Would there be a reason why my dentist would have not wanted to opt for a graft from onset?

Q. I had a post under the dental implants section of the forum entitled “too late for an implant?” I was wondering if you could advise on the following…. Since my last post I had my implant fitted in August of last year. I also had my natural teeth whitened. Last week I had my temporary crowns removed and replaced with my permanent crowns. I am due to go back for a check up on them next week. Whilst the final results are better looking aesthetically than my previous bridge on the NHS, I have since noticed that my permanent front crowns appear to protrude more than the natural surrounding teeth. They also appear slightly bigger. I suspect that this was a necessary evil in order to compensate for the gum recession I’ve experienced and an attempt to give the illusion of symmetry all round. Before I had the implant fitted, I enquired as to whether I would require any kind of gum/bone grafting as I could not understand how it would ever look the same again without this. I was advised that this would not be necessary and that he could achieve a good result without this so I went along with his recommendation. Now that I see the final result, I feel a little disapointed. Is it worth bringing this up when I go back next week for my check up? Would there be a reason why they would have not wanted to opt for a graft from the onset? Does this mean I can’t get one now in the future? I look forward to any advice you have.

A. In most situations once the implants are in place you have to work with the position that they are. Bone grafts would not alter the appearance. The graft does add another stage that is one more stage for variation to occur. They dont always work, but in the case of a block bone graft, when they dont the main downside is the extra discomfort of the procedure and the site specific risks of surgery.
It is worth bringing up because it will give your dentist the chance to respond.
Rob

Dr Rob Tennet St Johns Dental Practice 18 Bennett’s Hill, Birmingham, B2 5QJ Web: www.e-dentalpractice.co.uk

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