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Treatment provided by Dr Andrew Nixon (implant-restorative dentist) and Dr Paul Coceancig (oral & maxillofacial surgeon).
When a metal crown fails, cracks and decay underneath the crown margin leads to bacterial inflammation and infection of surrounding gum and bone tissue. The process is called periodontitis.
Chronic gum i inflammation is a difficult thing to treat. It requires both removal of the cause, and repair of the tissue breakdown that inflammation causes.
Often when something like an infected tooth, or poorly contoured crown is removed, the swollen gum slightly shrinks away as it becomes more healthy and less engorged. Replacing fractured teeth with implants, especially where there is a long standing history of gum and bone inflammation, can become technically difficult.
This 50 year old lady was overseas when she felt a sharp crack in her front tooth.
She had had a root canal filling many years previously following a fall, and the artificial crown was now loose.
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Artificial upper left central incisor crown, with distinct blue hue in the overlying gum, indicating penetratingly deep inflammation above crown. |
Over the next few days swelling developed in the gum overlying the tooth.
The artificial crown was very poorly contoured (non-anatomical), and the adjacent gum was blue, engorged, and very puffy. There was considerable bone loss around the tooth root itself. Whilst implant replacement was possible, the implant required deeper bedding in order to remain surrounded by healthy bone.
Healing abutment in place 3 months after tooth was removed, and replaced by a titanium implant. |
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After three months, some gum recession occurred as inflammation slowly resolved.
Despite loss of gum width, there was no significant loss of gum line height.
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Ideal aesthetic management of deeply placed implants can be a challenge for the implant-restorative dentist and technician.
Plaster model showing zirconia (white) based core, with overlying tooth matched porcelain. The implant depth is placed relatively deeply, level with bone height, and zirconia is used to provide support for overlying gum tissue.
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Appearance of zirconia cone with tooth shaped and coloured crown. |
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X-ray appearance showing zirconia cone linked inside the internal female cone of the the embedded titanium implant. |
Final tooth colored porcelain/zirconia crown, with perfect gingival health. Treatment provided by Dr Andrew Nixon, implant restorative dentist.
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