Loose Crown on Nobel Implant: What Can I Do?

Question:

Tami asks:
I had a RP 5.0 x 10mm Nobel Biocare Active Implant placed in tooth area #19 on July 2009 by an oral surgeon. In December 2009 the crown was placed. Approx 2 weeks later the crown came loose, the dentist removed the crown, had another one made and placed it on the implant. I then moved 1500 miles away. Approx 9 months after the second crown, the crown came completely loose again from the implant and fell out of my mouth. My new dentist drilled a hole in the crown and torqued it back down. A week later it was loose again, she torqued it down a second time, 2 days later it is loose again. What do I do? What could be the problem?

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Dental Implant Restoration

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Expert Advice and Comments

Loose crown over implant

Answered By: Dr. H. Ryan Kazemi - Bethesda , MD

Hello,

Here is what I suggest:
1. Dentist should use a new screw and re-torque it. They should not use the old screw
2. Make sure there is good precision fit of the abutment and crown and implant components.
3. Check your bite carefully.
4. If you have grinding or clenching habits, consider a night guard.

Hope this is helpful.

Dr. H. Ryan Kazemi
http://www.facialart.com/

I would agree with the above

Answered By: Dr. Edward Kusek - Sioux Falls , SD

I would agree with the above doctor, but feel it is an occlusal problem. You may be bitting in an area that places side forces to the crown/implant. The design of the crown also could be a problem, if it is wide like the dimensions of the old tooth this could be a problem. Without a photo and x-ray it is hard to say for sure.
good luck

Dr. Edward Kusek

Loose crown on implant

Answered By: Dr. Scott Ganz - Fort Lee , NJ

Hi Tami -

I agree with the other comments, but would like to add a few thoughts. The area of tooth number 19, is the largest tooth in the lower jaw, the first molar. Therefore with, or without implants it is the prime area for chewing, where a lot of force is generated.

I would want to know if there is another tooth posterior, or in back of the implant tooth... and what kind of teeth are opposing in the upper arch. This appears to be an issue of force on the implant which is causing vibration and the screw to loosen. X-rays would help...!

Good luck.

Scott D. Ganz, DMD

Dr. Scott Ganz

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