A Screw in a Screw?! 🤯 How does a crown get attached to a dental implant?
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- Опубликовано: 4 окт 2024
- A really common question I get when discussing implants with my patients is how their implant crown gets attached to their implant. Whenever possible, we prefer to attach the implant crown to the implant via a screw. The alternative is to cement the crown onto the implant. Cement can cause problems down the track which we want to avoid!
I have been a practicing Dentist in Morley, Perth Western Australia since 2010. With these videos I hope to inform and educate ways to improve your oral health, and explain common dental procedures. Through this channel I hope to take away some of the fear and unknown when it comes to visiting the dentist!
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Transcript:
What you're going to see in this video is how the implant crown gets attached to the implant.
Intro scene
What is a little bit tricky to get our heads around sometimes is that, the implant itself is a screw, and then the way the crown is attached to the implant is also a screw. So the screw that attaches the crown to the implant goes down through the middle of the crown. Okay so there's a channel down through the middle of your crown, and that allows the screw to seat, and for us to use our drivers and our instruments to tighten that screw so its really nice and tightened to 35 Newton centimeters. We have a little torque wrench that we make sure its nice and secure.
Once we have done that, then that channel which is through the center of the crown, we fill up with white filling material. That way it looks like there is a whole complete tooth and nothing is going to get stuck inside there.
The benefits for having a crown attached to the implant with the screw, are that it is completely retrievable, so that if anything happens to your crown, like if it gets chipped or it needs to be replaced or repaired or if there's something going on with your implant and we want to take the crown off to check everything, we can easily remove it but without destroying the crown. The crown can come on and off.
The other way that implant crowns can be attached to the implant is that they get cemented. So this is how our crown gets attached to the natural tooth... it gets cemented on. The disadvantage of using cement is that if you want to take it off... you have to destroy the crown and also its very hard to control where the cement goes on an implant.
Procedure on the live patient:
So the first thing we have to do is take off the healing abutment. Its the little protective cap that screws into the implant so that the gum can heal around it. It's titanium, with different colors corresponding to the different sizes of the implant. You can see that this one here is gold.
And there is a really nice healthy looking gum, you can see that there is a really good thick band of attached gum there.
We've tried the crown in, checked the contacts, and we just screw it in to finger tightness. We then take an X ray to make sure everything is seated well into the implant. Once we have confirmed that everything is fitting beautifully, you can see here we have the torque wrench and we are torqueing it around to 35 Newton centimeters to make it really nice and secure.... there it is.
After filling most of that access channel with Teflon tape, we fill the top part with white filling material. This way, it looks just like the ceramic.. its nice and strong so you can chew on it properly, but if we every need to remove the crown for whatever reason, we can easily drill through that white filling material, remove the Teflon tape and access the crown.
There it is looking very nice. This will give a really long service life and good function
Great vid! I'm having my crowns installed in just a few weeks and I was curious to see how they are attached. This was great to see
Glad it was helpful!
Hi, wanted to ask if ur crown placement go okay or if ur still waiting?
@@nashantastanley3261 hey hey, I have all three in and they are doing great! I’m soo glad I remedied this
@Raw Natty N8 Nice!👍 Oh did they numb u for crown fitting?
@@nashantastanley3261 no. Not fit the fitting but definitely for the implant they did.
Thank you for this video. I was wondering why I have a sliver spot in the middle of my implant crown. it's possibility because my dentist did not cover it with the white filling material. I am going to ask him to cover it. Thanks again.
Hi carla so good to see your videos on here 😍 love this video very informative 👍 thank you
Oh wow he lost the same tooth as I did just that mine is on the right 😂😂😂
When my dentist screwed on the crown, it hurt so badly that he had to give me an injection of novacaine. I felt a terrible sharp pain all the way up to my eye! Could he have over-torqued it and caused the implant to break loose from the bone? It's been almost 24 hours and it still hurts. I'm to return in 5 days for him to adjust the crown if needed after my gum swelling decreases.
Hi there, that doesn't sound good, there could be many reasons for the pain. I hope you have had resolution of pain with your implant crown
@drcarlathedentista8143 I have a question. I had an implant abutment screwed into bone but it's not properly centered. Would that affect anything?
