Q: I am angry at my dentist. I just had an implant and crown placed last year; now the crown is loose. Do I have to go through the whole procedure again which took over nine months? What happens with loose crown on an implant?
A: And we start off the new year with a fresh edition of: “Don’t shoot the dentist”: An HBO series I would like to pitch whereby I set up intentions, as I referee the heated arguments between disgruntled patients and their doctors. (I am still looking for scrubs that have black and white vertical stripes, but I can only find the horizontal stripes used in prisons.)
What Happens with a Loose Crown on an Implant
An x-ray would shed some light showing if your implant has become infected and failed. This would require that you have it remove, bone-grafted, followed by placement of a new implant, abutment and crown. This would be the worst case scenario. Implants in general have a 5% failure rate, especially in the posterior maxilla, the back upper jaw. This is not the doctor’s fault, but just the luck of the anatomy of us Homo sapiens (and some of my old college roommates, often seen dragging a knuckle or two on the sidewalk).
If the X-ray is cool and no bone loss is found around the implant, and now sign of implant component fracture, then very often the abutment screw which connects your crown to the implant can be tightened. (I just did this today.) Using high powered magnifying loops, I drilled a small hole into the porcelain crown and inserted a hex torque wrench and tightened everything. A small white filling is placed in the porcelain crown on the chewing surface, invisible to the naked or “scantily cladded” eye.
Sometimes removing the crown and remaking it is needed, but this still saves your implant and will finish your case in less than three weeks with only two visits. You may want to get a second opinion when you are told that something is not kosher with your implant.
Dr. Mitchell Josephs practices Implant, Cosmetic and General Dentistry with an emphasis on implants, porcelain veneers, and complex crown and bridge treatment. He is on staff at JFK Medical Center and is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. He completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.