I have seen a number of patients complaining about a loose dental implant. What is the cause?
First one has to determine is the implant loose in the bone or is the crown attached to the implant loose.
Most frequently the patient has a screw loose. (pun intended) All implant crowns are attached to an implant by a screw. Usually it is the screw that has loosened, hence the crown feels loose. Less often, the screw breaks. There are two ways to use a screw to attach a crown to an implant. Let me explain. An implant is an anchor, sort of like a lead anchor that you would place in a wall. To attach a crown to the implant, one needs an abutment which is attached to the implant with a screw. A crown is then fabricated which is cemented on top of the abutment. This is fine for use on front teeth.
However, if something breaks or a screw is loose, you may have to cut the crown off and make a new one. An alternative is a screw retained crown. A screw retained crown contains the abutment and crown in one piece which is then screwed into the implant. Personally, this is what I prefer for the back teeth.
Because of retrievability.
If a screw loosens or porcelain fractures one can gain access to the screw through a small opening at the top of the crown. That opening is sealed with a tooth colored composite. Once you have access to the screw it can be tightened or the crown can be sent to the lab for repair.
Now, what if you determine it is not loose screw. Just like natural teeth, implants can develop gum disease which causes erosion of the supporting bone. If the implant is loose because of deterioration of the bone, the only recourse is to take out the implant and perform a bone graft with the hope of placing a new implant at a later date.
Bottom line, take care of your implants if you want them to last.
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