical crown would cause too much tortional force that would loosen the screw. This is issue needs to be resolved. From what I''''m hearing, the area may need to be retreated.

Reply: Implant cap responses
added: October 11, 2007 - 11:32 PM

Wow, you definately have had an ordeal as I keep reading on (again monthes later). I am so sorry to hear about your frustration -- I would be very frustrated too! You know a really good place to get another opinion and help that would not cost you a lot -- Nova Southeastern University Dental School. This is in Davie on University Dr just off 595. I went to school there. They have an outstanding periodontal department. If you would like assistance in getting in there for an evaluation, please call my office 561-433-9694. I would love to help you anyway that I can. Dr Miriam Rubano

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