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Crown Loose: Recommendations?

posted in Abutments, Patient Questions on Dental Implants

« Surgical Motor Units for Implant Placement? | Hydraulic Sinus Condensing Technique »

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AJ, a patient from Mississippi, asks for help:

I had a dental implant put in 4 years ago. I have returned to my dentist 3 times because the crown became loose. Now after seeing a different dentist who reviewed my x-rays for the past 4 years, he says that the abutment was never properly seated onto the implant and that is why the crown keeps coming loose. After cutting off the crown and removing the abutment the screw is stuck fast in the dental implant and he cannot get it out. What do you recommend to correct this?

16 Responses to “ Crown Loose: Recommendations? ”

• Alejandro Berg May 29th, 2007

  
  

  Do to the nature of the problem I am assuming this is an internal conection implant.
  Many implants like zimmer or straumann implants have friction, due to this the abutment is hard to remove.
  The only thing he needs is a retrieval screw or retrieval wrench. This are very easy to use, just insert and screw clockwise untill the abutment becomes loose.
  If this is an astra implant things are a little harder but same principle.
  best of luck

• Dr John A Murray May 30th, 2007

  
  

  The problem is not related to the initial seating of the abutment. Assuming the crown and abut CAN seat ok, the 2nd fixing would have cured this.

  Some systems to make provision for screw-lossening, but whether or not this is so, damaged or fractured screws periodically prove problematic.

  Let me know the implant system, and I’ll give you the most up-to-date soln.

  info@nationalimplantdentistry.com

  Dr John A Murray

• JA May 30th, 2007

  
  

  Let me understand this, The crown was loose?? or kept coming off? but now the crown is cut off and the abutment cant come out? Crown’s falling off are for several different reasons. In my experience the most common reason that crowns fall out whether they are on teeth or on implants is insufficient crown height. i.e. either the tooth is broken down so much and very little of it is left for the crown to hang on to or the abutment is not thick or tall enough ( usually a problem with a pre-fab Abutment) or even more so you bite/occlusion is off. Several different ways to look at it. As for removing a torqued abutment screw, like they DDS above mentioned depending on the system some have friction lock system that need a special removal tool.
  Good Luck

• Dennis May 30th, 2007

  
  

  This reads as though the screw has broken, as Dr. Murray suggests, and remains in the fixture.
  There were several good posts a couple of months ago regarding broken screw removal

• berry May 30th, 2007

  
  

  I am confused. the crown kept coming loose but not the abutment or was it both the abutment and crown. If it were the former, the crown should have been removed and the abutment loosened and reseated and a new crown made.. if it was the latter you should have cut off the crown, reseated the abutment or made a new abutment then a new crown. Also until the occlusion is set and refined to be maximal, implant screws and abutment tend to come loose. If it was an external hex and the screw is broken off in the implant , it would require a number of steps. first if it were loose, you try to tease it out with an explorer. It has taken me up to a 1/2 hr to do it at times. If it is truely ” stuck” then you have no choice but to drill it out and retap the implant. Kits are available from various manufacturers.
  Good luck

• Charles Bretz May 31st, 2007

  
  

  I have Straumann inplants to hold my lower dentures in place. The problem is, they do not hold the teeth in place. The dentist fixes this but within weeks, or even the next day, the denture comes out again, especiall when eating. What can be done to fix this permanently? Not only has the dentist worked on this but also a couple of Straumann factory reps have been on hand. No one seems to know what the cause is and I am getting very frustrated. Thank you.

• ElieVictor June 1st, 2007

  
  

  Dear Charles Bretz
  What kind of Straumann abutments are holding the overdenture?
  If you have ball abutments torqued at 35 Newton your dentist should change the holding titanium matrixes. If you have a bar the riders should be changed.
  Hope my comments will help
  Send me a more detailed info
  Elie Victor

  .

• Ophelia August 18th, 2007

  
  

  I had my crown cemented to my Straumann implant about a year ago and it had come off 4 times since then. Every time I went back to my dentist, he assured me that he used a stronger cement and it would work, but each time, it had disappointed me.
  The implant was placed at a slanted position to avoid a sinus lift. I believe my problem lies with the slanted abutment and not the cement. Any comment?