@@MyName-cp7qc I know you were asking the Dr, but I just wanted to let you know my experience. I thought the same thing when I got my implant. But my crown is centered just fine. I am not sure if they center it to bone or gum when they do the implant screw. But crown placement turned out just fine.
@@cshamberdid they numbed you up for the abutment and crown placement?
@@kojowiredu yes
my proposed dental implant plan states there will be an autograft bone grafting followed by a "screw & tripodal pin" placement on top of which, a porcelain crown will go. Is the screw and tripodal pin a proper dental implant or not?
I have the implants in with temporary crowns. I will eventually get the permanent crowns in and I’m nervous for it. How long will it take? Plus my biggest fear is gagging and throwing up so will they have medicine for that?
Sir
Is gum form naturally around single implant??
Can you adjust the height of a screwed crown if it is too low?
Why did you take off the crown...what can be used to clean out bacteria underneath if you have a infection?
what I removed is the healing abutment. If you have an infection in your implant you require intervention from a dental professional. It depends on the type of infection as to what treatment is proposed.
Should we expect some discomfort or gum tenderness soreness when an implant crown is placed/screwed in like in @2:56? Thank you.
Just had my crown screwed in yesterday and it hurt like hell when he did it. I've been in pain since then and wonder if he might have over-tightened the crown! My gums surrounding are swollen but the pain is all the way up to my sinus. I just pray that the implant didn't break loose from the bone!
@@alau2058 Oh no!! It shouldn’t break the bone or titanium implant. But please call the dentist to prescribe antibiotics for you ASAP to stem any possible infection. I made mine prescribe for me! Also, get some Chlorofluor gel (use a interdental brush or cotton bud to apply it around the crown and gum areas). Also use salt water warm gurgles too, it soothes the gum and helps keep bacteria load down. You MUST make sure the area doesn’t get infected so all these steps will help. I did these diligently and after two weeks everything settled down and now I am totally fine. 3 questions: Are you able to floss the implant already or is it too painful to do so? How long has your implant been in your gums before this crown was placed? Will allow me to further advise? Do you know chlorhexidine mouth rinse?
the wideness of the crown under the gum ('subgingival profile') may be impinging on the gums and squishing them. This can cause a lot of discomfort. Typically the torque is determined by the implant manufacturer and a special wrench with a force gauge is used to tighten the screw. If you have pain that pain killers are not covering you should return to see your dentist ASAP!
Why do the crowns that I just had placed on my upper palate hurt WAY more than when I had just the posts put into the bone months ago? My gums around the new crowns on the right hand side (and for some reason also the gums on the natural teeth directly below them, which have no implants), are throbbing in pain for 2 days now and show no sign of letting up.
Painkillers and anti inflammatories aren't working, where the usually work quite well with any past dental work related pain I've had. They've given me Peridex Rinse and Amoxicillin for 7 days, something I've taken before, but I'm wondering if during the cap screw removal, pre-crown placement, if I got some bacterial infection in there. I remember it smelled unpleasant when they were taking the post cap screws out on the right upper palate. I had 4 implants, 2 on each side of the upper palate, all molars, except for one small tooth beside the front tooth- a tooth that never grew in for me, so this was an add on. This crown seems to be the most painful of all 4. The 3 other implants were previous molar root canals that eventually were redone until they couldnt be redone anymore and were extracted, necessitating the implants.
Any update?
At what pressure the crown should be tighten on the implant? My dentist did the crown and he tight at 32 Newton and my bottom jaw hurting
Hi, there may be several reasons your jaw is hurting. The actual torque depends on the implant system and the abutment type, these are things determined by the implant manufacturer, 32Ncm is not unreasonable. Some other factors may include the subgingival profile of the crown (may be very bulky, so squishing the gum), and if the bite it too heavy from the opposing tooth. These are just a couple of things. You are best returning to your dentist if the pain hasn't gone away.
Can the crown be taken out and made made smaller ?
yes it can do but hopefully the prep work done beforehand will avoid this
This patient needs dental braces FIRST!