implant special

Gum recession around implant abutment: recommendations?

Last Updated December 11, 2019

7 months ago, I inserted a fixed cement-retained 6-unit bridge replacing upper six anterior teeth over 4 implants. Recently, I noticed gum recession exposing 2mm of metal abutment in #23 site. On x-rays, there is a gap between the metal abutment and the ceramic crown ( not only in this area but on the other two areas also). The implants were subcrestal so the abutments are subgingival. My lab advised me that sometimes it is very hard to extend the ceramic crown to fit abutment margin, but most importantly it should be sealed. The bridge fit very well, implants are very solid and no bone loss noticed. My question: is the gum recession due to the gap or not? And what should I do now?

Background patient information:
Patient age 60 yrs old
MH: taking immunosuppressive medication
Oral hygiene is fair, PD 2-3 mm all around and no BOP.
Heavy grinder missing lower posterior teeth bilaterally.

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