Implant Crowns

What Are Implant Supported Crowns And Why Are They Used?

Implant crowns are self-supporting, non-removable structures that most closely replaces a missing tooth or multiple teeth for the best strength and longevity. An implant replaces the root portion of the missing tooth inside the jaw bone and the visible, above the gum portion of the tooth is replaced by a crown that is attached to the implant.
The use of dental implants to support replacement teeth has a significant advantage over other methods of tooth replacement in that the replacement teeth (crowns) are attached directly to the implants and does not involve any cutting, modification or attachment to your remaining natural teeth giving your remaining natural teeth the best chance of lasting a lifetime.    Dental implant supported crowns are fixed into place and are not removed from the mouth unlike removable partial dentures.

Dental implants may be less, similar or more expensive than fixed bridges.  Because implant crowns generally have the best strength, the long term costs are most likely less than fixed bridges which are not as likely to last as long.  Dental implants will also reduce the rate of bone shrinkage that occurs when natural teeth are removed from your jaw, which will help maintain a natural appearance.

Implant Supported Crowns
Single Implant Supported Crown vs. Multiple Implant Supported Crown

Did you know:

  • Unreplaced missing back teeth often result in many other teeth including the front teeth becoming crooked, worn and a problem overbite
  • Missing front teeth often result in speech impediments

Frequently Asked Questions

The first step is to design and plan the implant crown, similar to a construction blueprint to optimize its size, shape, your bite, access for cleaning and sometimes an implant guide stent is needed to guide the correct surgical placement of the implants.  If required, temporary replacement teeth are made if not already present, usually in the form of a removable partial denture.

Teeth in the area of implant placement are removed either well before or sometimes at the time of implant placement. Often all the implant surgical treatment can be completed in a single surgery but there are situations when treatment is best completed in multiple stages.  This surgery requires meticulous care in an appropriately prepared office and localized anaesthesia to ensure you are completely comfortable. Your denture will be modified for ongoing use usually at or soon after each surgical appointment. Usually three to five months is required for the bone to solidly stabilize the implants; a process called osseointegration.

Once your bone has solidly grown around the implants, fabrication of the implant supported crowns can begin.  Occasionally, some treatment situations require minor surgical enhancement of the soft tissues (gums) that surround the top of the implant to facilitate cleaning or to obtain the esthetic result desired.  The implant crown is usually made using a gold alloy framework for strength and an outer layer of tooth colored ceramic to create a natural appearance. The making of your implant supported restoration is exacting to achieve the optimum results for you and therefore can require multiple appointments with your implant prosthodontist.

High quality, natural looking implant crowns need to be more than just ‘white’, they must approximate the complex color scheme of your other teeth or they will stick out like a ‘sore thumb’.  Color is approximately matched using standardized color tabs which are selected with your approval and is included in basic implant crown fees. If your implant crown is prominently visible, some degree of additional customization will usually be required to more closely match your other teeth.  This customization process can proceed until the best possible match is obtained subject to the limitations of man-made materials with fees based on the length of time required for customization. When skillful clinical treatment is combined with artful laboratory technical work it is often difficult to detect the difference between a well made implant crown and your natural teeth.  Natural teeth will tend to slowly darken with age. Teeth replaced and restored with an implant crown will remain the same color.

Shape is extremely critical and is one of the most frequently overlooked aspects of many implant crowns.  This has resulted in an otherwise attractive smile being ruined by implant crowns not matching the remaining teeth and appearing as if they stick out.  Proper shape is also required to prevent food jamming between teeth and to permit easy and thorough cleaning to avoid bad breath.

Red, blue or swollen gums and gum recession are ugly and can be caused by improperly made implant crowns.  The gum around the implant crown should be pink, firm and not bleed during cleaning.

A well made implant crown should have a perfect bite and feel completely even with the other teeth on the very first day and does not require time to settle in.  An uneven bite will either be uncomfortable or allow your other teeth to shift and become crooked.

