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Question:
Dental Implant Removal and Repair causes Bone Loss:
I had 4 implants to replace my top incisors. They were placed in the wrong position not allowing individual implant placement.
I had the surgeon remove them and had them placed in the correct position. Now my top gumline is far above my canine teeth gumline.
The surgeon says no bone was lost on the removal and bone cannot be added for height only width. Is there any way to get a more natural gumline inline with my eye teeth? ... Visitor from Nova Scotia
Answer:
Every time the tissue is reflected to expose the bone there is bone recession.
The only way to eliminate the bone loss is to place the implants using a flapless technique. Until recently this was rather unpredictable.
Today a CT scan is performed with a radiographic template. The surgery is performed virtually on a computer. After the optimal position is determined, along with the shape length and width, a drilling guide is created.
The day of surgery the guide is placed in the mouth. The implants are placed with a tolerance of 200 microns. On the same day the custom abutments are placed and provisionals (temporaries) are placed. The entire procedure requires an hour of time.
Since the implants have already been placed twice I would not recommend that they be removed. This would result in additional trauma to the tissue.
Ideally a straight line drawn from the gingival margin of both canines would intersect with the gingival margin of the central incisors. The lateral incisors would be one millimeter below this line.
Depending on your lip line (how much teeth show when you smile) determines the extent of the problem. In some cases the gingival tissue around the canines can be laser recontoured to create a more natural look. Another possibility is to have the gingival area on the restorations mimic the root.
Editorial Staff
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