Two Implant done on tooth #s 23 and 26 now getting four crowns.

I got implants on tooth #'s 23 and 26. I am in the process of getting two abutment and four crowns. My dentist says that I need a small flap of porcelain in the color of gums in the bottom of my crowns to cover the gap between the crowns and my gum. He also said that I have the option of having four very long crowns and no flap but that he would not recommend this. I just don't know what to do. Health wise what would be the best thing to do.

Doctor Answers 2

Ovate Pontic. Pink Porcelain

Dear 2278:Your dentist is asking you a very important question about the final aesthetics of the work.  It does not impact on the health implications of the final restoration.  If you show the lower teeth when you speak, or smile, it might be a good idea to have pink porcelain at the gum portion of the teeth so that they do not look so long and look more real.The more important question to ask is whether the pontic area (where the teeth are missing-- #24 and #25) are designed as ovate (shaped like the blunt part of an egg) and rest into the tissue.  If they are designed in a traditional manner called a ridge-lap pontic, the fake teeth on the bridge will be resting on top of the tissues and food and plaque will be able to collect under the bridge and it will be much harder for you to keep it clean in a long run.  The ovate pontic, which is a much more contemporary way to design the bridge will allow your fake teeth not only to look as if they are emerging from the gum, but will not allow for food and plaque to trap under the bridge.  The only drawback to the ovate pontic is that not all dentists and labs are familiar with the concept and it actually requires your dentist to possibly perform a tissue guided procedure.  The ovate pontic design is FAR superior and might even negate the need for pink porcelain.  If you google ovate pontic you will find plenty of information on the procedure.Best,

Gum tissue colored porcalain

Health wise the color of the porcelain will make no difference.  What your dentist is talking about doing is an attempt to make you implant supported bridge as cosmetic as possible.  By placing the gum colored porcelain at the bottom they are attempting to mask the length of the teeth which may appear too long if not.  

David M. Schertzer, DDS
Saint Louis Dentist
5.0 out of 5 stars 1 review

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.