Depending on the type of implant restoration and patient variables, different esthetic results are possible.  Some parts of the implant or supporting framework may be visible if the lips or cheek are artificially pulled back but in most instances the implant restoration appears very natural in normal viewing.  An implant crown should feel comfortable, look natural, maintain or restore your ability to eat and speak. Our patients routinely can’t feel the difference between a real tooth and an implant.

Research has shown that high success rates of over 95% are routinely achieved but success can never be guaranteed.  In the unlikely event that the bone fails to stabilize the implant, then after implant removal and subsequent healing in the area, a replacement implant can usually be placed.  Because smoking compromises the body’s ability to heal, there is a somewhat reduced success rate for implants and especially bone rebuilding or grafting in smokers. You are encouraged to reduce or preferably quit smoking as soon as possible, prior to implant placement.

Implant dentistry is best completed by a dental specialist who has extensive training and the appropriate knowledge and skills in implant dentistry.  Do not expect your general dentist or a denturist to obtain the results routinely obtainable in our prosthodontic specialty office. General dentists try to stay on top of all the general routine treatments patients need but can’t be expected to be capable of providing specialized treatment.  A denturist is not a doctor or specialist and only completes about a 16 month trade course that allows them to provide a cook book approach to making ‘one style suits all’ dentures. There are some capable dental specialists in Mexico and elsewhere but always beware of ‘discount dentistry’. An attempt to obtain specialty treatment from those without the appropriate training and experience is likely to create problems and regret.

Implants and their crowns will not get dental decay like teeth but if not designed well and regularly cleaned and checked, the bone around the implant can break down, similar to teeth.  Cleaning implant supported crowns is not too different from cleaning natural teeth. You must thoroughly brush your teeth and clean between the teeth using either floss or other cleaning aid every day.  You will be shown and coached on the techniques necessary to care for your implant restoration.

An extremely well fitting implant crown can be properly cleaned.  An implant crown with average fit can’t be cleaned properly and is much more likely to result in gum infection and bone loss around the implant which can also affect other implants and teeth.

In the event that one of several implants is lost, or if additional teeth are lost and more implants are required, or even if the appearance of your teeth changes, this type of implant is versatile and well suited for future modification or change.  The existing implants would be maintained as is, additional implants placed if needed, and the original implant crowns either modified or new ones made. We only use implants that are manufactured with safe bio-compatible materials that have been adequately tested and are of a standardized size and shape from a large reputable manufacturer.  Beware the risks of using new designed product from a new manufacturer who may not remain in business for all the years we expect implants to last.

Replacement of missing teeth using these particular dental implants and techniques is supported by volumes of research and has demonstrated successful experience for more than thirty years in Sweden and was introduced into North America at the Toronto Conference in 1982.  Implant dentistry is best completed by a dentist who has extensive training and the appropriate knowledge and skills in implant dentistry using researched and proven materials and techniques to obtain years of success for patients.

All Tooth Replacements

All tooth replacement treatments, in our office, should achieve the following:

  • Restore a smile and chewing ability by eliminating gaps caused by missing teeth
  • Prevent teeth in the area of a missing tooth from tipping over or becoming crooked
  • Help maintain the natural shape of your face by providing support for your lips and cheeks
  • Ever since I was young, I knew that due to a congenital condition, I would never have two permanent teeth. … I was 41 when I found that one of them had deteriorated to practically a transparent shell with the other tooth not far behind in the disintegration process. … Several factors weighed in my decision which resulted in my final choice of treatment by way of implant supported crowns. … And now that I have the dental implants in place? I LOVE THEM, I LOVE THEM!!! Forget the cruise; nix on the down payment on new wheels; let the minks keep their pelts, BUT let me keep these marvellous teeth. I’m the one smiling with abandon, butter drippin’ off my chin at the corn roast, and I haven’t even a shadow of a doubt that I made the best choice possible in getting these new teeth. I would recommend them to anyone and (touch wood here) would, in a New York minute, opt for the same treatment if I needed it again. Thank you, thank you, for your incredible work, Dr. Neale and for your wonderful staff’s assistance…
    Mrs. L.B. Morinville
  • You have given my girl the joy of smiling. You and your team are the Greatest!
    Sincerely grateful, Mrs. K.C. NWT
  • I can’t thank you all enough for all that you have done. I would have never expected to find so much passion about fixing peoples teeth in an office. It’s truly been an experience for me to observe the level at which you all operate and care about the people you serve.
    Indebted to you, with humble gratitude, Mr. J. M. Slave Lake

