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Question:
Gum Recession at Implant Sites: My girlfriend had four front implants 4 years ago and she has noticed that her gums are receding back and the metal pegs are vissable.
She had some gum removed from the rear and put over the front when the implants were fitted. She also smokes.
What could be the possible reason for this and what treatment is needed? ... Visitor from Bournemouth Newfoundland
Answer:
This is a very tough problem to solve if your girlfriend easily shows this metal during a relaxed smile.
One of the most difficult things in dentistry is making front implants look great in the gum area. If too much bone is gone (the reason you can see metal) the implants may have to be removed.
The area will need bone grafting with bone from her chin, jaw, hip or donated bone, and then the implants need to be placed all over again. Nothing will make bone grow back around these failing implants, just as we can't make bone grow back in people with periodontal disease.
Smoking has been demonstrated to cause a higher failure rate in implant patients. The hot smoke, tar and nicotine is poison to beautiful gum tissue and bone, so I would suggest she see her physician to begin a smoking cessation program or you may have this problem on the next go around.
Lastly, smoking would lead to higher failure for the bone grafting so before you invest in reconstructing her mouth I would encourage you to pursue this aggressively.
A fixed bridge is an option, but removal of these implants, coupled with smoking would lead to huge bone loss, and the resulting bridge would look very "long in the tooth" so if she has a gummy smile, they may need to use pink porcelain to hide this bone loss - this can be a very compromised esthetic result.
Wisconsin Reconstructive Implant Dentistry
Richard Winter, DDS MAGD
Winter Dental Associates
5323 W. Hampton Avenue
Milwaukee Wisconsin WI 53218
(414) 464-9021
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