Dental Implant Exposure
Dental Implant Exposure
As a board certified dental specialist, my practice is focused on dental implants, gum disease, and soft tissue grafting treatment modalities. Therefore, it isn’t uncommon for complex and unusual cases come through my door. The current case is no exception to this occurrence. This patient presented with a anterior dental implant with a ill-fitting crown. Clinically, dental implant exposure was noted with recurrent inflammation. The patient reported no symptoms or pain at the time, and his only concern was the poor esthetics. At first glance, I assumed that there was severe bone loss (peri-implantitis) around the dental implant. However, radiographically the bone level was adequate with no apparent bone loss compared to the initial x-ray.
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After some investigation, the dental implant was a NobelDirect Groovy One-Piece. The difference between this dental implant and others, is that the dental implant and abutment are all in one and not two separate pieces. Therefore, the abutment (supports the crown) is intended to be prepared in the mouth to the proper shape and size. Nobel claims that the advantage with a one-piece design includes improved soft tissue management and no need to change between temporary and final abutments. The exposure that the patient presented with is not actually implant exposure due to inflammation, but abutment exposure due inadequate knowledge and preparation by the previous restorative Dentist. Therefore, the permanent crown is ill-fitting and clinically short. To correct this situation, I treated the patient with esthetic gingival re-contouring and re-preped the abutment. I fabricated and cemented a long term temporary. The esthetic results compared to how the patient presented are dramatic. After adequate healing, I referred the patient back to his Dentist for impressions and permanent crown fabrication.
Implant Revision – Temporary
