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Implant Retained Crowns

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What is an implant crown?

An implant crown replaces a missing tooth and is permanently fixed in place. An implant abutment (similar to a post) is permanently screwed into the inside of the implant and the crown then fits over the abutment. An implant crown is the closest we can get to abutment. An implant crown is the closest we can get to giving you back a natural tooth, however, it is a replacement for a natural tooth and as such, is quite different.

How is it retained?

Implant crowns are sometimes screwed into place and sometimes cemented. Screw retained crowns will have a hole which needs to be covered with tooth colored filling material after the crown is fitted. For crowns at the front of the mouth this hole will be on the inside surface and therefore won't be visible, however, you may feel it slightly with your tongue. For back teeth, premolars and molars, the hole will be on the biting surface of the crown. This is sometimes slightly visible. These small fillings can, on occasion, come loose and need to be replaced. However, this is very simple and could probably be done by your general dentist.

Cement retained crowns are often initially cemented with a slightly soft cement so that they can be removed if necessary. They can therefore sometimes come loose and will need to be re-cemented with stronger cement. Once permanently cemented they rarely come loose.

What will it look like?

Every effort will be made to match the crown to your existing teeth. However, an exact match is not always possible due to the limitations of the materials used. The crown will always blend with our teeth and should not be noticeable in normal speech.

What are the alternatives?

The alternative treatments are either to accept the space, have a denture, or a bridge. Some spaces are not cosmetically acceptable and most patients don't wish to wear a denture for one or two teeth. Wearing a denture also tends to encourage plaque build up, which can cause decay or gum disease around the natural teeth.

Adhesive bridges might sometimes be possible but these are usually viewed as short to medium term solutions (approximately 5 years) as they can keep falling out. Conventional bridges require the teeth either side to be drilled away, which causes irreversible damage. Implant crowns do not cause any damage to the adjacent teeth and are often the treatment of choice for this reason.

How long will it take?

The final implant crown is usually fitted 5 months after the implant is placed. Following placement of the implant, the area will be left for 2-3 months to heal. Restorative treatment can then begin and usually takes 4-6 visits over 2 months.

What will fill the space while I am waiting for the final crown?

The temporary restoration will be planned as part of your treatment. If you already have a plastic denture this can usually be worn as a temporary throughout the treatment. However, we do advise that the denture is worn as little as possible during the first 2 weeks after the implant surgery. Following implant surgery, the denture will be trimmed away from the head of the implant to avoid overloading of the implant. Unfortunately, this can make the denture looser and some patients find they are more comfortable if they use denture adhesive.

If the space is at the back of the mouth it is probably best to avoid a temporary denture.

We occasionally use adhesive bridges as temporaries. These have to be removed and re-cemented at each treatment stage. They have the disadvantage of potentially falling out between appointments. If this happens we would usually ask your general dentist to re-cement it for you.

How long will it last?

This is a difficult question to answer as it will depend on the health and success of the underlying implant and the health of the surrounding teeth and gums. Certainly, we would expect it to last many years and it will last longer if you are very careful with your daily cleaning. Over a period of years the implant crown will wear out and will need repair replacement in the long term. This is a more complex and therefore expensive procedure than having a conventional crown replaced, but as long as the implant itself is healthy it will not be as expensive as the initial treatment.

How will it feel?

For most patients, implant crowns feel entirely normal within 2-4 weeks. However, initially the new tooth will feel a little strange, especially if you have been used to the smooth palate of a temporary denture. The implant crown will have a more definite shape and sometimes can be more bulky than the adjacent teeth. You may even notice a slightly alteration in your speech patterns. This usually settles as the mouth adapts to the new shapes. Very rarely, speech can take a little longer to settle down. Occasionally, patients are aware that the implant tooth "feels different" to the natural teeth. This is because the implant is permanently fused to the bone and doesn't have the same feeling as a natural tooth.