Post-Cementation Pain for Implant Patient: What’s Going On?

It's possible that the implant has lost integration or was not integrated in the first place. If all else fails I recommend removing the crown and checking integration by reverse torquing. Good luck.

Pain five months after restoration is a sign of trouble. You show no radiographs or pictures to give more information. You might want to take a CBCT scan of the implant and reevaluate it's placement. If it has to be removed, you will have an esthetic problem unless you can maintain the soft and hard tissues at the correct level. Good luck!

Dr.C has not told us which tooth the implant has replaced...but judging from his sending the crown back to the lab five times, leads me to believe that it must be a front tooth...and probably in the premaxilla. This being assumed, I would venture to guess that the buccal plate of bone is very thin, and the implant is right up against it.......and physical pressure against the fragile bone is causing a dehiscence to the buccal plate. The ZOE cement Fynal....does this mean it is final and the crown cannot be easily removed? If the cement is too strong, and there is a risk of damaging the implant, then try to remove the crown by drilling a hole in the cingulum, and accessing the abutment screw ( if an angled abutment was used, then cut the crown off). I assume that the oral surgeon who was consulted took a radiograph and comented that it looked fine based on a two dimensional radiograph and not a three dimensional cbct scan. If there is no pathology, and the implant is in fact butted up against a fragile labial plate, then take off the crown and abutment, let the gingival tissue close up...and at a later date open a flap, and place a graft on the buccal surface to thicken the buccal wall. Good luck....and let us know what happns with a further posting six or more months from now. Gerald Rudick dds Montreal, Canada

I would say its lost and you will have to start all over, Sorry.

Four changes to the crown and unexplained pain raises possibility of psychological component to the symptoms. .Any history of other painful apparently healthy teeth ?

An unexpected pain after a period of five months I thınk is a good sing of extra stress on the implant which may be caused by the micro ftactues of the periimplanter bone.Secondly the pain may come from the adjacent teeth because you have mentioned that contacts were tight.thirdly youmay have irritated the surrouding tissues during try in of the crown.Please take of the crown let the implant rest and evaluate the bone by an apical x ray after at least 4 week.İf you see the enlargement of the periodontal space which is a sign of inflamation wait for another 3-4 weeks and reevaluate the satuation again.İf every thing is ok go on with the prosthetic treatment if not explant the implant and try another one after bone healing.Good luck.

not enough data to even guess at what might be the problem. for sure get a 3-D image of the area and have a radiologist evaluate it. this is not very costly and could save your but. some times a patient that is not entirely happy with the aesthics will report having problems. I hope you find an answer soon.

the above mentioned case is need further information to assess the condition ... occulsion need to checked ..x.rays ..and the periodental condition of the surrounding area

Take the crown completely out of occlusion or remove the crown and abutment and place a healing colar, give it tincture of time! Radiographs and photographs would be helpful. Sorry this happens once and a while. Check out Implant Protected Occlusion.

may i suggest cutting the crown and then removing it with minimum pressure to prevent any damage to implant body and bone....put temporary crown making sure it is out of occlusion and keep it like that for a month or two...follow the region with IOPAs (CBCT causes lot of exposure...choose when necessary)...is no pain and things fine then choose "implant protected occlusion" for the final crown...if not...i guess signs will come on the radiographs...all the best

the main causes of pain after implant cementation are -Peri-implantitis -That the implant was not osseointegrated rather there is fibrous attachment which under tension causing pain this kind of pain is also noticed during abutment torquing the degree of pain related to the ratio between bone and fibrous tissue