Gingival Sensation in Implant Patient: What Could Cause This?

Last Updated: Feb 21, 2010

Dr. JC, aasks:
I placed an implant in one of my patients. The medical history was noncontributory and the surgical placement was uneventful. I placed a crown on the implant 3 weeks prior. When I placed the crown, the gingival margin was very tight around the margins. I decided not to place releasing incisions. The amount of stretching of the gingival was really within normal limits and nothing out of the ordinary. The patient is now complaining of having the sensation that something is caught in his gingival. The gingival tissue appears normal and is tight around the crown margins similar to other crowns I have placed. There is no swelling in the gingival tissue. What could be causing this? Should I do anything at this point or should I just watch the situation?

6 Comments on Gingival Sensation in Implant Patient: What Could Cause This?

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Carlos Boudet, DDS

06/22/2010

Dr JC If everything was within normal limits, as you say, it will pass. You may want to take a post-op x-ray to check the fit and for any excess cement that may have been missed at the cementation appointment.

Dr. Jigar Gala

06/22/2010

Initially I would recommend to just wait and watch. however since u say that thee is no swelling or inflammation, as time passes you might notice some kind of signs or symptoms. U havent mentioned that your crown was cement retained or screw retained. If it was screw retained, I would remove the crown and just scoop the gingiva around the implant head. If it was a cement retained crown, u have no option but to wait and observe. If needed you might have to remove the crown and make the necessary modifications and refit the crown. IOPA will mot help in this case. gud Luck,

Joseph Kim, DDS

06/22/2010

Perhaps part of the gingival margin is caught under the margin of the crown.

Joshua Shieh

06/23/2010

*Is the tissue around the crown still blanched? *It could be an over-contoured crown causing pressure on the underlying gingiva.

Richard Hughes, DDS, FAAI

06/24/2010

You may want to release the gingiva with an incision on the mesial and distal of the abutment, that runs to the adjacent tooth on each side. Release the side that is blanched with a currette. Next control bleeding and place the crown. This works very well and without recession.

Afshin Danesh

06/24/2010

Dear colleague; If in your post-op x-ray there is no gap ,the crown is seated completely, so no tissue is trapped, try to check for any exess of cement around the crown , w/c has to be removed. Or else te recoturing of the crown margin should be considered, since over contured crown might end up with gingival recession in the future , if left alone.

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