Dental implants have a long term proven record as the most successful modality of tooth replacement. However, despite a high success rate in the upper 90th percentile, both mechanical and biologic complications can occur. It is therefore equally prudent for providers that perform dental implant procedures to be competent in the management of any potential complications.
"Treatment of such scenarios in the esthetic area is challenging and surgical soft tissue techniques that are as minimally invasive as possible should be used."
DR. KAMRAN HAGHIGHAT, B.D.S., M.S., P.C.
Lynn was referred to us for assessment of her implant that was placed a few years ago and had been successfully restored. She had a cement-retained ceramic crown with a custom fabricated zirconia abutment. The cement margin was originally placed approximately 2mm below the gingival margin. This made removal of the excess cement post cementation challenging. Excess cement residue is a common cause of peri-implant biologic complication that may lead to inflammation and bone loss. In most cases, excess cement may go undetected radiographically. The biologic issues may not be immediate and signs of disease may take many years to become clinically evident.
Treatment of such scenarios in the esthetic area is challenging and surgical soft tissue techniques that are as minimally invasive as possible should be used. Inappropriate planning and techniques may worsen the original problem at hand.
The implant position and bone levels were assessed using state of the art CT scan imagery which revealed this to be satisfactory. The original crown and abutment were removed. Soft tissue augmentation with an autogenous graft placed in horizontal and vertical planes was performed and the implant was submerged. A removable appliance was provided during the healing period. This was followed by a new screw-retained temporary crown to sculpt the recreated soft tissues to the desired form.
The final restoration was fabricated using a Ti-base (angle screw channel) and custom zirconia abutment with stacked porcelain. This method facilitated the provision of a screw-retained restoration as apposed to a cement-retained type. The custom shade and the gingival profile restored the esthetic expectations for the patient.
Thank you for your trust in us. Enjoy your smile with confidence.
Here is what Lynn says:
"Dr. Haghighat is a perfectionist and truly a ‘Doctor’s Doctor.” I am a dental specialist (an endodontist) and could basically go to anyone, but I choose him because of his experience with implants. I’ve been very impressed with the final outcome of my 2 implants. He has meticulously performed all the steps to get the best result. It took longer than I expected but that’s because he wanted things just right. As did I, ultimately. He goes the extra mile to keep up with technology and I appreciate that. He is decisive and well, just very good at what he does. I highly recommend him and his team.“
