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Implant Crown Too Bulky Causes Bone Loss

This is a diagram I made based on a real patient that came to see me with a failing implant.

The implant will need to be removed as there is no way I can predictably save the implant or the crown.

This would classify as Peri-Implantitis…bone loss around an implant.

The implant crown is to big and bulky near the neck under the gum and bone. The gum and bone become inflamed from the chronic irritation so the body reacts to it by pulling the bone away to make space.

There is a good chance this patient will now lose the teeth 🦷 on either side of the implant because of this tiny detail.

Making a crown on an implant is NOT simple. It requires a skilled and experienced dentist and lab technician.

I spend A LOT of time shaping and forming the gum to be ideal. That shape is either straight or concave under the gum…then emerging out of the gum.

In the past, implants were not placed as deep as they are today so it wasn’t as much of an issue.

The crown can’t be under tension when it is screwed in. It must be a passive fit. If the emergence profile is bad, it won’t sit flush to the implant and worsen the problem.

Ramsey A. Amin, D.D.S.

Diplomate of the American Board of Oral Implantology /Implant Dentistry

Fellow-American Academy of Implant Dentistry 

8 thoughts on “Implant Crown Too Bulky Causes Bone Loss

  1. I know all aspects of your work are “a labor of love” 😁i am still having trouble finding the right person or people to help me/ i even tell them what i have seen and learnt from you/most are not interested,the odd person is / they all know i have done my research / maybe they do not like the fact that i have..
    Kindest Regards ..Julie

  2. I had an extraction of I think tooth 30, with a bone graph. I’m on the second week and the tooth area is not closed all the way yet. I can see the bone graph in the hole. I’ve had severe pain for 2 weeks. It feels like it is reducing today a little bit. I also have a bump at the base of my tooth area. How long does it take to go away?

    So pain normal?
    Swelling in jaw below extraction/graph go away?

  3. Hi Dr. Amin,
    I have a dental implant on my front tooth that does not meet my gum line and feels bulky, the implant goes over my gum line and has an edge and my gums now look darker, above the tooth. Is this normal? I would like to see a specialist in Northern Ca in the San Jose area for a second opinion. Can you please send me a referral?

  4. I had a failed implant months after placement. My implant along with crown became very loose about a week ago. Due to holiday this morning was when i was able to get into my dentist who applied the crown. My implant was literally almost completely out. My dentist sent me back to oral surgeon who removed implant and then explained why numbing injections did not work on one area as granulation tissue that had developed its own nerve endings that numbing meds would not touch. In removing that infected graft i literally came up off the chair in excruciating pain. It was awful. He removed old graft put in new snd said he’d see me in 10 weeks. Is this normal. This is the 2nd failed implant, thousands of $ later, and lots of apts that resulted in time off work. Im a little leary of a 3rd implant. Whats your advice

  5. Hi Dr Amin,I refer to this blog in my following comment RE your next blog / you know if it was not for you no patients would know this knowledge you provide ,but unfortunately, they may never get the true explanation of what really went wrong if they found themselves in this or similar situations as a lot of dentists are not truthful or just do not have the knowledge and ability you do so the patient just thinks it’s bad luck rather than bad decision/ choices or lack of experience/by the dentist so they suffer/ it is a sad situation 😥

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About Ramsey A. Amin, DDS

Dr. Ramsey Amin has extensive experience in surgical and restorative implant dentistry. As one of only less than 400 Diplomates of the American Board of Oral Implantology/ Implant Dentistry (ABOI/ID) he is considered an expert, and board-certified in dental implants. He is a former instructor at the UCLA School of Dentistry.