Is It Normal to See Implant Screw Shadows on Dental Crowns?

Q: Is It Normal to See Implant Screw Shadows on Dental Crowns?

Hello Ms. <br>He： It is likely that the absorption of the hard tissue around the implant has led to the exposure of the implant screw. <br>It is recommended to return for a follow-up appointment with the implant dentist for an examination and to assess whether a regenerative surg

Is it normal for the surface of the implant screw to be visible on the dental crown?

Last November, I completed the installation of three dental crowns for the lower left posterior area.
However, I have repeatedly experienced issues with occlusion, leading to multiple adjustments by the dentist (both the crowns and the upper teeth have been ground down several times, resulting in a corner of the upper tooth being chipped).
Additionally, there is a noticeable black shadow from the filling screw on the crowns that cannot be fully covered.
Could this be a fabrication issue with the crowns that requires remaking? Furthermore, the last tooth often causes gum inflammation and pain during occlusion (despite cleaning with a single-headed toothbrush and interdental brushes after each meal, I still experience discomfort and odor).

He, 50~59 year old female. Ask Date: 2023/04/01

Dr. Zeng Guanghui reply Dentistry

Hello Ms.
He: It is likely that the absorption of the hard tissue around the implant has led to the exposure of the implant screw.
It is recommended to return for a follow-up appointment with the implant dentist for an examination and to assess whether a regenerative surgery for the hard tissue around the implant is necessary.
Dr.
Tseng Kuang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2023/04/01

More Info

Seeing shadows of implant screws on dental crowns can be concerning for patients, and it often raises questions about the integrity and functionality of the dental work. In your case, it appears that you have undergone a dental implant procedure where three crowns were placed on the lower left side, but you are experiencing issues with occlusion (bite alignment) and visible shadows from the screws.
First, it’s important to understand that dental implants consist of a titanium screw that is surgically placed into the jawbone, which serves as the root for the crown that is placed on top. The crown is typically made of materials like porcelain or ceramic, designed to mimic the appearance of natural teeth. The presence of shadows or dark spots around the area where the screw is located can indicate a few things.

One common reason for seeing shadows is the exposure of the implant screw due to bone loss or resorption around the implant site. This can happen for various reasons, including infection, improper placement, or mechanical issues with the crown itself. If the crown does not fit properly, it can lead to food accumulation, which may cause inflammation of the surrounding gum tissue, leading to discomfort and potential infection.

In your situation, the fact that you have had multiple adjustments for bite issues suggests that there may be a problem with how the crowns were fabricated or how they fit with your existing teeth. If the crowns are not adequately sealing the area around the implant, it can lead to bacteria entering, causing inflammation and discomfort, as you have described. The persistent discomfort and foul odor you mentioned could indicate a possible infection or peri-implantitis, which is an inflammatory condition affecting the soft and hard tissues around the implant.

Regarding whether this is a manufacturing defect, it is possible. If the crowns were not designed or fitted correctly, it could lead to the issues you are experiencing. It is crucial to address these concerns with your dentist or oral surgeon. They may need to take new X-rays to assess the condition of the implant and surrounding bone, and to determine if there is any infection present.
If the shadows are due to bone loss or if the crowns are not fitting properly, your dentist may recommend a few options. These could include:
1. Re-evaluation of the Crowns: Your dentist may need to assess the fit of the crowns and determine if they need to be remade or adjusted further.

2. Bone Grafting: If there is significant bone loss, a bone graft may be necessary to restore the area around the implant.

3. Cleaning and Treatment: If there is an infection, your dentist may prescribe antibiotics and recommend a thorough cleaning of the implant site.

4. Regular Monitoring: If the situation is not severe, your dentist may suggest regular monitoring to see if the condition improves with time and proper care.

In conclusion, while seeing shadows of implant screws on dental crowns is not uncommon, it should not be ignored, especially if accompanied by discomfort or other symptoms. It is essential to consult with your dentist to evaluate the situation thoroughly and determine the best course of action to ensure the longevity and health of your dental implants. Regular follow-ups and good oral hygiene practices are crucial in maintaining the health of dental implants and preventing complications.

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