Crown on Implant Not the Right Size: What Can I Do?

Hi haron,

Actually, it is not so much the size of the implant as the space between the two implants. The original single tooth implants were usually 3.75mm diameter implants and molars were restored using these fixtures. As implant dentistry progressed, both the diameter of the implants and the size of the abutments became more variable. Also, the internal connection between abutment and implant provided a more stable platform that allowed for larger crowns.

In the past it was important to make crowns that were narrow and smaller than natural teeth to reduce the ‘cantilever effect’, meaning that there had to be minimal crown structure extending beyond the dimension of the implant. This issue has been overcome for the most part with today’s implants. Although I can only comment in general terms, it appears that your dentist is being cautious and wants to avoid screw loosening or fracture.

I realize that this is not an answer to your question. So here is what you can do:

Ask your dentist to make the two single crowns into a fused two-unit bridge. This would allow your dentist to create additional cantilever and make the molar bigger. If you prefer single crowns, ask your dentist to remove the molar crown and try to enlarge it in a provisional crown for several months. If you have no issues with screw loosening or fracture than convert the case to porcelain. Another possible solution might be to add another implant in the #15 position. I assume that there is no tooth in that position since a small molar would leave a space between #14 and #15. This would provide an additional tooth.

Discuss the problem with your dentist and even with your surgeon. If you are not happy, seek a second opinion from a prosthodontist. I would definitely give your dentist the option of adjusting the restoration to the way that you want it – within reasonable parameters. She sounds like an extremely responsible clinician.

Best of luck.

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