How to Make an Implant Crown when the Neighboring Tooth is not Straight?
Mr. Liu has lost the tooth #29 for a while. The tooth #30 has shifted mesially (Fig.1 arrow). An implant is placed distal to it (Fig.2). Orthodontics has started to upright the tooth #30, but he does not want to finish the treatment.
A crown fabricated at the site of #31 should have its normal anatomy (yellow outline in Fig.3; red: abutment; white: implant). The mesiodistal width should not be wide. Do not establish proximal contact with the tooth #30. Make a normal vertical contact with the opposing tooth, #2. Also the buccolingual occlusal table should be approximately 80% of normal dimension.
When the tooth #30 fails in the future, two more implants will be placed at the site of #29 and 30 after limited ortho moves the tooth #28 mesially (Fig.4 arrow).
Xin Wei, DDS, PhD, MS 1st edition 12/25/2013, last revision 12/25/2013