A dental implant from placement to restoration comprises of 3 main components. The implant itself, the abutment (which screws into the implant) and the crown (which is cemented to the abutment). The implant screw usually comes with the implant itself at time of placement therefore it does not have a separate code from the code used for the placement of the implant (D6010). The second stage implant surgery does have its own code (D6011) but is rarely covered by insurances. This will include the placement of the healing cap. A custom implant abutment is coded as D6057 and the abutment supported crown is coded as D6058.
If you are unhappy with the work done, simply have a conversation with your dentist. The dentist should remake it until you, the patient, are satisfied. Everyone has a different definition of what the word "perfect" means. Ultimately, you are the one who will be wearing it and looking at it everyday.
Many places will advertise "1 day implants" however this may only apply to 1% of cases. Depending on where the tooth broke off, it may be salvageable simply with a crown. If you would also like to correct the misalignment of tooth #8, have the two crowns done together. This is crucial when it comes to shade matching. If the tooth has sustained a complete vertical fracture or has broken off far below the gum line at a point where it will not sustain a crown, the tooth will need to be extracted. Due to the root anatomy of tooth #9, the implant could be placed at the same time as the extraction, assuming the bone volume in the area is sufficient. Though the implant may seem strong when initially placed in the bone, it will first become quite weak as the bone turns over and heals over the next 3 months (can't rush mother nature!). Some offices may restore the implant immediately after implant placement, though it is ill advised. Any movement of the implant in the early stages of healing during the first 3 months could result in losing the implant. Esthetically, no patient wants to walk around with no front teeth. An interim partial denture can be made ahead of time, before the extraction is even done, so that it is in the office waiting for you on the day of surgery so that you will have teeth to walk out with. The process from placing the implant to restoring it with the abutment and crown is long, however, it is best to do it correctly the first time so that it will last you the rest of your life with proper care.
At this point, from the symptoms that you are describing, the tooth has become sensitive and indicates the likelihood for a root canal. More than likely, the decay had worked its way under the filling and has reached the nerve that runs inside the tooth. This would explain the sensitivity. The pressure you are feeling from chewing is indicative of a degree of infection in the bone of the tooth. Simply replacing the filling may not suffice. A periapical x-ray should be taken and a treatment plan for the possibility of a root canal should be considered. Healthcare is not an exact science and sometimes, at its early stages, a symptom needs to be closely monitored before a definitive treatment is indicated. Whether or not you would like to consider seeing a different provider relies on the relationship and trust you have with them.
