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