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Patient wants implants removed as giving bad taste: thoughts?

Last Updated: Nov 28, 2014

I have a patient complaining of a bad taste coming from her dental implants and she wants them removed! Seems a little extreme to me but this patient is desperate and socially she feels embarassed by the smell coming from them. She has an implant on the 8 position placed in the 90s and about 3 mm of the implant surface is exposed. It is a non-threaded tissue level implant with a smooth collar. The soft tissue around the implant looks healthy with no pocketing deeper than 5mm present and no discharge or bleeding.

The second implant in position 5 is where most of the bad taste is coming from. Again soft tissue looks healthy with no pocketing deeper than 5mm present and no discharge or bleeding present. Radiographs show bone loss around the area.

I have no idea which implants are present so I have asked the patient to contact her previous dentists to find out.

I think I am going to attempt to remove the restorations and attempt to clean around the implants with a wire brush, tetracycline and air abrasion. Hopefully using i-prf and titanium mesh, the bone will regenerate. Anyone do something similar with success? The thought of removing implant in position 8 is giving me goosebumps because of the length of the implant itself.

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10 Comments on Patient wants implants removed as giving bad taste: thoughts?

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TOBooth

12/2/2014

Hi, i think all the bad taste is coming from ill fitting restorations to the abutments- which will smell!!! As you have said, no huge pocketing or bleeding hence no true frank periimplantitis. So therefore why would you use a prophylactic brush - please if your not sure how to diagnose and treatment plan -dont treat. Change the restorations for screw retained restorations the implanst dont look that bad at all!!! leave them alone. I would hazard a guess they are strauman tissue and bone level maybe with an IMz in there as well. Lool up Cumulative Supportive Interceptive therapy that will help you!

Ron

12/2/2014

I agree with the previous comment. BAD taste and odors is usually caused by bacteria and sense the implants have no indication of peri-implantitis, it is probably the abutments or restorations. Removing the restorations and abutments seem logical, also consider zirconia and porcelain crowns. Good luck

12/2/2014

Have to agree. Ill fitting crowns look to be the problem here.

Alejandro Berg

12/2/2014

That NÂ°8 is a very old ITI hollow cylinder. Implants dont look that bad actually. Just remove the restorations and clean, NO wire brush, detox and re do the crowns, that should solve it. Bets of luck

Gary

12/5/2014

Would you not worry about the bone loss around 5? Probed around the implant today and as I lifted the buccal gingival tissue, I could see the implant underneath. I think buccal plate is gone on the 5 and 6.

Gary

12/2/2014

No 8 has about 2mm of exposed threads to the buccal. Is there any aesthetic ways of covering this up apart from its removal and start again?

CRS

12/2/2014

Free gingival graft.

Mark Montana

12/2/2014

It is typically difficult to accurately probe implants with crowns in place. If you can remove the restorations, that is the best start. Remove them and evaluate each implant before making any new restorative plans.

CRS

12/2/2014

I would clean the implants, titanium scalers, LAPIP, Arrestin whatever your choice. See if it improves, if not the restorations need to be replaced this will be expensive! Perhaps provisionals first if no improvement then replace implants can cause significant bone loss. Good luck.

12/15/2014

Those crowns look like they are cement retained crowns. Is there an easy way to remove this type of crowns off implants? Do you cut them like with normal crowns ? And do u use crown remover on it like with crowns on natural teeth? Any better way?

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