This is a great example of a dental implant that is placed too shallow.
You want your dental implant perfectly placed. “Perfect implant placement is impossible.” In reality, there are small errors that have no clinical effect on your implant. Even dental implants that are placed with computer guided surgery have a certain degree of error…. And that’s okay most of the time (read on)!!
The position of your dental implant is one of the most critical factors to long term success. I have mentioned before that some implants are placed too deep! That is a whole another set of problems!
This is not my implant in the photo. This x-ray shows that the implant was placed above the bone level.
Ideally you want your implant to be placed level with the bone or a little bit below the bone depending on the type of implant being used. As a dentist that has restored thousands of implant crowns, I would always prefer an implant that is deep over an implant that is shallow.
All implants over time will lose a slight amount of bone. It is generally better if the implant is deeper to compensate for that slight normal bone loss. Our natural teeth lose bone as we get older! Dental implants are not immune!
Shallow implants can cause a number of issues:
- Your tooth will look too small compared to the others. This may make it look abnormal.
- Your crown will likely have to be held with a screw rather than cement. The screw hole may show and be unattractive.
- Your crown may get more food stuck between. This is because the flossing contacts are really small rather than broad.
- The implant will likely progressively lose bone if the threads are exposed… One of the conditions of peri-implantitis.
How do you correct a shallow implant? Oftentimes the only option is to remove it and place a newer one at a deeper level. Occasionally if it is minor it can be masked with a really good dentist and lab that can camouflage it well and still keep the contour very cleansable.
Factors that would lead to an implant that was placed too shallow:
- A dentist that has less experience is more likely to place your implant too shallow.
- Lack of adequate inventory of implants in the office. Maybe the office only stocks a few sizes. This is really common! At any given point I have more than 100 implants in my possession! I have to be ready for unexpected conditions.
Not all implants that are placed too shallow are complications. There are some implants that are supposed to be placed above the bone. The difference is they are “designed” to be placed above the bone at the level of your gum.
Ramsey A. Amin, D.D.S.
Diplomate of the American Board of Oral Implantology /Implant Dentistry
Fellow-American Academy of Implant Dentistry