A dental implant crown can be replaced, a common and relatively straightforward procedure in modern dentistry. The implant system is designed for this possibility, as the crown is the prosthetic part subject to wear and tear. This visible, tooth-shaped cap sits above the gum line, attached to the abutment, which connects to the titanium implant post anchored in the jawbone. While the implant post is a permanent fixture, the crown may require maintenance or replacement over time, similar to a natural tooth. This design separates the permanent anchor from the replaceable prosthetic, allowing for simpler repairs.
Reasons for Crown Replacement
The most frequent reason for replacing an implant crown is wear and tear over many years of use. Although materials like porcelain and ceramic are durable, they can erode or sustain damage from daily chewing forces. For patients who grind or clench their teeth (bruxism), this wear accelerates, causing the prosthetic to fail sooner.
Aesthetic concerns also commonly prompt replacement, especially for crowns visible in the smile line. Gum tissue may recede slightly over time, exposing the crown margin or the underlying metal abutment. This exposure results in a dark line that compromises the natural look. Furthermore, if the crown was placed many years ago, its color may no longer match the patient’s adjacent natural teeth, which may have changed shade.
Damage, such as chipping or fracturing of the porcelain layer, necessitates a full replacement if the damage is extensive. Replacement may also be required due to changes in the bite (occlusion), which can lead to discomfort or poor fit. Finally, the cement or bonding material securing a cemented crown can fail, causing the crown to become loose or fall off entirely.
The Steps for Replacing an Implant Crown
The process begins with a clinical assessment, including X-rays or digital imaging, to evaluate the integrity of the underlying implant and abutment. The first physical step is the precise removal of the existing crown. If the crown is screw-retained, the dentist accesses the screw channel, unscrews the crown, and lifts it off the abutment. For cemented crowns, the process involves carefully cutting or fracturing the crown to remove it without disturbing the underlying components.
Once the old crown is detached, the dentist inspects the abutment and the implant connection for damage or inflammation. If the abutment is reusable and in good condition, it is often kept in place; otherwise, it may be replaced or adjusted. New impressions are then taken, typically using digital scanners or traditional molds, to capture the exact dimensions of the abutment and surrounding gum tissue.
These impressions are sent to a dental laboratory, where a new custom-designed crown is fabricated to ensure a precise fit and match to the adjacent teeth. The laboratory process usually takes a few weeks, and a temporary crown may be placed during this period to maintain function and aesthetics. During the final appointment, the new crown is checked for accurate fit, bite alignment, and color match, and minor adjustments are made. The replacement crown is then permanently attached to the abutment, either cemented or secured with a retention screw.
Crown Replacement Versus Implant Failure
Replacing the crown is a prosthetic maintenance procedure, distinct from total dental implant failure. The crown is the artificial tooth component, similar to the part of a natural tooth above the gum line. Its replacement is generally non-surgical and focuses on restoring aesthetics and chewing function.
The implant, conversely, is the titanium post placed into the jawbone that acts as the artificial root. This fixture is secured through osseointegration, where the bone tissue fuses directly to the implant surface. Implant failure means osseointegration has been lost, often due to infection or excessive force, requiring surgical removal of the post. Crown replacement is a repair of the superstructure, while implant failure is a loss of the foundational anchor.