Metal Line Showing at Gums from Implant Crowns? (photo)

Hi,

I am Dr Amit ,see the best thing is go for zirconia abutments for your implants now and then on them go for zirconia all porcelain crowns of 3M-LAVA they are strong enough for posterior teeth -- i have given for some of my patients and results are good.

see the problem you are facing is not uncommon and if it arises then this is the only best solution

regards

Dr Amit Goswami.

Porcelain fused to metal crowns with a custom metal abutment are the strongest for posterior or back molar implants.  However, when aesthetics are a concern, then I like a zirconia abutment with an emax crown but they can be more prone to breakage.  The metal is for strength.  

Its difficult to tell from the photo but it appears that your lower molars are flat and worn.  If this is the case , your bite may have collapsed over time leaving the dentist less distance to work with the final restoration height.  In other words, the crowns would have to be shorter.  If these teeth were missing for a long time before the implants were place then this might be possible.

You should let your dentists know your concerns. If they can't seem to help you then seek out a second opinion from a dentist trained in cosmetics and occlusion both.  

I am afraid the crowns are done and they can't be modified at this point without replacing them.  Sorry.  Good luck!

 Dr Sarah

Judging by the photo, it looks like your dentist has placed a metal crown over your implant. The metal is mostly covered by porcelain leaving a little showing at the gumline along the palate. The metal allows for strength which is needed especially for the back teeth. Although it is usually possible to cover the entire metal so that none of it shows, there are instances where it may not be recommended. Speak to your doctor and ask if there is any reason why the metal could not have been covered up completely. From a functional point of view the crowns should be perfectly sound with a fantastic long term success rate but if the cosmetics are a concern then it would be best to communicate this.

The best crowns for implants are porcelain fused to metal crowns. They have metal underneath for strength and porcelain on top for looks. Many good dentists and labs leave a small collar of metal on the non-visible side because it is more polished and kinder to the gums. It attracts less plaque and bacteria and it is easier to clean. If this is the case then it is possible to re-make the crowns without the metal collar. As to who pays for it; this can vary between dentists. I would like my patients to be happy and I charge a pretty high fee for the best possible work I can deliver. So I would re-do them at no cost. Others may charge the lab fee only, and others may elect to charge full fee again (but you may not go back to them).

There may be another reason for the metal showing: the abutments or implants themselves (which are titanium) may be visible above the gum. If this is the case, then the abutments may have to be changed out (this is the post that sticks out from the gum). If the implants themselves are the ones, then this is not fixable, since you would have to have the implants removed and replaced deeper under the gums. This would contraindicated because it would cause bone destruction compromising the placement of new implants.

Good luck

Dr. T