Case Studies

Single Implant Crowns

Case Study

Ms. D.M. was 18 years old and her upper right lateral incisor was missing as it never grew. We reviewed the various treatment options, consisting of a bridge, adhesive bridge and an implant crown. The implant crown was the best option as it would be most likely to be long lasting, look and work similarly to a natural tooth and not damage the adjacent teeth. Ms. D.M. decided she wanted an implant supported crown to replace this missing front tooth but was a little nervous about having the implant work. She became much more relaxed about proceeding after her friend talked to her about the treatment, as he had recently had similar treatment completed. Coincidentally, her friend was also one of our patients!

Case Study

Mr. B.M. was a student at the University of Alberta when he came to our office. He had fractured his upper right central incisor 4 years earlier and had it repaired with a crown but the tooth did not last and had been removed a little less than a year prior to seeing us. Mr. B.M. had a small space between his front teeth which he was used to and did not want additional treatment to eliminate. Because of the space, a bridge was not possible and he did not want to have a partial denture so the decision was made that an implant supported crown was the best way to replace the tooth and restore his appearance and function as close as possible to a natural tooth.

Case Study

Mrs. T.H. was 30 years old when she was first came to our office. She had two baby ‘eye’ teeth that were still present because both of her adult lateral incisors never developed and her adult ‘eye’ (cuspid) teeth had come in next to the two front teeth. Mrs. T.H. felt self conscious about her appearance because the baby teeth looked much smaller than her other adult teeth and they were continuing to wear down. Her regular dentist did not offer her any options that she felt comfortable with. She then consulted another dentist who suggested placing 2 veneers on the central incisors as well as a bridge to replace the two missing teeth and also crowns on many other teeth to increase the height of the teeth overall, which she objected to because she felt all the other teeth were fine. She then asked a friend of the family who was also a dentist for their opinion, who recommended a consultation in our office. We suggested placing only two single implant supported crowns in the space of the baby teeth once they were removed. This treatment was completed leaving all of her other teeth unaltered and Mrs. T.H. comfortable and very happy with her smile.

Case Study

Mr. R.N. was 41 years old when he fractured his lower left first molar. Two years later he was referred to our office for an implant crown to replace this missing tooth and is happy to be able to chew on that side again.

Case Study

Ms. L.B. was missing her upper right lateral incisor and had a very small and narrow ‘peg’ shaped left lateral incisor. We discussed the treatment options for tooth replacement and creating a normal sized appearing tooth on the other side. Ms. L.B. and her parents decided to proceed with an implant supported crown and a veneer on the ‘peg’ shaped tooth. She was in the process of having her teeth straightened with braces at the time she first saw us. We advised the orthodontist how much space to leave for the planned implant and once the teeth were nicely aligned and Ms. L.B. was fully grown, our treatment was started. Ms. L.B. was age 16 when her treatment was finished.

Case Study

Mr. B.S. was age 19 when he had an accident at work that fractured his jaw and broke many of his teeth. It was decided that the best way to repair the fractured teeth would be with crowns and for two of the teeth that were fractured beyond repair, to replace them with implant supported crowns. Mr. B.S.’s teeth also happened to be somewhat crooked which he had always wanted to have fixed. So he decided to proceed with orthodontic braces to straighten his teeth. Once the teeth were straight, we then proceeded with three crowns and two implant supported crowns, which were paid for by Worker’s Compensation.  Mr. B.S. now has the straight teeth he wanted and has recovered his smile and full use of his teeth following his accident.

