I had a dental implant and it looks crooked. I'm reluctant to have my crown placed seeing how crooked this is? (Photo)

I'm a 36 year old non smoker. This is my first major dental work, just a few cavaties. I had a botched filling which resulted in me needing an implant. When they placed the implant t the surgeon said I had plenty of bone. But when I got the abutment it looked incredibly crooked. Will this work? When I went to my regular dentist the hygienist aid she's never seen an implant at that angle. The dentist said it should work with a custom abutment. Is he trying to Cover for the surgeon he recommended?

Doctor Answers 4

I concur

I have to agree with you; it appears that implant is angled towards your cheek which will make for a difficult restoration and a dangerous bite (your chewing forces will not be lined up with the long axis of the implant). You may also have long term issues if that implant has taken the place of some important (keratinized) tissue which is important for implant health and longevity. I would definitely have that evaluated closely and hope that the abutment isn't screwed in correctly which is causing it to appear angled. That's wishful thinking, but it's possible. If that abutment is seated properly and the implant is in fact at that angle, I would probably have that removed and re-positioned, or removed, grafted, and then have a new implant placed after healing has occurred. Implants can be very long lasting, wonderful restorations, but if the initial placement sets you up for a lifetime of irritated tissue, an unnatural looking crown, and an unfavorable bite it is better to remove it and do it correctly. If you limp it along until if fails, it will likely destroy some good bone and gingival tissue as it goes South which will set you up for a harder second round. Ideally that abutment would line of with the central grooves of the biting surfaces of the teeth on either side of it. If your surgeon tells you he went where the bone was, then tell him you'd rather have it positioned properly even if bone grafting is required. Best of luck!


Atlanta Dentist
5.0 out of 5 stars 2 reviews

Implant appears crooked

In this photo is does appear that the implant is markedly angled toward your cheek.  Restoring this, even with an angled abutment will probably be a challenge and result in a compromised restoration.  A surgeon with a 3-D imager (CT) can check this for you and advise you  if removing the implant and repositioning it would be the best option for you.

Ramon Peleaux, DDS, MD
Charlotte Oral & Maxillofacial Surgeon
5.0 out of 5 stars 7 reviews

Poor Implant Positioning and Angulation

I must agree with you based on that photo.  The implant appears to be in a far buccal (towrds the chek) position.  A custom abutment with angulation correction may be able to help restore the implant but the final restoration may not be ideal.  Like previously mentioned a cone beam CT scan should be done to ensure thereis enough bone around the implant especially on the cheek side.  If not even if the implant is restored the long term prognosis may be questionable.  In these instances removing the implant and replacing it in the proper position is the most reliable way of ensuring good long term prognosis.  Talk to your doctor and see what he/she fels is thebest option for you

Brian Dorfman, MD, DMD
Phoenix Oral & Maxillofacial Surgeon
5.0 out of 5 stars 12 reviews

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Poor Implant position for crown

I completely agree. The implant seems to be aligned outward (buccal inclincation) and it may have many implications if restored. I suggest you see your dentist and see if possibly it can be properly restored with angled abutment. Also it should be checked to see if it is well supported in bone or note using a cone beam CT scan. My guess is it has little or no bone on the outside wall. If there is no bone or implant is not restotable, then it should be removed completely and re-done properly once the site has healed. See link below

H. Ryan Kazemi, DMD
Bethesda Oral & Maxillofacial Surgeon
5.0 out of 5 stars 5 reviews

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