Metal abutment showing on implant crown?

M

MountainMama

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I had my implant crown placed a few weeks ago on my lower left first molar. Everything went well, but it was a different type of crown than I had previously (new dentist). This one is also screw retained, but has a metal abutment that screws into the implant and then the crown is placed, then a screw is put in. Then a filling. My other ones had no abutment, as far as I understood. They were placed and the screw was then placed and tightened.
With this new one, at my cleaning last week, I brought up the dark metal showing on the inside. The hygienist said she didn’t think it was a problem. I didn’t see the dentist since I had just seen him the previous week.
Now, the metal is showing on both the inside and outside. Will that cause problems with cleaning? Or will it compromise the implant in any way? It doesn’t look nice but it doesn’t show when I smile. I am hoping there is no more gum recession or it will really be obvious.
Sorry the picture is not focused but you can see the dark line where the crown ends. The inside is even worse.
 

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Gordon

Gordon

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In theory a metal margin should be more highly polished and therefore less of a plaque trap than porcelain, so it should in theory be kinder to the surrounding tissues and easier to clean. Practically it probably doesn't make a lot of difference.
 
drhirst

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Hi MountainMama,

As Gordon says, it will, if anything enhance, your ability to clean for the reasons he stated.

For a dentist to have a harmonious relationship with his patient, communication is key. Here is a prime example. If your dentist had discussed whether you would mind having the metal margin visible and explained the reasons for it you might have opted for a different crown design or felt more comfortable this design. Also if it was not planned but turned out like this then a discussion at the crown fit would have avoided this worry.
The gum and bone around implants is much less robust that around natural teeth so anything that can help protect them without being too unsightly is a good thing in my opinon.
L
 
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MountainMama

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Thank you, @Gordon . That makes me feel better.
 
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M

MountainMama

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Thank you for the reassurance, @drhirst. I don’t think it was planned. I don’t even think the dentist noticed it. At the crown placement, he spent a lot of time getting my bite right…way more than my last dentist. I noticed the metal line at home on the inside of my jaw a few days later. The one on the outside wasn’t visible at all until several days ago. I guess my gum receded a bit…maybe it was swollen a bit as he kept taking the crown on and off to adjust it. It was very tight and he kept adjusting the sides.

I don’t mind it aesthetically, as it doesn’t really show when I talk or smile. I was just worried about food getting stuck under or between the crown and abutment, since the crown is not cemented on. I guess that is kind of silly, though, isn’t it?

There is a little ridge there, where I can feel the edge of the crown on the inside, and that drives me crazy. My tongue keeps going to it. 😐 I guess I will eventually get used it.

Thinking back, he was explaining that this was a tissue level implant, while my other ones were bone level. So does that mean it is actually the implant showing and not the abutment?
 
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