The first picture tells the whole story. My patient came to see me in Burbank and she said "I have loose crown and I hope it is savable." She had another tooth break about a year earlier.
What you are looking at is a broken tooth. Actually the root is broken. So it wasn't the crown that was loose, the whole root was broken.
This is an upper premolar tooth (#13) that is located on the left side usually 3rd from the back if you don't have your wisdom teeth. This tooth often looks "slanted in" when a minor detail is missed if it is a dental implant restoration.
The tooth was extracted. I placed an immediate dental implant at the same time the tooth was extracted. A simultaneous sinus lift bone graft was done to add bone at the tip of the implant.
This picture shows how the shade is selceted with the aid of hig resolution photos that I email my lab.
When I first inserted the new crown it looked slanted inward. This can occur due to a lab error or an implant that is placed to far towards the tongue. It also happens because the implant is smaller and more circular than the original long, oval shaped root.
In her case, it was a correctable error easily fixed by adding more porcelain to the "cervix" of the tooth. The danger here is that too much porcelain is added, leading to a ridge lap that cant be cleaned or measured as the years progress
I had the lab alter the gum-line area of the crown based on a drawing that I sent back with her slanted dental implant crown. Below you can see how the implant now blends right into the corridor of the smile.
The side view shows harmony with the other teeth. The tooth next to it a bit of recession of the gum line where the yellow shows.
She was happy that the slanted look was able to be corrected. She likes the look, feel and fit of her new dental implant crown.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow of the American Academy of Implant Dentistry