Dental Implants & Crown Design

Dental Implants & Crown Design

How important are the design of dental implant supported crowns to the overall long term success?  The simple answer to this question is – absolutely.  The next question is why?  The answer to this question is a little more complex.

Interested in more information about dental implants, check out our Dental Implant Page.

As the number of dental implants exponentially increases, the long term success still remains high – around 90 percent.  However, failures do occur after the dental implants are functionally loaded with crown/tooth restorations.  These failures are directly related to the bacterial plaque control and access for oral hygiene.  Accumulation of bacteria around dental implants and the crowns that they support leads to inflammation/bleeding and subsequent loss of supporting bone and soft tissue (Peri-Implantitis).  Primary factors that lead to this scenario include excess cement and over-contouring of the crown.  Excess cement can easily be eliminated by the clinican being attentive to the amount of cement used and removing excess from the dental implant-crown margin. Over-contouring or bulbous crowns are typically caused by improper implant placement and/or poor lab fabrication.  It is imperative that the restorative Dentist analyze and determine when a crown from a lab is over-contoured before permanent cementation.

Case 1

I wanted to present a case where the placement of the dental implants and the supported dental crowns/restorations are in harmony.  What I mean by that, the angulation and distance between dental implants allow for the restorative Dentist to fabricate crowns that are not bulbous and allow the patient proper access to clean.  The photos above show a patient that I treated with three dental implants.  The patient was referred to his Dentist for the permanent restorations.

Case 2

Case 3

Also, I wanted to show some cases where the dental restorations were bulbous / over-contoured.  The photos above demonstrate dental crowns supported by dental implants that are over-contoured and allow for minimal access.  This dilemma inevitably leads to the patient having difficulty with proper home care and subsequent bacterial induced inflammation / bone loss.  The end result is a lower long-term prognosis.

by