Case Studies

Multiple Implant Crowns

Case Study

Miss. C.G. had an accident in which her upper front central incisor was knocked out and then was successfully put back into the socket when she was 9 years old. She then wanted her teeth straightened and had braces that were finished when she was 15 years old. Her general dentist noticed that the roots of some of her teeth had become very short, a deterioration that can sometimes result from trauma and as a consequence, a number of her teeth were becoming very loose. There was no way to stabilize the upper front four teeth and replacement with implant supported crowns was clearly the best option. After three or four years, when the family was ready to proceed, two implants were used to support four crowns when Miss. C.G. was 20 years old. These teeth now feel solid, don’t have any looseness and Miss C.G. has normal use and appearance of her upper front teeth.

Case Study

Mrs. J.L. had traumatized her two lower front teeth when she was 36 years old, root canal treatments had subsequently been completed and then crowns were placed on these teeth 20 years later which had been problematic. Her dentist then referred her to our office and she indicated that she wanted these teeth removed. The adjacent teeth were very small and would not make good supports for a bridge so implant supported crowns were the only good alternative. Two implant supported crowns were completed when she was 68 years old and she now has regained function with comfort like her natural teeth.

Case Study

Mrs. P.W. was in a motorcycle accident when she was 38 years old. Her upper front right tooth was knocked out and many other front teeth were chipped and damaged as well as some facial skin scarring. She had finished orthodontic braces to straighten her teeth just 6 years ago as an adult. As a result of her accident, the two upper front teeth required replacement with implant supported crowns, the adjacent tooth on either side as well as one lower front tooth required a veneer to restore the chipped areas. Mrs. P.W. now feels that she has her nice smile back.

Case Study

Mrs. J.G. had a bridge that was supported in the back by her lower right wisdom tooth and this bridge replaced three missing teeth.  At the age of 55, she had to have this wisdom tooth removed, which left her with many missing teeth in the lower right area. Because of some unrelated medical concerns, she was not able to consider proceeding with any dental treatment for a few years but she had always been interested in looking into implant supported crowns. Finally, treatment was started and three implant supported crowns were completed in this area restoring her ability to chew on this side of her mouth.

Case Studies

Extensive Combination Tooth Replacement and Repair

Case Study

Mrs. K.G. had heard of us through her office, which works with many dentists. She came to us when she was 55 years old. She had caps put on most of her teeth about 25 years ago. Her dental work was certainly quite deteriorated at this point, but in addition, unfortunately a number of her back teeth had a lot of decay and could not be saved. She had not had any dental cleanings done for a few years but now she wanted to fix her teeth. An examination revealed how many of her teeth could be saved and led to a discussion on the alternatives of replacing the missing teeth. We determined that bridges could be used to replace the missing upper back teeth and crowns would restore the upper and lower front teeth. Because all of the lower back teeth were missing, bridges in this area was not possible. A removable partial denture would not have been as strong, long lasting or felt like real teeth so it was decided to have 7 implant supported crowns to replace the missing lower back teeth. Mrs. K.G. is now on a regular cleaning program and is very happy with her restored smile and teeth that feel and work naturally.

Case Study

Mr. R.B. was referred to us by his general dentist when he was 53 years old. He said he wanted to fix his really worn down teeth because they no longer were as visible when he smiled. He had been told by his dentist that he had been wearing down his teeth with his teeth grinding habit. He had been told about a night-guard, but had never worn one. The ‘final straw’ was that he fractured a lower front tooth recently and he couldn’t ignore his tooth problems anymore. Following examination, it was agreed that the lower front four teeth as a group were not strong enough to keep and it would be stronger and likely last much better to remove them and replace them with four crowns supported by two dental implants. All of the other teeth were rebuilt with crowns once some gum work was completed on the lower teeth. A night-guard was recommended and made for use every night during sleep to minimize the risk of fracture and wear.

Case Study

Mr. B.G. was 57 years old when he decided that he would have to have his teeth fixed as they had been patched many times and were in a state of considerable disrepair and also looked that way. He experienced bleeding gums, food catching between his teeth, mouth odor, marked tooth wear and had many missing back teeth without good replacement. Unfortunately, his jaw bones had also shrunken considerably so that there was not enough bone to hold dental implants. Some options were discussed and he decided that he would prefer to keep as many teeth as possible, rebuilding the missing and damaged upper front teeth with a large bridge. The lower front teeth would be repaired simply with tooth colored fillings and the other lower teeth repaired with crowns. All the missing back teeth in both the upper and lower jaws would be replaced with removable partial dentures held in place with snap attachments to avoid the unattractive display of clasps. Several root canal treatments were required as well as foundation fillings and the removal of an extremely decayed tooth. A night-guard was also made to protect the dental work and supporting teeth from wear and fracture for use every night during sleep. Mr. B.G. can eat foods without much concern as the partial dentures stay in place quite well due to their design and the use of the snap attachments which also make the teeth look quite natural.

