Which is Best Material for Single Front Tooth Restoration on Implant? (photo)

Question

I have an implant on the #10 tooth and my dentist can't find the right restoration for me (screwed in, not permanently cemented). The first try was zirconium base with porcelain finish, but it was too opaque and didn't match my natural teeth. The second was a composite resin tooth, but again looked fake. Now he suggests a "traditional" metal-porcelain restoration, but I am afraid that the metal will show through my gum line and it will be too opaque again. Please help! I'm getting desperate!

Georgios Antonopoulos, DDS · Answer

A zirconia
implant abutment together with a zirconia or e-max crown give the most
aesthetic results for front teeth restorations. A skilled dental technician
with the appropriate guidance, can create a very natural looking tooth. In our practice, the dental technician
typically participates in an initial appointment with the patient and as
results mishapsare minimized.

The only
reason I can think of a dentist recommending PFM crowns for front teeth, is if the
adjoining teeth consist of PFM crowns and you are not willing to replace
all of them.

Charles Sutera, DMD · Answer

It is wonderful you are restoring your missing lateral incisor with an implant, and it is excellent you are striving for the best aesthetics. I think overall you will be able to achieve a beautiful final result. The zirconia implant abutment is typically the most aesthetic option for the connection between the implant and the crown. I would suggest that your dentist send photos of your smile to the dental lab with the shade-tab that matches placed next to the adjacent teeth in the photo. The photos will be very helpful in achieving the proper crown translucency. As far as material, the most aesthetic crown is typically made of a material called Emax which is a pressed porcelain. In reviewing your photos, I think the implant crown is both too opaque and too light (too high of value) compared to the adjacent teeth. Compare the shade tabs to your natural teeth with your dentist. Just judging by the photos it looks like your implant crown is probably shade A1 or A2 and your natural teeth are really A3 or A3.5. Make sure when you select a new shade that the shade tab looks identical to the adjacent teeth. If the shade tab looks even slightly off, the crown wont look natural. Whitening the adjacent teeth is an option if you feel your natural teeth are too dark. Whiten all teeth first, then re-select the shade. The final alternative for a single tooth crown that is difficult to match is to porcelain veneer the adjacent teeth in the identical shade as the single crown. Veneering #7,8, 9 could be a last resort to achieve excellent shade match of the front teeth. Good luck and best wishes.

Michael Dorociak, DDS · Answer

Don't be desperate, be patient.It is your front tooth and it will be on display for a long time.It is often referred to as the hardest thing in cosmetic dentistry: matching one single front tooth to the restof the natural teeth.  A couple of thoughts:Has the dentist considered a cemented crown vs a screw crown. In other words, use a zirconium abutment (white) screwed into the implant and cement a lithium disilciate (eMax) crown over the top. These can be among the most esthetic restorations for the front.Whether it be zirconium base, composite, or metal-porcelain, a good lab and skilled ceramist with photos, communication, AND PATIENCE can match the adjacent teeth and achieve a high level of esthetic success.. Other than eMax, zirconium base with porcelain overlay should be reconsidered.Thank you,MIchael R. DorociakSarasota, Florida

Which is Best Material for Single Front Tooth Restoration on Implant? (photo)

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Which is Best Material for Single Front Tooth Restoration on Implant? (photo)

Answers (3)

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Everything you need to know about Dental Implants

Our mission is to create a world where every investment in modern beauty is Worth It.