Metal Alloys for Implant Supported Crowns and Bridges: Is Discoloration of Gingiva a Concern?

Look into keystone dentals genesis implant. It has charged titanium which makes it pink. ( thus matching the gingiva and not creating issues with thin tissue)

Dear Dr W. Surely we understand Galvanic reactions within the oral cavity and I feel that if you are seeing discoloration within these areas, this is the case. Maybe we need to look into the metals used. personaly I like to use Titanium within the whole case to reduce any reactions. Derek

There are many issues here. Any C & B restorations could have compromised esthetic issues at the gingiva from poor light refraction if sub gingival or from the thin opaque/porceain layer at the gingiva or from the crown margin showing. Use of the porcelain margin is good to prevent this. I feel the labs can produce the best result with a noble type alloy and I can get a color match predictably. I have never used a base metal so I dont know if this leaches into the gingival margin. The labs are now coming on line with Titanium sub structures that are considered noble and also are more stable in cost on the world metals market so they hedge inflation. There are some bonding and color issues to look out for and I would ask the lab to back up the work more than in a normal case due to the "experimental curve" that we dentists always get caught up in when some new material or technique comes out. Use of Zirconia would follow the guidelines for a non-implant restored tooth. Prep design, occlusal clearance, occlusal scheme, esthetic matching to adjacent teeth, gingiva margin placement: supra, sub or at the fgm. One thing to note for implant treatment is the abutment should be zirconia if it is in an esthetic area. Depends on biotype: thick, thin, width of attached, etc. Zirconia abutments could be custom or standard. The zirc. abutment may save some esthetic issues if there is future creep of the fgm. Zirconia crowns do not bond (? new pdt claims it does) so any cement can be used. Zirconia crowns will not show through either, so a titanium or gold abutment is not contra-indicated. I would stay with the predictable materials for best results. The fact is that if a patient really does not like the esthetic result, we will have to redo the case or live with the consequences of the patients reaction. Just some thoughts. Thx for the info on the implant that turns pink. Sincerely Leonard

My lab won't make implant crowns in non-precious pecause of potential galvanic reaction. All of mine are nobel precious. Zirconia would also eliminate the problem.

I agree with comments by Leonard

The base metal alloys in the changing pH environment may be leaching out ions causing the discoloration and tissue irritation.