Case Study

Mr. W.F. was referred by his general dentist when he was 45 years old as he had been in a severe hang gliding accident, losing many front teeth, damaging the jaw bone and a lot of his other teeth and dental work. Mr. W.F. wanted to spread out the costs of his treatment and he was also very nervous about dental implants so he proceeded with his treatment in stages, starting first with the teeth in the lower jaw. The back teeth that remained required new extensive bridges and the missing front teeth he wanted to replace initially with a removable partial denture, to delay implant treatment. The removable partial denture was of a specific design that required no clasps in the front because of the special design of the bridges that restored and replaced all the other lower back teeth. Once the lower teeth were completed, attention was turned to the upper teeth as Mr. W.F. then felt more comfortable considering the implants and required associated treatment. Only two crowns were required on damaged teeth. Before the implants could be placed, the remaining deficient bone had to be rebuilt. Then the missing 6 teeth were replaced with 5 dental implants supporting a complicated structure that not only replaced the 6 teeth but also a large area where the bone and gum had been damaged in his accident and could not be fully repaired. The implant crowns were designed to be fixed and not removable. Mr. W.F. is convinced he will proceed with implant crowns eventually to replace the missing teeth in the lower front but the partial denture we made is working so well he is happy to just enjoy things the way they are for now.

Case Study

Mrs. L.J. was 41 years old when she was referred to us by her dentist. She wanted to restore her chewing ability because her jaws got tired easily when she ate and also wanted to eliminate the gaps between her teeth. She told us that she was not keen on having dentures and she had stopped wearing her previous partial dentures that had been made 20 years ago because they made her teeth ache. She did not like the color match of a bridge that had been placed on some of her upper teeth 5-10 years ago and some of her teeth were sensitive to hot and cold. Following examination, we outlined the possible alternatives to improving the damaged and replacing the missing teeth. There was not enough bone without augmentation procedures for implant supported crowns to replace the missing back teeth. Enough upper teeth remained to build cantilever bridges that rely on supporting teeth in the front and extend back a short distance to replace some of the missing back teeth. This created a situation where a removable partial denture was not necessarily required in the upper jaw. Because even fewer teeth remained in the lower jaw, cantilever bridges were not recommended and specially designed crowns were fabricated on some teeth with snap attachments allowing the use of a snap attachment retained lower partial denture.

The teeth in the very front of the lower jaw were simply reshaped and polished to create a more even bite and straighter looking teeth. Mrs. L.J. was pleased with her new teeth and the attachment partial lower denture has worked out to her satisfaction.

Case Study

Ms. M.A. was only 17 year old when she first sought out our office. She had been born with a type of inherited genetic condition that resulted in many missing adult teeth and some other traits. She had previously received some initial care elsewhere and was aware that a great deal of treatment was going to be required, but wanted to avoid having orthodontic braces and it was paramount that her appearance was satisfactory at all times. Following examination, some recommendations were made that included crowns and bridges in some areas of her mouth to create normal sized teeth and implant supported crowns in the other areas where she was missing the most teeth. All of the baby teeth had to be removed so in all, 10 adult teeth remained and 10 implants were placed with 6 in the upper jaw and 4 in the lower front with a total of 24 replacement teeth consisting of crowns, bridges and implant supported crowns. It took a little time to explain what was being done and reassure Ms. N.B. that at each step of the way she would have some form of temporary teeth allowing her to work, go to school and socialize with her friends. In all, a large amount of co-ordination was required as she lived a thousand kilometers from the office. Ms. M.A.’s smile made the effort worthwhile for all concerned but we will especially remember the looks of appreciation from her family.