A dental implant showing can be an esthetic or biological issue or both.
Dental implants that are above the gumline and you can see are an issue. If the threads are exposed it will be difficult to clean and cause biological issues. If you can see the metal it will cause an esthetic issue.
How can we fix a dental implant that is showing.
3 ways to fix, but first have patient hold a mirror at arms length and give “e” smile and count the sixties to see what really shows. If does not show easiest option is to let unesthetic area be.
- Prep the implant, I’ve seen done for lower anteriors for overdenture where a lot is showing. This can be used for more severe cases
- Make a buccal flange to cover. For less severe cases. If too much showing then have to use pink porcelain.
- Rebury it with soft tissue graft, for minor cases in anterior. Pedicle graft and SECTG are methods that may work. If threads exposed then needs bone graft and membrane. There are not many doctors that can accomplish this kind of treatment Stefanini IJPRD 2020. Tavelli IJPRD 2022 has some beautiful cases.
How to treat exposed implant threads.
If there is 360 degrees of bone loss the chance of recovering is close to zero. If want to attempt then the following is a good protocol. Otherwise smoothing the threads to create an easier surface to clean is better plan.
- Healing cap
- Expose area
- Clean with cotton and air power abrasive unit of Na2CO3
- Irrigate NaCl .9% Baxter Health
- Graft autogenous or allograft
- Collagen membrane or maybe Ti reinforced better here?
- Suture 2 weeks remove
- Leave 6-9 months
How to treat a case when the implant is not showing but is close.
McLaughlin JPD 2023 shows a nice case for an anterior implant that is showing but just slightly. The method involves screw retained and porcelain overlay in the office.