Implant question

nettlesoup

Hi, I hope one of the dentists on this forum might be able to answer my question.

I have 3 crowns in my front upper teeth. In 2005 I had to have a root canal on the upper right incisor (Number 8) through the back of the crown. The Root canal was a success but the dentist did not bother to smooth the surface where the root canal was done leaving a dip/depression at the back of the crown. The surface of the tooth was eventually made smooth but by this time I had developed TMJ from the constant attention my tongue was giving to the uneven surface. After so much time focusing on the tooth my tongue started focusing on the end of the crown where the edge meets the gum as there was a slight ledge on the crown. To cut a long story short i had the crown replaced but where it meets gum is still not even and I continue to focus on it with my tongue especially when tired/stressed.

I full accept that this seems trivial to anybody that reads this but it has caused me huge problems especially with the TMJ. My question is: would replacing the tooth with an implant remove the problem as I assume the gum would fit over the implant and new crown like a regular tooth?
Then I could address the TMJ problem.

vishal

this is though to answer and really you need to see your dentist.
it is unlikely the roughness has caused tmj.

the backside surface of the crown needs to have a good natural contour because it allows the lower jaw to move freely without causing a restricted envelop of function.

perhaps the crown is bulky?

there will always be a small marginal discrepancy between the margin of the crown and tooth, but usually can be polished until it is smooth or it can be placed just slightly below the gum (although this may not be healthy for the gums). You need a good impression and dentist and lab tech.

something like this may help with your tongue habit. it is generally used by orthodontists in the U.S. for tongue training for dental open bites.
http://www.fivestarortho.com/Fixed%20Myofunctional%20tongue%20trainer.pdf

vishal

to answer your question:
an implant is a usually a titanium screw that is screwed down into the bone below the level of the gum. the abutment usually (titanium, gold alloy or zirconia) screws down into the implant. the crown then fits over this abutment.
the crown is usually just placed below the level of the gum so you do not feel the margins.

but the abutment and crown must be made properly by the lab tech and the crown must have proper shape and be just below the level of the gum.

If your real tooth is ok than an implant is a poor substitute and not recommended.

i found some animations on this website for you http://www.cosmeticdentistryguide.co.uk/implants.html

please note i am not affliated with this group, i just googled dental implants

nettlesoup

Vishal, Thanks for your reply. Yes, I went back to my own dentist numerous times to get him to adjust/polish the edge of the crown but it was never successful. Eventually I decided to change the crown and this was an improvement but there is still a marginal discrepancy. I am not sure if it is worth going back to him again with the same problem in the new crown. The other front tooth which is also crowned is perfect
with no issues.

I have read in other forums where people have said they were very happy with there implant and they could feel no difference between there real tooth and the implant. Therefore I am suprised to hear that an implant is a poor substitute.

The dentist I attend is not a specialist. If I were to get a cosmetic dentist to replace my crowns what could they do differently. Would the comsetic dentist be likely to have more specialist training or technology in this area?

vishal

http://www.youtube.com/watch?v=2nTZ6NHlcr4

look at the video, it explains it better. the first bit that is screwed in is the implant, the second gold thing is the gold abutment, the third thing is a porcelain fused to gold crown.

notice the the gold abutment is below the level of the gum, so therefore the crown margin is below the level of the gum too.

When I said it is a poor substitute, I didn't mean it like that. Obviously implants are great and everything but if your tooth is fine, your root canal is fine and there is a good amount of tooth structure left then a simple crown, done well, should suffice. That is my thoughts on it anyway.

I would ask your dentist and say you still feel there is a problem, ask him what he thinks you should do.
maybe he can send to for a second opinion? patients should never have a problem asking their dentist questions.

toldidental

Mod edit ***spam *** as of today the 20 may 2009 this users 4 posts are all spam promoting their dental practice. If you wish to advertise please contact the site admins who will gladly sell you a banner ad.

The spam must stop.

tbh

toldidental, why didn't you sign up for commerical membership?

Actually, let me rephrase that. Toldidental, please don't post on this forum again until you have obtained a commercial membership. If you post again from this account, you'll be permanently banned.

splanc

I used The TMJ Appliance from Myofunctional Research Co Australia and it helped me