What if I'm unhappy with an implant?

pillphil

I had an implant placed by an oral surgeon. It was crowned today by a prosthodontist and it looks terrible.
I think the implant was placed badly. The surgeon said it would be slightly high(after the implant had been placed) but this just looks awful.
I think I needed bone grafts but that was never suggested.

Oral Surgeon

pillphil wrote: »

I had an implant placed by an oral surgeon. It was crowned today by a prosthodontist and it looks terrible.
I think the implant was placed badly. The surgeon said it would be slightly high(after the implant had been placed) but this just looks awful.
I think I needed bone grafts but that was never suggested.

What tooth was it and could you post a photo??

pillphil

[Redacted]

Big_G

Oral Surgeon and Fitz, ye might have a go at this one…
My feelings on this: looks like there is a deficit of tissue that will not be correctable without grafting or not correctable at all, hard to know how much tissue was there before without before photos.

OP this is a very difficult case to get right, my advice is the same I offer anyone who is unsatisfied with an outcome: speak to the people who did the work before doing anything else. Putting an implant into that spot and making an implant crown look like a tooth is always about trying to create a harmony between the tooth and the soft tissue or gum, that is, a nice balance between pink and white. You do not have this here, but we are not privy to the challenges encountered during the treatment planning of this implant. You may not have had enough gum, or the gum could have shrunk after the implant was placed.

There may be alternative options for you but you should see the people who put this in first and put your concerns to them.

btkm8unsl0w5r4

Firstly

In my humble opinion that is you have a point about the poor aesthetics. You have a high smile line, and you knew you had one from your post history. The gum has gone around the implant and now the tooth looks long, also the bone was likely deficient and the implant is placed far to the lip side.

Where these things unavoidable...who knows, maybe not. High lip line cases are the hardest and require that the entire bag of advanced dental tricks are thrown in. If there was a bad tooth there before the damage was likely done at that stage. However that gets you nowhere, you need a fix.

However there are fixes for this.

The best option is usually to remove the implant. Rebuild the gum with grafts and then the bone and replace the implant or possibly re-plan for a bridge (case below of implant replacement, but the defect was not as bad as yours, and the papilla were present). Its a long drawn out procedure but can get good results.

The second would be prosthetic masking with pink ceramic on the neck of the implant, this would improve matters but the lack of papilla (the pink triangles of gum between the teeth) leaving black triangles between the teeth would remain. I will post an example of a partially successful masking I did below, but in a patient with only a moderatly high lip, when the lip is retracted the illusion is totally lost.

I think perfection in your case is not achievable, if its 50 percent now, maybe you can get to 85 percent. Report your dissatisfaction to the treating dentists and see what they can do.