• Dr. Bill Woods September 7th, 2007

  
  

  To A.J.the Mississippi patient:
  Was your problem solved? I am from Meridian and would like to know and help if I can if you are close. It has been awhile since you posted this problem.
  To Charles, I hope yours was solved as well. let us know what happened. And Ophelia, sorry, but your crown should stay. In my view, implants should not be placed just to avoid the sinus but placed to support the crown in the proper vertical position. If the implant position involves encroaching the sinus, the a sinus lift to augment the area should be done in most cases.Possibly a shorter implant might be a solution. There are cases for off angled placement but if this is a single crown, I would think this isnt one of them, but I dont have an xray and model. fr me to feel confident about my implant placement, I tell my patients that they will need a lift to give the implant crown longevity. A stronger cement isnt working, so something has to be happening. There are also other factors to look at such as occlusion (your bite), chewing habits, abutment type, crown height, abutment anatomy, or partial dentures that may torque the crown. Hope this helps.

• Jim Morrison January 19th, 2008

  
  

  I have a theoretical question: suppose a crown is temp cemented to the abutment on a single-tooth implant, and the screw becomes loose. Can the crwon be popped off with a crown puller without damaging the screw threads?

• satish joshi January 20th, 2008

  
  

  Yes,If your prep is not very retentive and cement used is tempbond type.But you have to gain access to abutment either thru gingival retraction or small flap and hold on to abutment very firmly with narrow beak hemostat and use another hemostat to loosen crown from an abtment.
  Best bet is to drill a hole in occlusal suface holding a crown with hemostat, and tighten screw.

• Ophelia February 3rd, 2008

  
  

  To Dr. Bill Woods,

  Thank you for your comment.

  My dentist replaced my crown that kept falling off with a ’smaller’ crown (It is slightly shorter that the adjacent teeth). It had lasted me another 5 months since then (which is longer compared to an average 2-3 months previously) and yesterday, it fell off again!

  I am getting mad with my crown. My dentist mentioned about changing the abutment. The thought of unscrewing it makes me tremble. Will the abutment break and get stuck in the process of unscrewing it? And does it hurt? I read that Straumann implant has friction and it is difficult to unscrew.

  I have a crazy thought that perhaps I should buy some dental cement from my dentist and do it myself the next time it comes off again. Do you think this is feasible?

• Donna Campbell January 11th, 2009

  
  

  I went for a dental check-up and my dentist said she noticed my implant crown was loose. I went to a specialist who said it would be a simple procedure of drilling the crown, tourquing the screw and refilling the crown. Not so. The dentist did not have the correct size wrench so he said the screw must be broken (it wasn’t) and proceeded to drill out the tooth. I was charged almost $200 for this. So instead of a simple fix I am left with no implant crown and a sharp piece of implant metal in my mouth. I will need a new implant and implant crown for something that could have been a quick fix. Do I have any recourse for this? I really don’t want to go back to this dentist but do want my implant fixed.

• Linda Filbern January 11th, 2009

  
  

  Just a question in response to Donna Campbell.
  When the crown became loose, did you go back to the dentist who placed it? If so, he should have had the proper wrench. If not, are you sure the dentist just said the screw was broken because he didn’t have the right wrench? Maybe it was broken. These things get extremely complicated and expensive sometimes even with the best care and qualified dentists.

• Wendy Wallach February 21st, 2009

  
  

  The crown on my dental implant just fell off. It is Saturday night…do I need to call my prosthodontist tonight or tomorrow or can it stay out until Monday? I saw the oral surgeon yesterday, when I found it was loose, and it is not a bony failure, just a problem with the crown that has been fine for 5 years.

• Jean February 23rd, 2009

  
  

  Donna,… If worse comes to worse, you can always file a complaint with your state’s Dental Board. I hope that it doesn’t have to come to this but if you know the dentist did not tell you the truth, after a 2nd opinion, you should file a complaint.

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