Complications from India

34 year old, Female.

• Recurrent peri-implantitis (gum and bone infection around dental implant) – upper left central incisor tooth. Cemented dental crown (unretrievable) on unknown dental implant system

• Poor dental implant placement – unsatisfactorily subcrestal (deep below bone height) implant placement and extreme buccal position and angulation (towards upper lip rather than palate) – leading to
  • Cemented dental implant crown use – (not screw retrievable).
  • Severe gum and bone loss on the front surface of the dental implant.

• Removal and replacement of dental implant crown (screw retrievable) – accepting gum and bone defect, impact on gum and dental crown aesthetics / cosmetic appearance and unfavourable mechanical load (vertical and horizontal cantilever forces) during masticatory function (eating and chewing) and parafunction (clenching and grinding).
• Alternative treatment declined by patient: Surgical removal of dental implant, extensive gum and bone grafting, placement and crown restoration of new dental implant.

• Removal of existing cemented dental implant crown use – using CTScan as guide for drill entry to locate dental implant abutment screw.
• Construction of new dental implant crown (screw retrievable) – using
  • Pink ceramic to mimic and camouflage gum and bone tissue loss.
  • Cross-pinned crown design – to allow for dental crown retrievability which can aid any future gum and bone assessment and remediative peri-implant tissue surgery if required.