Implant or Crown?
Hi, I’m Dr. Todd Shatkin and welcome to this Monday Morning Minute. We get the question all the time. How do I know if it is the implant that’s moving or the crown that’s moving? It could be a failure of the implant or it could be a failure of the cement.
Listen, we don’t have 100% success with anything we do in dentistry. So once in a while, something is not going to be perfect. Sometimes the cement loosens and the crown wobbles on the implant or implants, and sometimes an implant will fail. We have about 95% success with many implants, but sometimes you have a failure. So when an implant fails and a tooth is loose, it usually will move buckle lingually like this, and that will let you know that the implant itself is loose.
But if the crown is just wobbling, like teeter tottering back and forth on the implant and there’s no buckle lingual movement, it’s most likely just the crown that’s wiggling, which means the cement loosened up. And look, we have cement loosened up under natural teeth all the time. The difference is, with a natural tooth, if a crown loosens, you usually just pull it off and recement it. On a mini implant with an O-ball under it, the cement locks under the O-ball, so it just kind of wobbles back and forth, but you can’t really pull it off. So what I like to do, if I think that it’s a crown that’s loose, I use a spring loaded crown remover.
And this is a product that I buy from Carl Schumacher, but I know other companies have them as well. But I’ve been buying them from Carl Schumacher instruments. And what I like about it is the spring action. There’s a lot of them that you have to tap like this without a spring action. The spring loaded crown remover works very well.
All you do is put it under the crown, pull it down, and one quick snap will pop that crown right off. So it’s very, very easy. I’m going to just demonstrate it here. Of course, this is a bridge, but I’ve got Mark here holding it for me. You just get underneath there and pop it off.
And once you pop that crown off, double check and make sure that implants nice and secure, which it should be. If it was just a crown that was loose, clean out all the cement in the crown and just recement that crown like you normally would cement a crown. So, again, how do you know if it’s the implant or the crown? If the tooth is moving buckle lingually, it’s probably the implant. If it’s wobbling, it’s probably the crown.
But either way, you’re going to tap it off. If you want to give them a little local anesthetic beforehand, that’s fine. Just in case it is the implant, either way, you’re going to pop it out. Either the crown is going to come out or the crown with the implant is going them out and then you’re going to know for sure what’s going on. But most of the time, it’s just a crown that’s loose and all you got to do is take it off and recement it like you normally do.
So thank you again for joining me on this Monday morning minute. I hope this tip was helpful. I’ll see you next Monday.