Dental implant hex distorted - now what?

Implant

Implant

Hello. I have a BIG problem and I don't know what to do. As you can see from the picture, the hex of my dental implant is distorted. The implant was placed in 2006 and it only recently became a problem.

My crown became loose in 2010.
My periodontist who placed my implant tried to take the crown off and eventually succeeded in doing so. He made a custom abutment and a new crown, but two days after he placed the new abutment and crown, it became loose again. After this, I went to five consults with 5 diff periodontists/prosthodontists.

The consensus thus far is that there's an issue with the hex of the implant. Popular belief is that my periodontist ruined the hex when he tried to take my crown off/put the new abutment-crown on. The 5 periodontists/prosthodontists I've seen so far have tested the implant and confirmed that it is completely integrated with my bone. All of them have said that the implant should not be taken out.

So far the periodontists/prosthodontists (the top in NYC) have given me different options to "resolve" my situation, but all seem very hesitant on how to proceed. One suggested to customize a custom abutment, but did not sound confident in a positive result. He says that if that is unsuccessful, then the periodontist would step in and strip out the threads inside the implant, and proceed as if they were putting a crown on a root canal tooth (not sure what that means). This also sounds strange to me and a bit risky.

The other prosthodontist said that he could try to shave the hex to replicate what a normal hex looks like. Another suggested that he could drill holes into the hex and hook an abutment onto it. I don't understand any of these solutions and ALL of these dentists seem very hesitant about their suggestions. There is no guarantee that any of this will work. Additionally, I am not rich and I cannot spend an exorbitant amount of money on this one tooth. Here is the make of my implant if it helps:

Nobel
Branemark
MK III Groovy RP
4 x 11.5 mm
Procera Esthetic Abutment
Branemark System

I would appreciate ANY help or suggestions. I don't know which of their suggestions has a higher likelihood of reaping a positive outcome, or if any of these suggestions are legitimate, or if there are better solutions out there that none of them have suggested, etc ... Thank you!

Comments for Dental implant hex distorted - now what?

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Implant design issue
by: Dr. Rich Guerra

The fact that the implant is an EXTERNAL hex implant is the inherent problem. These issues are very rare for an internal hex implant. If this was placed recently I am willing to bet they had an inventory of external hex implants they are trying to finish up. The newer manufacturers do not even produce external hex implants and I see no need to every buy one or attempt to use one.

damaged hex NEW
by: Rui

Dear implant crown user,
I find it strange that none of the 5 professionals you contacted tried to sove your problem.
The simple solution is to make a post crown. Dentist will make an impression of the implant as it is in the mouth, lab makes a custom abutment to be tried in mouth and then make a crown to be cemented in the implant.
If he likes he can use the direct method, by making a duralay post direct in mouth and send to lab to cast.
alternative is to aapt a castable abutment to the deformed hex or use a rotational abutment without hex, and count on interproximal contact points to avoid rotation, this way crown can be open design.

A further sugestion is to visit a clinc with intra oral scanner, this way they can send file to a model production lab and cad cam a new abutment.

if you have no solution, ask any clinician to take an impression and send it to me, I will try my best to find a solution.

Best regards
Rui.

Thanks NEW
by: jarvis

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